Strategic Provider Relations Lead

The Cigna Group

United States

Remote

USD 67,000 - 111,000

Full time

8 days ago

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Benefits offered by this job

Health benefits

401(k) plan

Tuition reimbursement

Paid time off

Paid holidays

Job summary

The Cigna Group is seeking a Provider Relations Manager (Provider Relations Lead Analyst) in California to manage a medium to low complex book of business and own the provider experience. This external-facing role collaborates with matrix partners to drive service improvements.

You will develop strategic action plans, track performance, educate providers on Cigna objectives, and advocate for the network. Local market knowledge and strong communication are required; travel up to 10% may be

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.

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