Provider Network Manager - Cigna Healthcare - Remote
About the position
This role is an individual contributor within the Nonpar Provider Contracting Team, supporting our enterprise strategy to deliver affordable, predictable, and simple health care. The position is responsible for prioritizing and negotiating nonpar single case agreements, ensuring compliance, and fostering strong partnerships with internal and external stakeholders. Summary of Responsibilities The Provider Network Manager (Provider Relations Sr. Analyst) skillfully navigates reimbursement conversations with nonpar health care professionals while providing exceptional service. Responsibilities include negotiating reimbursement rates for nonpar health care providers, utilizing excellent verbal and written communication skills, partnering with internal teams to resolve complaints and disputes, ensuring compliance with policies, procedures, and regulatory requirements, suggesting process improvements and fostering innovation, utilizing knowledge of medical terminology and standard reimbursement methodologies, and managing multiple priorities in a fast-paced environment.
Responsibilities
• Review and prioritize daily work assignments for timely single case agreement negotiation.
• Develop individual case pricing strategies and present to management and/or providers.
• Accurately document case outcomes in all systems and communicate results to stakeholders.
• Serve as team subject matter expert (SME) for highly complex cases.
• Support department goals contributing to organizational success.
• Communicate and collaborate effectively with internal and external partners.
• Adhere to all Compliance/Program Integrity requirements and HIPAA regulations.
• Promote professional growth through continuing education and skills development.
Requirements
• Minimum 2+ years of experience in healthcare contracting, provider relations, or reimbursement negotiations required
• Demonstrated experience in interpreting and applying reimbursement methodologies.
• Proficiency in medical terminology and healthcare industry standards.
• Strong negotiation and conflict resolution skills.
• Advanced proficiency in Microsoft Office Suite (Excel, Word, Outlook).
• Ability to manage multiple priorities in a high-volume environment.
• 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.
Benefits
• For this position, we anticipate offering an annual salary of 58,100 - 96,900 USD / yearly, depending on relevant factors, including experience and geographic location.
• This role is also anticipated to be eligible to participate in an annual bonus plan.
• At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health.
• 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.
• For more details on our employee benefits programs, click here.
Apply Now
Apply Now
This role is an individual contributor within the Nonpar Provider Contracting Team, supporting our enterprise strategy to deliver affordable, predictable, and simple health care. The position is responsible for prioritizing and negotiating nonpar single case agreements, ensuring compliance, and fostering strong partnerships with internal and external stakeholders. Summary of Responsibilities The Provider Network Manager (Provider Relations Sr. Analyst) skillfully navigates reimbursement conversations with nonpar health care professionals while providing exceptional service. Responsibilities include negotiating reimbursement rates for nonpar health care providers, utilizing excellent verbal and written communication skills, partnering with internal teams to resolve complaints and disputes, ensuring compliance with policies, procedures, and regulatory requirements, suggesting process improvements and fostering innovation, utilizing knowledge of medical terminology and standard reimbursement methodologies, and managing multiple priorities in a fast-paced environment.
Responsibilities
• Review and prioritize daily work assignments for timely single case agreement negotiation.
• Develop individual case pricing strategies and present to management and/or providers.
• Accurately document case outcomes in all systems and communicate results to stakeholders.
• Serve as team subject matter expert (SME) for highly complex cases.
• Support department goals contributing to organizational success.
• Communicate and collaborate effectively with internal and external partners.
• Adhere to all Compliance/Program Integrity requirements and HIPAA regulations.
• Promote professional growth through continuing education and skills development.
Requirements
• Minimum 2+ years of experience in healthcare contracting, provider relations, or reimbursement negotiations required
• Demonstrated experience in interpreting and applying reimbursement methodologies.
• Proficiency in medical terminology and healthcare industry standards.
• Strong negotiation and conflict resolution skills.
• Advanced proficiency in Microsoft Office Suite (Excel, Word, Outlook).
• Ability to manage multiple priorities in a high-volume environment.
• 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.
Benefits
• For this position, we anticipate offering an annual salary of 58,100 - 96,900 USD / yearly, depending on relevant factors, including experience and geographic location.
• This role is also anticipated to be eligible to participate in an annual bonus plan.
• At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health.
• 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.
• For more details on our employee benefits programs, click here.
Apply Now
Apply Now