Vice President, Network Management and Contracting - Nashville, TN at 091 Cigna Health & Life Ins. Co. in FRANKLIN, Tennessee

Job Description:

This position has overall accountability for managing the contracting functions in the markets. The incumbent will manage contracting and relationship management activity for the assigned healthcare markets. In addition, they will be responsible for managing total medical cost, including the execution of a total unit cost plan for the market, provider collaborative and value-based initiatives, and network access and provider satisfaction/network stability across all CIGNA products.

Duties and Responsibilities

• Within the markets, leads the technical operations of the Contracting functions, including service area analysis, physician contracting, network development, and problem resolution.


• Contributes to and executes the markets strategic planning, direction and evaluation of the Contracting departments.


• Partners closely with leadership from our key matrix partners from Sales, Underwriting, Medical Economics, etc. in developing and implementing a market strategy to support medical cost improvement and profitable growth in this market.


• Leads and participates in market-based vendor negotiations. Interfaces with senior leaders in the medical community. Negotiates, evaluates and writes physician contracts in order to partner with quality, cost-effective providers of healthcare services within the defined geographic area and drives competitive unit cost relative to top tier competitors across all CIGNA products. Conducts market-based financial analysis and participates in cross-functional teams to analyze business opportunities and address critical issues (e.g. network growth, provider termination, etc.)


• Supports growth and persistency through strategic collaboration with Market Medical Execs, Sales and Account Management to achieve Regional/Market Segment Sales goals


• Executes/ensures compliance with CIGNA HealthCare National Contracting standards


• Drives improvement in market Provider and Member satisfaction results by partnering with Medical Management, Marketing, Finance, and Service Organization staff


• Identifies opportunities for service improvements and cost savings. Manages the execution of market-based total medical cost plans and manages medical expenses across all CIGNA products


• Participates in the development of financial plans, business plans and strategy to support administrative, financial, and marketing objectives


• Manages the markets provider relationships and identifies opportunities for improvement in provider education and communication


• Ensures that provider data is loaded timely and accurately in support of administrative and accuracy objectives


• Responsible for People Strategy within their department, including successful execution of all attraction, development, motivation and retention efforts


• Coordinates all budget and expense management activities through effective planning, monitoring and forecasting

Position Requirements

• Bachelor’s Degree; MBA or Master’s Degree in HealthCare Administration or health-related field preferred


• Minimum of 8 years managed healthcare experience


• Extensive experience (8 years, preferred) in provider contracting and network development involving complex hospital systems, integrated delivery systems and large physician groups (IPAs and PPMs) etc., including risk arrangements


• Excellent knowledge of hospital and managed care finance


• Strong knowledge of managed care (e.g. network design, products, customer service, provider communities, etc.) regulatory environment and compliance issues (e.g. NCQA accreditation issues, credentialing, delegation and oversight standards, etc.)


• Excellent interpersonal and relationship management skills


• Excellent oral, written and presentation skills


• Proven ability to function in a heavily matrixed environment


• Proven ability to foster collaboration, value others perspective and gain support and buy-in for organization proposals


• Proven success in managing growth and charge of business operations. Proven ability to drive and lead an organization through significant change


• Strong organizational and analytical skills that result in conclusive recommendations


• Ability to drive results, think strategically and implement a national strategy


• Ability to establish community-based partnerships with providers and other stakeholders


• Proficient with Excel, Word and presentation applications


• Technical/Functional expertise: Contracting, Negotiating, Provider Services, Financial Management, Project Management

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.