Provider Network Manager - Cigna Healthcare - Remote
About The Position
The job profile for this position is Provider Relations Senior Analyst, which is a Band 3 Senior Contributor Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. This role is an individual contributor within the Nonpar Provider Contracting Team, supporting our enterprise strategy to deliver affordable, predictable, and simple health care. The position is responsible for prioritizing and negotiating nonpar single case agreements, ensuring compliance, and fostering strong partnerships with internal and external stakeholders. Summary of Responsibilities The Provider Network Manager (Provider Relations Sr. Analyst) skillfully navigates reimbursement conversations with nonpar health care professionals while providing exceptional service. Responsibilities include negotiating reimbursement rates for nonpar health care providers, utilizing excellent verbal and written communication skills, partnering with internal teams to resolve complaints and disputes, ensuring compliance with policies, procedures, and regulatory requirements, suggesting process improvements and fostering innovation, utilizing knowledge of medical terminology and standard reimbursement methodologies, and managing multiple priorities in a fast-paced environment.
Requirements
- Minimum 2+ years of experience in healthcare contracting, provider relations, or reimbursement negotiations required
- Demonstrated experience in interpreting and applying reimbursement methodologies.
- Proficiency in medical terminology and healthcare industry standards.
- Strong negotiation and conflict resolution skills.
- Advanced proficiency in Microsoft Office Suite (Excel, Word, Outlook).
- Ability to manage multiple priorities in a high-volume environment.
- 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
- Review and prioritize daily work assignments for timely single case agreement negotiation.
- Develop individual case pricing strategies and present to management and/or providers.
- Accurately document case outcomes in all systems and communicate results to stakeholders.
- Serve as team subject matter expert (SME) for highly complex cases.
- Support department goals contributing to organizational success.
- Communicate and collaborate effectively with internal and external partners.
- Adhere to all Compliance/Program Integrity requirements and HIPAA regulations.
- Promote professional growth through continuing education and skills development.
Benefits
- Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
- We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
