Experienced Medicare Provider Network Contractor - Remote Opportunity with Cigna Healthcare

Join Cigna Healthcare as a Medicare Provider Network Contractor and Drive Growth in Healthcare Cigna Healthcare, a division of The Cigna Group, is a leading advocate for better health through every stage of life. We're committed to guiding our customers through the healthcare system, empowering them with the information and insight they need to make informed decisions about their health and vitality. As a Medicare Provider Network Contractor with Cigna Healthcare, you'll play a vital role in developing strategic direction and managing day-to-day contracting and network management activities for a local territory. About the Role The Medicare Provider Network Contractor serves as an integral member of the Provider Contracting Team, reporting to the Provider Contracting Senior Manager. This remote opportunity allows you to work from home while making a meaningful impact on the healthcare industry. As a key member of the team, you'll be responsible for managing complex contracting and negotiations, building relationships with providers, and driving value-based business opportunities. Key Responsibilities Manage complex contracting and negotiations for fee-for-service and value-based reimbursements with hospitals and other providers, including hospital systems, ancillaries, and large physician groups. Build and nurture provider partnerships, seeking broader value-based business opportunities to support the local market strategy. Initiate and maintain effective channels of communication with matrix partners, including Claims Operations, Medical Management, Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing, and Service. Develop strategic positioning for provider contracting, identifying opportunities for greater value-orientation and risk arrangements. Contribute to the development of alternative network initiatives and provide direction to develop network analytics required for the network solution. Work to meet unit cost targets while preserving an adequate network to achieve and maintain Cigna's competitive position. Create and manage initiatives that improve total medical cost and quality, driving change with external provider partners through clinical informatics and consultative expertise. Prepare, analyze, review, and project the financial impact of larger or complex provider contracts and alternate contract terms. Create 'HCP' agreements that meet internal operational standards and external provider expectations, ensuring accurate implementation and administration through matrix partners. Assist in resolving elevated and complex provider service complaints, researching problems and negotiating with internal/external partners/customers to resolve highly complex and/or escalated issues. Manage key provider relationships, demonstrating knowledge of providers in an assigned geographic area through understanding the interrelationships and competitive landscape. Ensure accurate and timely contract loading and submissions, interfacing with matrix partners for network implementation and maintenance. Provide guidance or expertise to less experienced specialists as needed. Essential Qualifications To succeed in this role, you'll need: A Bachelor's Degree in Finance, Economics, Healthcare, or Business-related fields (significant industry experience may be considered in lieu of a Bachelor's degree). 3+ years of experience in Healthcare Provider Contracting and Negotiating, involving complex delivery systems and organizations. Experience in developing and managing key provider relationships. Knowledge of complex reimbursement methodologies, including incentive-based models. Proven ability to build and nurture strong external relationships with provider partners. Intimate understanding and experience with hospital, managed care, and provider business models. Strong written and verbal communication skills, with experience in formal presentations. Customer-centric and interpersonal skills, with the ability to influence both sales and provider audiences. Managerial courage and the ability to maneuver effectively in a changing environment. Superior problem-solving, decision-making, negotiating skills, contract language, and financial acumen. Proficiency with Microsoft Office (Word, Excel, PowerPoint, Outlook). Preferred Qualifications While not required, the following qualifications can enhance your candidacy: MBA or MHA degree. Experience working in a matrix organization. Knowledge of Medicare and Medicaid programs. What We Offer As a Medicare Provider Network Contractor with Cigna Healthcare, you'll enjoy: A competitive annual salary of $87,000 - $145,000, depending on relevant factors, including experience and geographic location. Eligibility to participate in an annual bonus plan. A comprehensive range of benefits, including medical, vision, dental, and well-being and behavioral health programs, starting on day one of employment. 401(k) with company match, company-paid life insurance, tuition reimbursement, and a minimum of 18 days of paid time off per year, plus paid holidays. Work Environment and Company Culture As a remote worker, you'll enjoy the flexibility and autonomy to work from home while staying connected with the Cigna Healthcare team. Our company culture values diversity, equity, and inclusion, and we're committed to creating a work environment that's supportive, collaborative, and inclusive. Career Growth Opportunities At Cigna Healthcare, we're dedicated to helping our employees grow and develop in their careers. As a Medicare Provider Network Contractor, you'll have opportunities to: Develop your skills and expertise in healthcare provider contracting and negotiations. Take on new challenges and responsibilities, driving value-based business opportunities and improving total medical cost and quality. Collaborate with cross-functional teams to drive business outcomes and improve customer satisfaction. Why Join Cigna Healthcare? By joining Cigna Healthcare as a Medicare Provider Network Contractor, you'll become part of a team that's dedicated to making a positive impact on the healthcare industry. You'll have the opportunity to drive growth, improve lives, and contribute to our mission of advocating for better health through every stage of life. If you're a motivated and experienced professional looking for a challenging and rewarding role, we encourage you to apply for this exciting opportunity. As an equal opportunity employer, Cigna Healthcare is committed to diversity, equity, and inclusion, and welcomes applications from qualified candidates. Ready to take the next step in your career? Apply now to join our team as a Medicare Provider Network Contractor! Apply for this job