Hybrid Provider – Hospital Contracting Manager

at The Cigna Group

• Job title: Provider – Hospital Contracting Manager
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: Not specified
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, Hartford, United States

About the role

• Provider/Hospital Contracting Manager developing strategic provider relationships for Cigna Healthcare. Managing complex negotiations and leading initiatives to improve healthcare delivery and cost management.

Responsibilities

• Serves as an integral member of the Provider Contracting Team and reports to the AVP, Provider Contracting.
• Assists in developing the strategic direction and management of the day to day contracting and network management activities for a local given territory.
• Manages complex contracting and negotiations for fee for service and value-based reimbursements with hospitals and other providers.
• 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.
• Contributes to the development of alternative network initiatives.
• Supports and provides direction to develop network analytics required for the network solution.
• Creates and manages initiatives that improve total medical cost and quality.
• Drives change with external provider partners by assessing clinical informatics and offering consultative expertise.
• Prepares, analyzes, reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms.
• Creates healthcare provider agreements that meet internal operational standards and external provider expectations.
• Responsible for accurate and timely contract loading and submissions.

Requirements

• Should possess a bachelor’s degree; preferably in the areas of Finance, Economics, Healthcare or Business related.
• Significant industry experience will be considered in lieu of a bachelor’s degree.
• 3+ years Managed Care 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.
• Demonstrates an ability to maneuver effectively in a changing environment.
• Superior problem solving, decision-making, negotiating skills, contract language and financial acumen.
• Knowledge and use of Microsoft Office tools.

Benefits

• Health insurance
• 401(k) matching
• Flexible work hours
• Paid time off
• Professional development opportunities