Cigna Jobs – Provider Relations Lead

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

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