Contract Manager – Hospital & Physician Negotiations
The Cigna Group
full-time
Posted on:
Location Type: Hybrid
Location: Pittsburgh • Pennsylvania • Virginia • United States
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About the role
- Lead complex negotiations with hospitals, health systems, ancillaries, and large physician groups to support both fee‑for‑service and value‑based strategies.
- Build strong, trust‑based provider relationships that expand opportunities for partnership and help advance local market goals.
- Partner closely with matrix teams—Claims Operations, Medical Management, Credentialing, Legal, Medical Economics, Compliance, Sales, Marketing, and Service—to ensure smooth operations and contract execution.
- Contribute to the design of alternative network strategies and support the development of analytics needed to evaluate network performance and opportunities.
- Help achieve unit cost targets while preserving a competitive, high‑quality provider network.
- Lead and support initiatives that improve total medical cost and quality outcomes by using data insights to influence provider behavior.
- Use clinical and cost analytics to guide provider partners through constructive change that supports affordability and performance improvement.
- Prepare and analyze financial impact models for complex contract structures and innovative reimbursement terms.
- Develop provider agreements that align with internal requirements and provider expectations, ensuring accurate implementation through matrix partners.
- Resolve escalated provider concerns through thoughtful engagement, root‑cause analysis, and practical solutions.
- Maintain deep knowledge of market dynamics, provider relationships, and competitive positioning to inform strategy and decision‑making.
- Ensure timely and accurate contract loading, submissions, and network maintenance activities.
- Provide guidance to less experienced team members to support learning, collaboration, and continuous improvement.
Requirements
- Minimum 3+ years of managed care contracting and negotiation experience within complex delivery systems.
- Experience developing and managing key provider relationships.
- Strong understanding of reimbursement methodologies, including incentive‑based and value‑based models.
- Experience working with hospitals, managed care organizations, and provider business models.
- Strong written and verbal communication skills with the ability to influence provider and sales audiences; experience delivering formal presentations.
- Customer‑focused approach with strong interpersonal and relationship‑building skills.
- Ability to navigate change and contribute effectively in a fast‑paced, matrixed environment.
- Strong problem‑solving, decision‑making, negotiation, contract interpretation, and financial analysis skills.
- Proficiency with Microsoft Office tools.
Benefits
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Applicant Tracking System Keywords
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Hard Skills & Tools
managed care contractingnegotiationreimbursement methodologiesfinancial analysiscontract interpretationdata analyticsprovider agreementscost analyticsperformance improvementunit cost targets
Soft Skills
communication skillsinterpersonal skillsrelationship-buildingproblem-solvingdecision-makinginfluencing skillscustomer-focused approachcollaborationcontinuous improvementnavigating change