Provider Contract Negotiator – Cigna Healthcare – Lake Mary or Tampa, FL

Cigna Healthcare•Lebanon, VA

About The Position

The Provider Contract Negotiator supports the Florida market and serves as an integral member of the Provider Contracting Team, reporting to the Contracting Manager. This role assists with and supports day-to-day contracting and network activities. Duties and Responsibilities Manages the submission process for contracting and fee-for-service negotiations with physicians and ancillary providers. Supports the development and management of value-based provider relationships. Builds and maintains relationships that strengthen provider partnerships in support of local market strategy. Initiates and maintains effective communication with matrix partners, including but not limited to Claims Operations, Medical Management, Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing, and Service. Supports strategic positioning for provider contracting, assists in network development, and helps identify opportunities for greater value orientation. Contributes to the development of alternative network initiatives and supports analytics required for network solutions. Works to meet unit cost targets while preserving an adequate network to achieve and maintain Cigna’s competitive position. Supports initiatives aimed at improving total medical cost and quality. Drives change with external provider partners by offering consultative expertise to support total medical cost initiatives. Prepares, analyzes, reviews, and projects the financial impact of provider contracts and alternative contract terms. Creates HCP agreements that meet internal operational standards and external provider expectations; ensures accurate implementation and administration through matrix partners. Assists in resolving provider service complaints by researching issues and negotiating with internal and external partners to resolve escalated concerns. Manages provider relationships and serves as a critical interface between providers and internal business partners. Demonstrates knowledge of providers within an assigned geographic area, including interrelationships and the competitive landscape. Ensures accurate and timely contract loading and submissions and partners with matrix teams for network implementation and maintenance. Performs other duties as assigned.

Requirements

Ideal candidate will currently reside in Lake Mary, Tampa, Miami-Dade, or Broward areas.
Bachelor’s degree strongly preferred in Finance, Economics, Healthcare, or a related business field; significant industry experience may be considered in lieu of a degree.
One (1) or more years of provider contracting and negotiation experience with healthcare providers or ancillary groups strongly preferred.
One (1) or more years of provider servicing or provider relations experience strongly preferred.
Proven experience developing and managing professional relationships.
Understanding of managed care and provider business models preferred.
Team-oriented with the ability to build strong working relationships in a fast-paced, matrixed environment.
Ability to influence diverse audiences through strong written and verbal communication skills; experience delivering formal presentations preferred.
Customer-centric mindset with strong interpersonal skills.
Demonstrated ability to adapt effectively in a changing environment.
Strong problem-solving, decision-making, negotiation, contract interpretation, and financial analysis skills.
Proficiency with Microsoft Office tools 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.

Responsibilities

Manages the submission process for contracting and fee-for-service negotiations with physicians and ancillary providers.
Supports the development and management of value-based provider relationships.
Builds and maintains relationships that strengthen provider partnerships in support of local market strategy.
Initiates and maintains effective communication with matrix partners, including but not limited to Claims Operations, Medical Management, Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing, and Service.
Supports strategic positioning for provider contracting, assists in network development, and helps identify opportunities for greater value orientation.
Contributes to the development of alternative network initiatives and supports analytics required for network solutions.
Works to meet unit cost targets while preserving an adequate network to achieve and maintain Cigna’s competitive position.
Supports initiatives aimed at improving total medical cost and quality.
Drives change with external provider partners by offering consultative expertise to support total medical cost initiatives.
Prepares, analyzes, reviews, and projects the financial impact of provider contracts and alternative contract terms.
Creates HCP agreements that meet internal operational standards and external provider expectations; ensures accurate implementation and administration through matrix partners.
Assists in resolving provider service complaints by researching issues and negotiating with internal and external partners to resolve escalated concerns.
Manages provider relationships and serves as a critical interface between providers and internal business partners.
Demonstrates knowledge of providers within an assigned geographic area, including interrelationships and the competitive landscape.
Ensures accurate and timely contract loading and submissions and partners with matrix teams for network implementation and maintenance.
Performs other duties as assigned.