Friday , December 1 2023

Cigna Jobs – Provider Relations Lead

Website Cigna

Job Description:

Develops and maintains positive relationships with physicians, providers, practice managers, hospitals and/or ancillaries within the provider network.

Let us tell you a little more. We’re a global health service company dedicated to helping people improve their health, well-being and sense of security. But we don’t just care about your well-being, we care about your career health too. That’s why when you work with us, you can count on a different kind of career – you’ll make a difference, learn a ton, and share in changing the way people think about healthcare.

Job Responsibilities:

  • Researches and resolves provider issues.
  • Develops, maintains, and distributes reports.
  • Performs quality checks on provider communication material.
  • Maintains provider contract files and system information.
  • May assist with physician bonus distribution.
  • May be responsible for support of the Ancillary Network team through problem resolution and researching appeals for facilities (hospital and ancillaries) through claims review, pricing, and authorization requirements.
  • May research MSM inquiries through the claims systems to resolve discrepancies and draft letters to send to providers for resolution to issues.
  • Prepares documentation for meetings, schedules meetings, visit PCP/specialist officers for relationship building and performance insight.
  • Educates providers regarding member benefits and referral process.
  • Responsible for assisting with the general oversight of provider network financials, including monthly action plans, reviews, trend analysis, and verification
  • Provides internal support to Network team.

Job Requirements:

  • Possess strong business acumen
  • Strong time management, project management and organization skills with the ability to manage/support multiple projects and priorities
  • Demonstrated ability to work in a highly-matrixed environment and with all levels
  • Excellent verbal and written communication skills
  • Competent in data management
  • Technical: Computer skills: Excel, Power Point, Word
  • Relationship management and building trust
  • High degree of financial acumen
  • Ability to develop win/win scenarios between Cigna HealthSpring and business partners
  • Ability to use available IT systems to generate meaningful insight to drive business performance

Job Details:

Company:  Cigna

Vacancy Type: Full Time

Job Functions: Business Development Sales

Job Location: Lake Mary, FL, US

Application Deadline: N/A

Apply Here