Manager – Cigna Remote Jobs

Job Type: Manager from home
Location: Massachusetts work from home
Company: Cigna

Location: Newton, Massachusetts-based remote role serving the New England market. must be a resident of southern New Hampshire, Massachusetts, or Rhode Island.

The Senior Manager of Provider Contracting is the manager of Network Management, who also contributes significantly to the Provider Contracting Team. This position supports the creation of a local given territory’s strategic direction and management of day-to-day contracting and network management activities.

Responsibilities:

• Manages intricate contracting and negotiations with hospitals and other providers for fee-for-service and value-based payments (e.g., Hospital systems, Ancillaries, and large physician groups).
• To complement the local market strategy, one develops connections that foster provider alliances and looks for larger value-based commercial prospects.
• Establishes and maintains efficient channels of communication with matrix partners, including as but not limited to, Medical Management and Claims Operations. Legal, medical economics, compliance, sales and marketing, and service are all related to credentials.
• Manages provider contracting’s strategic positioning, builds networks, and spots chances for increased value- and risk-oriented arrangements.
• Aids in the creation of projects for alternate networks. helps to generate the network analytics needed for the network solution and provide guidance in doing so.
• Works to achieve and keep Cigna’s competitive position by meeting unit cost targets while maintaining an adequate network.
• Develops and oversees projects that enhance the overall cost and standard of care.
• By evaluating clinical informatics and providing consultative knowledge to support total medical cost objectives, drives change with external provider partners.
• Creates, assesses, analyzes, and estimates the financial impact of more complicated or extensive provider contracts, as well as alternative contract terms.
• Creates “HCP” agreements that satisfy the requirements of both external providers and internal operating standards. through matrix partners, ensures accurate deployment and administration.
• Helps to resolve difficult and serious provider service issues. investigates concerns and bargains with internal/external partners/customers to settle complicated or escalating difficulties.
• Oversees important interactions with providers and business workers while managing crucial provider relationships.
• Understands the relationships between providers in a certain geographic area and the landscape of competition to demonstrate knowledge of providers in that area.
• Accountable for the precise and prompt loading and submission of contracts, as well as for liaising with matrix partners for the setup and upkeep of the network.
• May offer advice or knowledge to specialists with less experience.

Requirements:

• Should hold a bachelor’s degree, particularly in business, finance, economics, or a related field of medicine. A Bachelor’s degree will be substituted with significant industry experience. Preferably, an MBA or MHA.
• Experience with complicated delivery systems and organizations and 3+ years of provider contracting and negotiation are necessary.
• A history of building and managing important provider relationships
• Strong preference given to candidates with experience in sophisticated reimbursement approaches, such as incentive-based models.
• Experience in seeking out, establishing, and maintaining fruitful connections with external supplier partners.
• Intimate knowledge of and expertise with provider, hospital, and managed care business models.
• Team player with a track record of building trusting relationships in a matrix company that moves quickly.
• The capacity to persuade providers and sales audiences through effective oral and writing communication. formal presenting expertise.
• Interpersonal and customer-focused skills are needed.
• Shows boldness in management and the capacity to adapt well to a changing environment.
• Superior ability to solve problems, make decisions, negotiate, understand contract language, and have financial acumen.
• A mastery of Microsoft Office (Word, Excel, PowerPoint, Outlook)
• Trips to network providers must be local at least 25% of the time.

Whether you intend to work from home on a regular basis or infrequently, you must have an internet connection from a cable broadband or fiber optic internet service provider with minimum download and upload speeds of 10 Mbps and 5 Mbps, respectively.

We anticipate paying between 84,400 and 140,600 USD per year for this role, depending on relevant aspects like experience and location.
Additionally, it is anticipated that this position will qualify for the yearly bonus program.

We want you to feel balanced, safe, and healthy. You will therefore benefit from a wide variety of advantages with an emphasis on promoting your overall health. You will be provided with a number of health benefits beginning on the first day of your job, including medical, vision, dental, well-being, and mental health programs. In addition, we provide a 401(k) with company match, life insurance paid for by the firm, tuition reimbursement, at least 18 days of paid vacation per year, and paid holidays.