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This position serves as an integral member of the Payment Innovation Team and reports to the Payment Innovation Lead. This role assists in developing the strategic direction and management of the day to day Cigna Collaborative Care contracting and network management activities for their assigned Region.
DUTIES AND RESPONSIBILITIES
Present CCC programs to prospective CCC providers / facilities.
Attend CCC Pre JOCs and Reconciliation calls as assigned or needed and escalate specific group needs, as appropriate.
Participate in CCC Planning process as appropriate.
Key resource for matrix partners in the management of operational needs related to CCC relationships.
Specialize in and manage inquires from the Markets related to CCC programs.
Collaborate with the CCC Analyst to insure CCC Pipeline tracking is current.
Escalate unique CCC program needs to the Payment Innovation Lead, as appropriate.
Manage CCC operational timelines / workgroups and escalate risks as appropriate.
Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist with value based program initiatives.
Assists with contract review and escalation.
Assists in resolving elevated and complex CCC Program challenges and complaints. Researches problems and negotiates with internal partners / customers to resolve highly complex and / or escalated issues.
Manages Market relationships and is accountable for critical interface with staff.
Demonstrates knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape.
May provide guidance or expertise to CCC Analysts.
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.
Three to five years contracting, negotiating, and / or network management experience.
Experience in developing and managing key external facing relationships.
Knowledge of complex reimbursement methodologies, including incentive based models strongly preferred.
Demonstrated experience in seeking out, building and nurturing strong relationships with matrix partners.
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.
The ability to influence external audiences through strong written and verbal communication skills.
Customer centric and interpersonal skills are required.
Superior problem solving, decision-making, negotiating skills, contract language and financial acumen.
Advanced knowledge and use of Microsoft Office
Qualified applicants will be considered for employment without regard to age, race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status.
If you require an accommodation based on your physical or mental disability please email : SeeYourself cigna.com. Do not email SeeYourself cigna.
com for an update on your application or to provide your resume as you will not receive a response.