Provider Contracting Senior Manager - Cigna Healthcare - Hybrid - West Tennessee Market

Assistant Vice President, Network Management / Provider Contracting Senior Manager

This person must be based out of the TN market.

The Assistant Vice President, Network Management / Provider Contracting Senior Manager serves as an integral member of Cigna's local market network management and provider contracting team, and reports to the Vice President of Network Management. This role is a key contributor to affordability, medical cost management, and strategy for the West Tennessee market.

Duties And Responsibilities

• Manages contracts and negotiations for fee for service and value-based collaborative programs with hospitals, physicians, and other providers.
• Potential to directly manage other contracting associates, providing leadership and mentoring.
• Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
• Responsible for Cigna's cost of care, affordability, network composition, and competitive position for commercial networks.
• Responsibility for network and business strategy for other customer segments such as Medicare and individual, should they apply to the market.
• Initiates, nurtures and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service.
• Responsible for meeting unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position.
• Lead collaborative, value-based relationships with local providers.
• Assists in resolving elevated and complex provider service complaints. Researches problems and negotiates with internal/external partners/customers to resolve highly complex and/or escalated issues.
• Manages key provider relationships and is accountable for critical interface with providers and business staff.
• Demonstrates comprehensive knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape.
• Responsible for accurate and timely contract loading and submissions and interface with matrix partners for network implementation and maintenance.

Position Requirements

• Should possess a bachelor degree. Significant industry experience will be considered in lieu of a Bachelor degree. MBA or MHA preferred.
• Minimum of 5 years contracting and negotiating experience involving complex delivery systems and organizations required.
• Prior experience in network governance highly preferred.
• Prior experience managing direct reports and leading project teams in a non-centralized work environment preferred.
• Experience in developing and managing key provider relationships including senior executives.
• Knowledge of complex reimbursement methodologies, including incentive based models required.
• Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners.
• Intimate understanding and experience with larger, more complex integrated delivery systems, 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. Experience with formal presentations.
• Customer centric and interpersonal skills are required.
• Demonstrates managerial courage and change leadership in a dynamic 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.

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. 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.

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.