Provider Relations Manager - Cigna Healthcare - Remote - CA
About The Position
The Provider Relations Manager (Provider Relations Lead Analyst) position is an external provider facing role with account management responsibilities for a medium to low complex book of business. The role is accountable for the overall provider experience by working in collaboration with matrix partners to drive on-going service improvements, understand, articulate and resolve service impacts, and drive the overall provider strategic planning solutions. This individual is empowered within their scope to make decisions as it pertains to the experience with Cigna, is required to have local market knowledge and visibility, builds and continuously improve the relationship between Cigna and the provider.
Requirements
- Solid experience using Outlook, Teams, Excel, PowerPoint, Word, etc.
- Demonstrated excellent oral, written, interpersonal, analytical, and negotiation skills.
- Understanding of medical insurance products and associated provider issues.
- Ability to assist an account management team through issue resolution.
- Ability to work in a matrix environment.
Nice To Haves
- Bachelor's degree or higher strongly preferred or equivalent work experience.
- 5+ years of experience in provider relations preferred.
- Successful account management experience preferred.
- Claims administration experience preferred.
- Experience with Proclaim or Facets preferred.
Responsibilities
- Accountable for the end-to-end provider experience and overall service delivery for assigned Book of Business aligned to medium to low complex providers
- Leads, collaborates, and supports local market direction as it relates to improving the provider experience
- Creates and maintains individual provider strategic action plans
- Proactively identifies new opportunities and risks for providers at market or national level and drives resolution
- Exercises good judgment and discretion to support the provider experience
- Responsible for capturing, documenting, and sharing market intelligence; use market intelligence to develop and drive strategic improvements
- External facing with providers in assigned BOB
- Collect, analyze, interpret, translate and distribute provider informatics, reports, dashboards
- Track and monitor performance guarantees for assigned BOB
- Promotes Provider Index score improvement through proactive and effective service and support of network
- Review provider reports/dashboard with individual providers
- Proactively educates providers on Cigna's business objectives, standard operating procedures, policies and programs to influence behavior and how to work with Cigna
- Understands and applies service culture principles and methodology
- Serves as a provider advocate both internally and externally
- Serves in a consultative role or subject matter expert to key matrix partners
- Develops and participates in presentations to existing and prospective providers and/or clients
- Serves as advocate in external community, representing Cigna to medical societies and external provider associations.
- Manage joint operating committees, including agenda development, facilitating appropriate meeting participation and follow up activities
Benefits
- medical
- vision
- dental
- well-being and behavioral health programs
- 401(k)
- company paid life insurance
- tuition reimbursement
- a minimum of 18 days of paid time off per year
- paid holidays
- leaves of absence
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
