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Company Name:
Cigna
Approximate Salary:
Not Specified
Location:
Wilmington, Delaware
Country:
United States
Industry:
Healthcare
Position type:
Full Time
Experience level:
3-5 Years
Education level:
Master's Degree

CGHB Provider Contracting Senior Specialist

 

Description
This role will be responsible for implementing programs and processes supporting Cigna Global Health Benefits’ provider contracting, provider relations, provider vetting goals, and provider data and network information needs for the Americas region. This person in this position will work with directly contracted providers and a key assistance vendor, and may engage with a CIGNALinks Alliance partner in order to deliver best in class service to CGHB’s providers, customers and clients.

Key Responsibilities

  • Leads the contracting and relationship management function for our primary assistance vendor supporting North America and Europe corporate CGHB. Identifies areas of opportunity for improvement and holds the assistance vendor accountable to contracted obligations.
  • Promotes process improvement initiatives by identifying and successfully positioning service improvement opportunities and strategies within the Global Network Management department, other CGHB departments and Alliance partner organizations.
  • Supports department Vendor Management staff in the ongoing evolution of CIGNALinks alliance partner’s systems, infrastructure, and business processes to assure there is a sustainable and consistent operating model which is aligned with the CGHB strategic business vision. 
  • Partners closely with Sales and Client Management, Underwriting, Medical Management, Medical Economics, and Service Operations to implement market strategies designed to support medical cost improvement, product enhancements, improvement in Provider, Alliance Vendor, and Member satisfaction results, and profitable growth in the region.
  • Supports Sales and Client Management by representing Cigna Global Health Benefits in Client and Broker meetings.
  • Supports growth and persistency through strategic collaboration with Sales and Client Management to achieve Regional sales goals and to meet unique client requests.
  • Ensures that provider contracts and other data are loaded in systems timely and accurately in support of administrative and accuracy objectives.
  • Demonstrates strong project and program management expertise in driving complex, cross-functional initiatives which involve a wide range of business areas and systems.


Key Challenges / Anticipated Changes in Environment

  • Ability to work in both a structured and an unstructured environment.
  • Work closely with the other department members, matrix partners and various CGHB departments
  • Effectively communicates and interacts with other business units to achieve goals; e.g. clinical operations, CGHB service operations (all regions), Sales and Client Management (all regions).

 

Qualifications:

  • MBA or Master’s Degree in Healthcare Administration or a health-related advanced degree beyond a Bachelors is preferred
  • Strong analytical skills, attention to detail, accuracy, and organizational skills are essential
  • At least 4 years of experience in business management of a related field such as provider contracting, provider relations, and/or vendor management. 
  • Excellent written, verbal and presentation skills. 
  • Proficiency with MS Office programs including: Word, PowerPoint, Excel, Project, and Visio required.

Experience/Knowledge Requirements:

  • Knowledge of high priority healthcare providers, third party administrators, CGHB competitor capabilities, and healthcare systems within various countries and major markets throughout the region.
  • Excellent interpersonal, communication and motivational skills, including negotiation and presentation skills
  • Strong influencing skills and ability to work in a complex, highly matrixed, environment, including balancing priorities of multiple organizations to deliver end results.
  • Strong people management and development skills
  • Effective problem resolution skills
  • Personal Competencies Required
  • Ability to organize and manage complex initiatives
  • Strong conflict resolution and people management skills
  • Excellent interpersonal, verbal, and written communication skills
  • Mature, with the ability to effectively communicate and influence individuals at all levels
  • Comfortable working in a fast paced environment with shifting priorities
  • Energetic and enthusiastic
  • A team player


US Candidates Only: Qualified applicants will be considered for employment without regard to race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status. If you require a special accommodation, please visit our Careers website or contact us at [email protected]

Primary Location: United States-Delaware-Wilmington
Work Locations: DE 300 Bellevue PK Suite 101 300 Bellevue Parkway, Ste 101 Wilmington 19809
Job: Provider--Provider Contracting
Work at home opportunity (External):No
Schedule: Full-time
Shift: Day Job
Employee Status: Regular
Job Type: Standard
Job Level: Individual Contributor
Travel: Yes, 25 % of the Time