Provider Contracting Manager – Cigna Healthcare – Walnut Creek, CA
About the position
Join Cigna Healthcare, a division of The Cigna Group, and help shape our provider network. As a Provider Contracting Manager, you’ll report to the Provider Contracting Senior Manager, AVP Network Management. In this individual contributor role, you’ll assist in developing the strategic direction and management of day-to-day contracting and network management. Responsibilities 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, identif y 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.
Responsibilities
• 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, identif y 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
• The ideal candidate will work a hybrid schedule in the Walnut Creek, CA office.
• 3+ years of healthcare provider contracting and negotiating experience involving complex physician groups and ancillaries
• 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
• 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.
Nice-to-haves
• Bachelor’s degree in a related field (industry experience may substitute); MBA/MHA preferred
Benefits
• Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
• We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
Apply tot his job
Apply To this Job
Join Cigna Healthcare, a division of The Cigna Group, and help shape our provider network. As a Provider Contracting Manager, you’ll report to the Provider Contracting Senior Manager, AVP Network Management. In this individual contributor role, you’ll assist in developing the strategic direction and management of day-to-day contracting and network management. Responsibilities 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, identif y 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.
Responsibilities
• 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, identif y 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
• The ideal candidate will work a hybrid schedule in the Walnut Creek, CA office.
• 3+ years of healthcare provider contracting and negotiating experience involving complex physician groups and ancillaries
• 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
• 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.
Nice-to-haves
• Bachelor’s degree in a related field (industry experience may substitute); MBA/MHA preferred
Benefits
• Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
• We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
Apply tot his job
Apply To this Job