Director, Network Management - Central & North FL Markets - Cigna Healthcare

Cigna Healthcare • Lebanon, VA

2d • Hybrid

About The Position

The Director, Network Management, is an Individual Contributor role that serves as an integral member of the Provider Contracting Team and reports to the Contracting Manager responsible for facility & ancillary contracting in Orlando, Jacksonville and surrounding areas of Central & North Florida. This role, which is a hybrid of work at home and in office in the Lake Mary, FL office, assists in developing the strategic direction and management of the day to day contracting and network management activities for areas in Central & North Florida. Duties and Position Responsibilities: Manages complex contracting and negotiations for fee for service and value-based reimbursements with hospitals and other providers (e.g., health systems, hospitals, ambulatory surgery centers, and other ancillaries). Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy. Initiates 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.

Requirements

• Bachelor degree required. Area of focus in Finance, Economics, Healthcare or Business related strongly preferred.
• Minimum 3 years contracting and negotiating experience involving complex delivery systems and organizations required.
• Experience in developing and managing key provider relationships
• Knowledge of complex reimbursement methodologies, including incentive based models strongly preferred.
• Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners.
• Intimate understanding and experience with hospital, 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.
• Experience with formal presentations.
• Customer centric and interpersonal skills are required.
• If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Nice To Haves

• MBA or MHA preferred.

Responsibilities

• Manages complex contracting and negotiations for fee for service and value-based reimbursements with hospitals and other providers (e.g., health systems, hospitals, ambulatory surgery centers, and other ancillaries).
• Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
• Initiates 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Director