AVP, Provider Contracting- Cleveland and North Ohio Markets - Hybrid - Cigna Healthcare

Cigna • Toledo, OH

162d • $127,900 - $213,100 • Hybrid

About The Position

This position serves as an integral member of the Provider Contracting Team and reports to the Vice President, Network Management, Liberty Valley. This role is a member of the Liberty Valley Network Management leadership team and is accountable for contracting and network management activities for multiple local geographies.

Requirements

• Bachelor's degree strongly preferred; preferably in the areas of Finance, Economics, Healthcare or Business related. Significant industry experience will be considered in lieu of a Bachelor degree. MBA or MHA preferred.
• 5+ years Provider Contracting and Negotiating experience involving complex delivery systems and organizations required.
• Prior experience managing or mentoring direct reports, developing talent, and leading project teams in a non-centralized work environment required.
• Experience in developing and managing key provider relationships including senior executives.
• Knowledge of complex reimbursement methodologies, including incentive models.
• Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners.
• Intimate understanding and experience with larger, more complex integrated delivery systems, managed care, and provider business models.
• Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization.
• The ability to influence both sales and provider audiences through strong written and verbal communication skills.
• Demonstrates managerial courage and change leadership in a dynamic environment.
• Superior problem solving, decision-making, negotiating skills, contract language and financial acumen.
• Knowledge and use of Microsoft Office tools.
• Able to travel as required.

Responsibilities

• Directly manages a contracting team and geography, providing leadership, mentoring, and development opportunities to their direct reports.
• Accountability for managing contracting and network management activity supporting Commercial contracting and other products/initiatives as applicable to market.
• Manages increasingly complex contracts and negotiations for fee for service and sophisticated value-based reimbursements with hospitals and other providers.
• Leads cross market and cross functional initiatives as needed.
• Proactively builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
• Initiates, nurtures, and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management, Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service.
• Manages strategic positioning for provider contracting, develops networks and identifies and acts upon opportunities for greater value-orientation and risk arrangements.
• Responsible for meeting unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position.
• Identify and manages initiatives that improve total medical cost and quality.
• Prepares, analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms.
• Manages key provider relationships and is accountable for interface with providers and business staff.
• Demonstrates comprehensive knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape.
• Responsible for accurate and timely contract loading and submissions and interface with matrix partners for network implementation and maintenance.

Benefits

• Comprehensive health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
• 401(k) with company match.
• Company paid life insurance.
• Tuition reimbursement.
• A minimum of 18 days of paid time off per year.
• Paid holidays.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees