Job Description

Provider Contracting Team Member

This position serves as an integral member of the Provider Contracting Team and reports to the AVP of Contracting. This role assists in developing the strategic direction and managing day-to-day contracting and network management activities for a specific territory within New Jersey.

Duties And Responsibilities

• Manages complex contracting and negotiations for fee-for-service and value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups).
• Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
• Initiates and maintains effective channels of communication with matrix partners.
• Manages strategic positioning for provider contracting, develops networks, and identifies opportunities for greater value-orientation and risk arrangements.
• Contributes to the development of alternative network initiatives.
• Works to meet unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position.
• Creates and manages initiatives that improve total medical cost and quality.
• Drives change with external provider partners by assessing clinical informatics and offering consultative expertise.
• Prepares, analyzes, reviews, and projects the financial impact of larger or complex provider contracts.
• Creates "HCP" agreements.
• Assists in resolving elevated and complex provider service complaints.
• Manages key provider relationships.
• Demonstrates knowledge of providers in an assigned geographic area.
• Responsible for accurate and timely contract loading.
• May provide guidance or expertise to less experienced specialists.

Position Requirements

• Should possess a bachelor's degree; preferably in the areas of Finance, Economics, Healthcare, or Business-related. Significant industry experience will be considered in lieu of a Bachelor's degree. MBA or MHA preferred.
• 3+ years of contracting and negotiating experience involving complex delivery systems and organizations required.
• Experience in developing and managing key provider relationships.
• Knowledge of complex reimbursement methodologies, including incentive-based models, strongly preferred.
• Demonstrated experience in seeking out, building, and nurturing strong external relationships with provider partners.
• Intimate understanding and experience with hospital, managed care, and provider business models.
• Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization.
• The ability to influence both sales and provider audiences through strong written and verbal communication skills.
• Customer-centric and interpersonal skills are required.
• Demonstrates managerial courage as well as an ability to maneuver effectively in a changing environment.
• Superior problem-solving, decision-making, negotiating skills, contract language, and financial acumen.
• Knowledge and use of Microsoft Office tools.

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.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That's why 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) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.

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. 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.

If you require reasonable accommodation in completing the online application process, please email SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

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.

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