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Cigna Provider Strategy Lead at CareCore National, LLC in FRANKLIN, Tennessee

Posted in General Business 30+ days ago.

Type: Full-Time

Job Description:


Partners with Cigna's Provider Experience team to build collaborative campaigns and strategies aimed at improving Cigna and eviCore relationships with providers. Conducts provider outreach activities as needed to Cigna's strategic providers. Coordinates collaborative provider strategies, on behalf of Cigna, to the eviCore provider experience team for execution. Proactively identifies and responds to issues and trends affecting Cigna. Leads and coordinates communication with providers, providing timely status of efforts to resolve escalated, complex, and sensitive provider issues in collaboration with other internal departments at eviCore. Identifies and prepares current, specialty-applicable information for site visit folders for review and discussion. Provides education to provider personnel to improve overall process efficiency that is patient-centric and educates providers on eviCore products and services. Engages appropriate provider staff regarding eviCore initiatives to ensure optimal impact of overall project efforts and outcome. Establishes appropriate meeting schedule with strategic provider groups to ensure quarterly targets have been visited and timely follow up to each meeting is conducted, including applicable research and issue resolution. Develops and leads presentations to providers, delivering effective verbal and written communications appropriate to the audience. Logs and documents all provider outreach interactions in SmartSheet. Partners with eviCore's provider experience team in assisting with the development and management of policies and procedures relating to Cigna provider participation including management and production of online provider manuals and production of provider newsletters. Interacts with other internal departments, including the Cigna Business Unit Learning Leader, to identify the education needs prior to a new implementation. Collaborates with other eviCore departments to fulfill provider engagement duties that lead to a successful implementations for Cigna. Develops and manages relationships with Cigna's strategic providers, monitoring and reviewing metrics and overall activity performance. Runs appropriate provider reports and delivers pertinent information to providers to assist with process efficiency. Works with appropriate dep. Interacts with other internal staff members to provide support with special projects or assignments as necessary. Approximately 25% travel is required to connect in-person with providers. May interact with the Claims Department to investigate and resolve billing and/or claims problems and complaints received from eviCore and contracting physicians and patients. Other duties as necessary.

Minimum Experience Required

A Bachelor's Degree in Business or Health Care and/or equivalent work experience

A minimum of seven years of experience in a provider relations capacity or a similar business environment. History of successful project management and multi-task capabilities.

Required Skills

Demonstrated ability to develop successful relationships both internally and externally.
Possesses initiative, an ability to work independently in a self-directed manner through obstacles and challenges
Execution focused with ability to prioritize, organize and ensure follow through.
Strong facilitation skills; ability to work effectively across functions and with people at all levels including clinicians
Proven analytical skills and ability to draw insights from data
Excellent communication skills, both oral and written
Strong relationships and knowledge of the provider landscape and systems
Knowledge of Medicare Advantage and risk-based performance arrangements highly desired

Ability to drive results using influence.

Effective problem solver

Our Company and What We Offer

eviCore healthcare is committed to making a positive impact on healthcare, and also making a positive impact on our employees. eviCore offers a variety of perks and benefits including, but not limited to:

  • Flexible scheduling and work/life balance with remote and work from home opportunities

  • 3 weeks of PTO(starting) per year plus paid holidays

  • Education assistance, tuition reimbursement and professional certifications

  • Health, dental, vision, and life benefits with employer funded HSA

  • Comprehensive employee discount program, onsite fitness facilities, and smart casual dress code

  • Paid Volunteer Community Service Days

  • Ample opportunities for growth, advancement, and promotion

  • 401k retirement plan with company match of 50% employee contributions up to 6%