Provider Network Contracting Manager
The Cigna Group
full-time
Posted on:
Location Type: Remote
Location: Louisiana • Texas • United States
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About the role
- Manage complex fee-for-service and value-based contracting and negotiations with large physician groups, ancillaries, and hospital systems.
- Lead key market contracting strategy projects with responsibility for managing direct reports as assigned.
- Build and maintain strong provider relationships to support network growth and value-based business opportunities.
- Coordinate closely with matrix partners (i.e., Claims, Medical Management, Credentialing) to ensure aligned execution.
- Develop strategic network positions, identify value-oriented and risk-based opportunities, and contribute to alternative network initiatives and analytics.
- Work to meet unit cost targets while maintaining an adequate, competitive provider network.
- Design and manage initiatives to improve medical cost and quality, offering consultative guidance informed by clinical informatics.
- Prepare, review, and project the financial impact of large or complex provider contracts and alternative terms.
- Create, implement, and ensure operational accuracy of HCP agreements through effective cross-functional collaboration.
- Lead resolution of escalated provider issues and manage key provider relationships with deep knowledge of the local market landscape including contract loading and maintenance.
Requirements
- 3+ years of healthcare provider contracting and negotiating experience
- Background in managed care, healthcare, or health insurance, including commercial contracting
- Proven leadership experience, including mentoring and guiding others
- Strong provider relationship management skills and success developing long-term partnerships
- Knowledge of complex reimbursement methodologies, including incentive-based models (strongly preferred)
- Deep understanding of hospital, managed care, and provider business models with the ability to influence sales and provider audiences
- Exceptional presentation and communication skills, including the ability to build internal relationships in a fast-paced, matrixed organization
- Customer-centric approach, strong interpersonal skills, and confidence in navigating change
- Strong problem-solving, decision-making, negotiation, contract interpretation, and financial analysis skills
- Proficiency in Microsoft Office
- Bachelor’s degree in a related field (industry experience may substitute); MBA / MHA preferred
Benefits
- Health insurance
- Professional development opportunities
- Flexible work arrangements
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
healthcare provider contractingnegotiatingreimbursement methodologiesfinancial analysiscontract interpretationvalue-based contractingmanaged carecommercial contractingclinical informaticscost management
Soft Skills
leadershipprovider relationship managementpresentation skillscommunication skillsinterpersonal skillsproblem-solvingdecision-makingnegotiationcustomer-centric approachmentoring
Certifications
Bachelor’s degreeMBAMHA