Senior Analyst – Cigna Remote Jobs

Job Type: Senior Analyst from home
Location: Georgia work from home
Company: Cigna

POSITION: A remote location oriented toward the Southeast USA market. These states are included in the region: Mississippi, TN, KY, AR, FL, GA, AL, NC, and SC.

The Network Operations Senior Analyst, who works under the direction of the Regional Network Access Lead, is a crucial component of the Network Development and Competitive Insights Team within Network Operations and Provider Contracting.

This position directs regional product-specific projects and/or parts of bigger, more comprehensive national projects for a specific region. manages the hospital/large group and/or significant provider termination management process for Commercial, IFP, and Medicare Advantage programs in the designated markets. To satisfy termination process management criteria and state laws, closely collaborates with Contracting, Network Solutions, Network Operations, Provider Services, Sales, and Compliance. the management of client- and/or product-specific recruitment initiatives, the gathering of comparable industry and network benchmarking data, and the support of commercial, IFP, and Medicare products. To meet the complicated business needs for projects, this person participates in the evaluation of system requirements, the development of procedures, processes, and policy solutions, and may even lead one or more teams of business matrix partners. Determine project requirements, outline project objectives, ensure state contracting and compliance guidelines are followed, direct business matrix partners to meet project deadlines, and produce timely, accurate reporting on project status for senior management are all responsibilities of the role for assigned projects.

Responsibilities:

• Lead as Project Manager for Middle Market, Local Sales, and National Account Recruiting Requests; if necessary, coordinate recruitment efforts with the market Contracting/Provider Services teams, Sales, Medical Recruitment Team, and national vendor specialized teams.
• Examine databases to determine the hiring universe; Check potential hires against Cigna systems to see if they have a current or former par status, have permitted specialist recruitment in particular regions, and to confirm whether the provider is presently recruiting as part of another initiative. To review and approve the final recruitment universe, the appropriate price schedule/contract document, and to identify market contacts to be matched with the project, meet with the market Contracting/Provider Services teams.
• Support regional provider network access build initiative projects with analysis and reporting.
• Maintain provider records for the duration of the project and upload project data to the recruiting tracking tool. Handle the reporting and distribution of projects to senior management and matrix partners.
• Manage the review of providers identified as non-participating through the Regional Support Unit provider review process to assist pre-sale efforts and current customer non-par enquiries in collaboration with Contracting and Sales/Service organizations.
• Do primary regional market research on the status of competitor provider networks’ participation, the development of competitor products, governmental changes, and other market changes as necessary.
• Big and/or Important Provider and Lead Hospital Stop holding weekly meetings of the workgroup. Handle and organize the region’s data reporting requirements for all segments, including Commercial, IFP, and Medicare pending terminations.
• To address segment-specific initiatives or improved termination techniques to support high-profile/difficult talks, lead separate and/or extra termination management meetings as necessary.
• Control the production and distribution of the workgroup’s weekly remarks on term management. Generate network change alerts and submit them for publication on Cigna’s internal Knowledge Xchange tool to notify outside parties of active potential hospitals/large groups or substantial terminations. Send out a coordinated communication regarding sales effectiveness to all owners of sales opportunities with impacted clients. For impacted clients who have given permission to obtain PHI, manage any sales requests for client-specific data.
• In order to support all role operations, including termination management, recruitment initiatives, and competitive analysis, strive to become the subject matter expert (SME) for all assigned states and segments in your Region.
• Oversee or coordinate continuing targeted hiring and business development initiatives for all segments in the designated markets.
• Collaborate cooperatively with regional, interregional, and national resources to ensure that projects are managed, tracked, and reported consistently.
• Special assignments as needed.

Requirements:

• College degree or similar work experience is desired.
• Required: 3+ years of experience working in the healthcare sector
• Good project management background is necessary.
• To enable the ability to evaluate massive datasets, strong Microsoft Excel skills are necessary.
• A plus are strong Access skills.
• Knowledge of health insurance goods
• Strong capacities for critical thought
• Superior analytical, interpersonal, and written/oral communication skills
• Within a fast-paced matrix company, a team player with the capacity to operate both independently and collaboratively must forge solid working relationships.
• Detail-oriented and capable of prioritizing work
• Possessing the ability to use PC programs like Outlook, WebEx, One Note, and Power Point

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 plan to give a pay range of 57,500 to 95,900 USD per year for this role, based on pertinent 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.