LOCATION: Hybrid/Remote position aligned to the Missouri. Requires one day a week in an Office/Provider site visits. Must reside in Kansas City or St. Louis

The Director, Provider Network Management position reports to the Mid America market VP of Network Management. This role assists in developing, coordinating and socializing the strategic direction and management of contracting for large, complex providers and network management initiatives in the Mid America market. Works closely with the Network VP on various initiatives.

DUTIES AND RESPONSIBILITIES

• Assist with relationship management and contracting strategy for complex health system providers.


• Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support local markets in their strategies.


• Initiates and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing, Affordability and Service. Represents Network Contracting in work groups involving various affordability initiatives.


• Works closely with Legal on pending arbitrations involving assigned providers, if applicable.


• Leads in resolving elevated and complex provider service complaints. Researches problems and negotiates with internal/external partners/customers to resolve highly complex and/or escalated issues.


• Manages some key provider relationships and is accountable for critical interface with providers and business staff.


• Demonstrates knowledge of provider and market dynamics, emerging trends, challenges and opportunities through understanding the interrelationships as well as the competitive landscape; Aggregates information to update markets on a regular basis.

POSITION REQUIREMENTS

• Bachelor's degree, strongly preferred; 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.


• Five years or more years in contracting and negotiating experience involving complex delivery systems and organizations required; specifically needing extensive experience in negotiating commercial facility agreements for fee for service and fee for value arrangements.


• Excellent project management and organizational skills


• Experience in developing and managing key provider relationships.


• Knowledge of complex reimbursement methodologies, including incentive based models strongly preferred.


• Demonstrated experience in seeking out, building and nurturing strong external relationships with provider 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 both sales and provider audiences through strong written and verbal communication skills. Experience with formal presentations.


• Customer centric and interpersonal skills are required.


• Demonstrates 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.


• Excellent project management and organizational skills


• Knowledge and use of Microsoft Office tools.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

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.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.