Provider Contracting Director - Transplant (LifeSource) - Remote

Cigna Health and Life Insurance Company; Pennsylvania; Ibrido; USD 106.000 - 177.000; Tempo pieno

Vantaggi offerti da questo lavoro

Health benefits

401(k)

Tuition reimbursement

Paid time off

Descrizione del lavoro

Cigna Health and Life Insurance Company seeks a Provider Contracting Senior Advisor to lead complex negotiations with hospitals, transplant centers, physician groups, and advanced cellular therapy providers in the Northeast. You will manage a portfolio of 40–50 facilities, handling renewals, amendments, and provider escalations to strengthen network access and affordability.

Success depends on strategic negotiation, deep financial acumen, and the ability to collaborate with cross-functional

Competenze

• Bachelor’s degree or equivalent professional experience.
• Five years of commercial healthcare contracting and negotiation experience.
• Experience negotiating reimbursement, financial terms, and contractual language.
• Strong financial acumen with interpretation of reimbursement models and contract performance.
• Proven ability to develop relationships with senior provider executives and internal leaders.

Mansioni

• Lead complex contract negotiations with hospitals, transplant centers, and healthcare providers.
• Negotiate reimbursements, financial terms, and new provider agreements.
• Develop agreements using various reimbursement methodologies (fee-for-service, case rates, bundled payments).
• Manage performance of assigned provider agreements, including cost targets and affordability initiatives.
• Interpret contract language and ensure accurate implementation and administration of negotiated terms.

Conoscenze

Negotiation

Relationship management

Analytical skills

Independent portfolio management

Formazione

Bachelor’s degree or equivalent relevant professional experience

Strumenti

Excel

Word

PowerPoint

Descrizione del lavoro

The Provider Contracting Senior Advisor leads contracting and network management activities for the LifeSOURCE Transplant Network across the Northeast territory. This position manages complex negotiations with hospitals, health systems, physician groups, transplant facilities, and advanced cellular therapy providers. LifeSOURCE includes more than 180 contracted facilities and represents approximately $1 billion in annual medical spend across commercial and government business. The Senior Advisor will help maintain a high-quality, competitively positioned provider network while advancing affordability, access, growth, and operational performance. This is a backfill opportunity on a small, fast-paced team. The successful candidate will independently manage a portfolio of approximately 40 to 50 facilities while handling contract renewals, new agreements, amendments, letters of agreement, provider escalations, and competing business priorities. Transplant contracting is highly specialized and may include bundled arrangements that cover multiple stages of care for solid-organ transplants, stem-cell transplants, and cellular therapies.

Key Responsibilities

• Lead complex contract negotiations with hospitals, transplant centers, physician groups, and advanced cellular therapy providers across the Northeast.
• Negotiate reimbursement rates, financial terms, contract language, renewals, amendments, and new provider agreements.
• Develop agreements using reimbursement methodologies such as fee-for-service, case rates, bundled payments, DRGs, and value-based arrangements.
• Manage the financial and operational performance of assigned provider agreements, including unit-cost targets and affordability initiatives.
• Evaluate claims, medical, financial, and market data to identify contracting opportunities, assess financial impact, and support negotiation strategies.
• Maintain a strong understanding of the Northeast provider landscape, including competitive dynamics, network gaps, market relationships, and emerging industry trends.
• Identify and recruit providers that strengthen network access, adequacy, quality, and geographic coverage.
• Build productive relationships with provider executives and contracting leaders while addressing escalations, performance concerns, and potential contract terminations.
• Interpret contract language and coordinate accurate implementation and administration of negotiated terms.
• Partner with Medical Economics, Clinical, Product, Operations, local market teams, Legal, Compliance, and other stakeholders to develop and execute network strategies.
• Serve as the primary point of accountability for assigned provider relationships and regional contracting initiatives.
• Manage multiple negotiations and deliverables simultaneously while adapting to changing priorities in a complex, highly matrixed environment.
• Travel within the Northeast territory as needed for provider meetings and negotiations.

Minimum Qualifications

• Bachelor’s degree or equivalent relevant professional experience.
• At least five years of commercial healthcare contracting and negotiation experience involving hospitals, health systems, large physician groups, or other complex delivery organizations.
• Demonstrated experience negotiating reimbursement, financial terms, and contractual language with sophisticated provider organizations.
• Strong understanding of hospital, managed-care, and provider business models.
• Experience independently managing a substantial portfolio of active contracts and concurrent negotiations.
• Strong financial acumen with the ability to interpret reimbursement models, claims information, contract performance, and financial analyses.
• Proven ability to develop and maintain relationships with senior provider executives and internal business leaders.
• Excellent negotiation, problem-solving, decision-making, organization, and written and verbal communication skills.
• Ability to work independently, shift priorities quickly, and deliver results in a fast-paced matrix organization.
• Proficiency with Microsoft Excel, Word, PowerPoint, and related business tools.

Preferred Qualifications

• Transplant, stem-cell, or advanced cellular therapy contracting experience.
• Experience negotiating bundled or case-rate arrangements for complex episodes of care.
• Knowledge of commercial hospital contracting, network affordability, and provider incentive programs.
• Experience with contract modeling, redlining, network analytics, and strategic provider negotiations.
• Familiarity with internal healthcare payer operations and cross-functional contract implementation.
• Established knowledge of provider markets in the Northeast.

Success Profile

The strongest candidate will be a strategic, adaptable negotiator who can balance affordability with provider partnership and network access. This person will be comfortable operating with autonomy, managing a demanding regional portfolio, influencing stakeholders without direct authority, and translating complex financial and contractual information into practical business decisions.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an annual salary of 106,400 - 177,300 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan.

At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health.

• Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
• We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence.

For more details on our employee benefits programs.

About Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you need a reasonable accommodation to complete the online application process, please email [e-mail] for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.