Provider Relations Manager - Cigna Healthcare - Remote - CA

Cigna Health and Life Insurance Company; California (MO); Hybrid; USD 67,000 - 111,000; Full time

Benefits offered by this job

Bonus plan eligibility

Comprehensive benefits

401(k)

Life insurance

Tuition reimbursement

Paid time off

Paid holidays

Leaves of absence

Job summary

The Cigna Group is seeking a Provider Relations Manager (Provider Relations Lead Analyst) in California to lead external provider relations for a mid-to-low complex book of business. You will own the end-to-end provider experience, work with matrix partners, and drive service improvements and strategic planning with providers.

In this external-facing role, you will develop action plans, analyze market data, educate providers on Cigna programs, and collaborate with internal teams to resolve

Qualifications

• Bachelor's degree or higher strongly preferred or equivalent work experience.
• 5+ years of provider relations experience preferred.
• Successful account management experience preferred.
• Claims administration experience preferred.
• Strong experience with Microsoft Office (Outlook, Teams, Excel, PowerPoint, Word).
• Experience with Proclaim or Facets preferred.
• Excellent oral, written, interpersonal, analytical, and negotiation skills.
• Understanding of medical insurance products and provider issues.
• Ability to assist an account management team through issue resolution.
• Ability to work in a matrix environment.
• Up to 10% travel required.
• If working from home, reliable internet speeds required.

Responsibilities

• End-to-end provider experience and service delivery for assigned Book of Business.
• Lead and support local market direction to improve provider experience.
• Create and maintain provider strategic action plans.
• Identify opportunities and risks for providers and drive resolution.
• Capture and share market intelligence to drive improvements.
• External facing with providers in assigned BOB.
• Distribute provider informatics, reports and dashboards.
• Track performance guarantees for assigned BOB.
• Promote Provider Index score improvement through service.
• Review provider reports with individual providers.
• Educate providers on Cigna's objectives, SOPs and programs.
• Apply service culture principles and act as provider advocate.
• Serve as SME to matrix partners.
• Develop presentations for existing/prospective providers or clients.
• Represent Cigna to medical societies and external provider associations.
• Manage joint operating committees: agenda, participation, follow-up.

Skills

Account management

Provider relations

Negotiation

Analytical thinking

Interpersonal skills

Communication

Problem solving

Education

Bachelor's degree

Equivalent work experience

Tools

Outlook

Teams

Excel

PowerPoint

Word

Proclaim

Facets

Job description

Due to the Book of Business, we are looking to hire from the California area.

SUMMARY

The Provider Relations Manager (Provider Relations Lead Analyst) position is an external provider facing role with account management responsibilities for a medium to low complex book of business. The role is accountable for the overall provider experience by working in collaboration with matrix partners to drive on-going service improvements, understand, articulate and resolve service impacts, and drive the overall provider strategic planning solutions. This individual is empowered within their scope to make decisions as it pertains to the experience with Cigna, is required to have local market knowledge and visibility, builds and continuously improve the relationship between Cigna and the provider.

DUTIES AND RESPONSIBILITIES

• Accountable for the end-to-end provider experience and overall service delivery for assigned Book of Business aligned to medium to low complex providers
• Leads, collaborates, and supports local market direction as it relates to improving the provider experience
• Creates and maintains individual provider strategic action plans
• Proactively identifies new opportunities and risks for providers at market or national level and drives resolution
• Exercises good judgment and discretion to support the provider experience
• Responsible for capturing, documenting, and sharing market intelligence; use market intelligence to develop and drive strategic improvements
• External facing with providers in assigned BOB
• Collect, analyze, interpret, translate and distribute provider informatics, reports, dashboards
• Track and monitor performance guarantees for assigned BOB
• Promotes Provider Index score improvement through proactive and effective service and support of network
• Review provider reports/dashboard with individual providers
• Proactively educates providers on Cigna's business objectives, standard operating procedures, policies and programs to influence behavior and how to work with Cigna
• Understands and applies service culture principles and methodology
• Serves as a provider advocate both internally and externally
• Serves in a consultative role or subject matter expert to key matrix partners
• Develops and participates in presentations to existing and prospective providers and/or clients
• Serves as advocate in external community, representing Cigna to medical societies and external provider associations.
• Manage joint operating committees, including agenda development, facilitating appropriate meeting participation and follow up activities

QUALIFICATIONS

Bachelor's degree or higher strongly preferred or equivalent work experience. 5+ years of experience in provider relations preferred. Successful account management experience preferred. Claims administration experience preferred. Solid experience using Outlook, Teams, Excel, PowerPoint, Word, etc. Experience with Proclaim or Facets preferred. Demonstrated excellent oral, written, interpersonal, analytical, and negotiation skills. Understanding of medical insurance products and associated provider issues. Ability to assist an account management team through issue resolution. Ability to work in a matrix environment. Up to 10% travel required. 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.

EMPLOYMENT AND BENEFITS

For this position, we anticipate offering an annual salary of 66,600 - 111,000 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.

ABOUT THE CIGNA GROUP

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.

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.

TOBACCO POLICY

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.