Analyst – Cigna Remote Jobs

Job Type: Analyst from home
Location: Florida work from home
Company: Cigna

WORK LOCATION: This is a flex position that requires three days at home and two days in the office. Sunrise, Florida is the location of the office.

The Provider Contract Lead Analyst reports to the South Florida Contracting Director and is an integral member of the Provider Contracting Team. This role assists and supports contracting and network activities on a daily basis.

Responsibilities:

• Manages contracting and fee-for-service negotiations with physicians, ancillaries, and hospitals.
• Aids in the formation and management of value-based relationships.
• Builds and maintains relationships with providers in order to support the local market strategy.
• Establishes and maintains effective communication channels with matrix partners, including but not limited to Claims Operations and Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing, and Service are all areas of expertise.
• Supports strategic positioning for provider contracting, aids in network development, and aids in the identification of opportunities for greater value-orientation.
• Contributes to the creation of new network initiatives. Analytics are required for the network solution.
• Works to achieve and maintain Cigna’s competitive position by meeting unit cost targets while maintaining an adequate network.
• Supports initiatives that reduce total medical costs and improve quality.
• Change is driven with external provider partners by providing consultative expertise to assist with total medical cost initiatives.
• Preparing, analyzing, reviewing, and projecting the financial impact of provider contracts and alternative contract terms.
• Creates “HCP” agreements that meet internal operational standards as well as the expectations of external providers. Through matrix partners, ensures accurate implementation and administration.
• Aids in the resolution of provider service complaints. To resolve escalated issues, conducts research and negotiates with internal/external partners/customers.
• Manages provider relationships and is responsible for critical interactions with providers and business personnel.
• Understands the interrelationships and the competitive landscape to demonstrate knowledge of providers in an assigned geographic area.
• Responsible for contract loading and submissions that are accurate and timely, as well as interacting with matrix partners for network implementation and maintenance.

Requirements:

• A bachelor’s degree is required, preferably in finance, economics, healthcare, or business. In lieu of a Bachelor’s degree, significant industry experience will be considered.
• Prior Provider Servicing, Credentialing, Account Receivables, or Claims experience is required, as well as knowledge of how contracts are paid.
• Experience in contracting and negotiating is preferred.
• Relationship development and management experience
• A working knowledge of and experience with hospital, managed care, and provider business models is preferred.
• Team player who has demonstrated the ability to build strong working relationships in a fast-paced, matrix organization.
• The ability to persuade audiences through effective written and verbal communication. Formal presentation experience.
• Customer service and interpersonal skills are essential.
• Capable of maneuvering effectively in a changing environment.
• Problem-solving, decision-making, negotiating, contract language, and financial acumen are all required.
• Understanding and application of Microsoft Office tools

If you will be working from home on a regular or permanent basis, you must obtain an internet connection from a cable broadband or fiber optic internet service provider with at least 10Mbps download/5Mbps upload speeds.