Manager, Client Account Services
T. Rowe Price
Hospital Contracting Manager
The Cigna Group
full-time
Posted on:
Location Type: Hybrid
Location: Richmond • Maryland, Virginia • 🇺🇸 United States
Visit company websiteSalary
💰 $91,200 - $152,000 per year
Job Level
Mid-LevelSenior
About the role
- Manages complex contracting and negotiations for fee for service and value-based reimbursements with hospitals and other providers.
- Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
- Initiates and maintains effective channels of communication with matrix partners including Claims Operations, Medical Management, Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service.
- Manages strategic positioning for provider contracting, develops networks and identifies opportunities for greater value-orientation and risk arrangements.
- Contributes to the development of alternative network initiatives and supports network analytics for solutions.
- Works to meet unit cost targets while preserving an adequate network to maintain Cigna's competitive position.
- Creates and manages initiatives that improve total medical cost and quality and drives change with external provider partners by assessing clinical informatics and offering consultative expertise.
- Prepares, analyzes, reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms.
- Creates HCP agreements that meet internal operational standards and external provider expectations and ensures accurate implementation and administration through matrix partners.
- Assists in resolving elevated and complex provider service complaints; researches problems and negotiates with internal/external partners to resolve escalated issues.
- Manages key provider relationships and is accountable for critical interface with providers and business staff; responsible for accurate and timely contract loading, submissions, implementation and maintenance.
- May provide guidance or expertise to less experienced specialists.
Requirements
- Should possess a bachelor degree; preferably in the areas of Finance, Economics, Healthcare or Business related.
- Significant industry experience will be considered in lieu of a Bachelor degree.
- MBA or MHA preferred.
- 5+ years Hospital contracting and negotiating experience involving complex delivery systems and organizations required.
- Experience in developing and managing key provider relationships.
- Knowledge of complex reimbursement methodologies, including incentive based models strongly preferred.
- Intimate understanding and experience with hospital, managed care, and provider business models.
- Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization.
- Ability to influence both sales and provider audiences through strong written and verbal communication skills.
- Experience with formal presentations.
- Customer centric and interpersonal skills are required.
- Demonstrates managerial courage as well as an ability to maneuver effectively in a changing environment.
- Superior problem solving, decision-making, negotiating skills, contract language and financial acumen.
- Knowledge and use of Microsoft Office tools.
- If working at home: internet connection must be cable broadband or fiber optic with speeds of at least 10Mbps download/5Mbps upload.
Benefits
- Health, vision, dental, and well-being and behavioral health programs starting on day one
- 401(k) with company match
- Company paid life insurance
- Tuition reimbursement
- Minimum of 18 days of paid time off per year
- Paid holidays
- Anticipated eligibility to participate in an annual bonus plan
- Comprehensive range of benefits focused on whole health
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
hospital contractingnegotiatingreimbursement methodologiesfinancial analysiscontract managementnetwork analyticsclinical informaticsprovider business modelsincentive based modelsproblem solving
Soft skills
relationship buildingcommunication skillsteam playerinterpersonal skillsmanagerial couragedecision-makinginfluencing skillscustomer centricitynegotiating skillsadaptability
Certifications
Bachelor's degreeMBAMHA
