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.
- 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.
- 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
Vacancy Type: Full Time
Job Functions: Business Development Sales
Job Location: Lake Mary, FL, US
Application Deadline: N/A