WORK LOCATION - Greenville, SC

SUMMARY:
Serves as primary contact for providers and provider staff to assist in contract management and provide supporting analyses for network and performance optimization. Develops and maintains positive relationships with physicians, health systems, administrators, and practice managers within the network, including oversight and managing performance in various incentives based and/or value based programs.

• Requires up to 50% local travel in the Greenville/Spartanburg area


• Car & valid driver's license required (mileage reimbursement provided)

RESPONSIBILITIES:

• Provide tactical operations support to assigned provider groups/health systems, including contracting, data integrity, communications, and relationship management


• Create and deliver materials to educate providers and provider staff on contracts, policies and procedures, quality and service line initiatives, and financial performance


• Prepares and delivers presentations with providers, provider staff, and/or physician leadership during monthly operational meetings


• Understands, develops, tracks, monitors and reports on key program performance metrics, such as utilization, coding, and STARs/quality performance


• Perform root cause analyses and resolution related to provider concerns, grievances, claims and care delivery


• Assist in the STARS and clinical metrics data collection, and design plans for enhanced provider engagement in quality initiatives


• Partners with other internal departments, including but not limited to Health Services, Finance, Claims, and Coding in order to develop solutions for strategic business needs


• Supports strategic positioning for provider contracting, assists in the development of networks and helps identify opportunities for greater value-orientation.


• Contributes to the development of alternative network initiatives. Supports analytics required for the network solution.


• Works to meet unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position.


• Supports initiatives that improve total medical cost and quality.

REQUIREMENTS:

• Bachelor's degree, preferred


• Working experience with health care providers as well as proven success building and maintaining these relationships


• 1 or more years of experience in provider relations or health care


• Demonstrated excellent oral, written, interpersonal and analytical skills


• Understanding of CMS STARs measures


• Ability to use PC software and multiple Cigna systems


• Understanding of medical insurance products


• Ability to work in highly matrixed environment


• Ability to analyze larger volumes of data


• Ability to work independently and with matrix partners


• Excellent presentation skills and data management


• Strong communication skills


• Project Management skills


• Attention to detail


• Proficient in Excel table creation and algorithm design


• Must be commutable to theCharlotte office as needed for training or team meetings

About Cigna

Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. We offer an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products. Together, with our 74,000 employees worldwide, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation.

When you work with Cigna, you'll enjoy meaningful career experiences that enrich people's lives while working together to make the world a healthier place. What difference will you make? To see our culture in action, search #TeamCigna on Instagram.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.