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Provider Contracting Advisor - Express Scripts at Cigna in St. Louis, Missouri

Posted in General Business 30+ days ago.

Type: Full-Time





Job Description:

POSITION SUMMARY

Primary responsibility of the Provider Contracting Advisor is to manage a portfolio of Chain and PSAO pharmacy providers with complex escalated issues, education and performance data, and metrics. The Provider Contracting Advisor will coordinate a high volume of issue research and resolution on a daily basis for internal and external partners. As a Provider Contracting Advisor, you will also support execution of operational activities with Retail Network in accordance with ESI’s work plan and compliance with requirements for Express Scripts clients and any regulatory agencies, while supporting the needs of chain providers; support Supply Chain Sr. Management in the execution of strategic plans within our network; and work independently to lead, own and manage the relationship of assigned chain and PSAO pharmacy providers. Managing the relationship is complete with performance management in strategic planning, analytical development and processing, as well as operational management of any requirements which impact Retail Network Providers. Champion cross functional issue escalations/resolution; communicate progress and key milestones to appropriate internal partners in a timely manner.

ESSENTIAL FUNCTIONS


  • Responsible for the relationship and daily operational support of complex/high profile chain and PSAO providers. Operational support includes, but not limited to, claim investigation, escalated issue management.

  • Responsible for collaboration cross functional internal and external teams on-going support of Health Plan Sponsors and their requirements.

  • Work with appropriate teams for data mining and analysis of files to ensure efficient and effective communication to Providers.

  • Serves as subject matter expert for team on analytics and technical support.

  • Execution of assigned strategic work plan initiatives including but not limited to network development, implementing initiatives benefiting Express Scripts clientele and promoting Corporate and Departmental objectives.

  • Assists with development of strategic plans for assigned providers, providing consultative input to further foster strong provider relationships.

  • A key extension of the Provider Strategy and Contracting Management teams- supporting channel development program launches and communication of program implementation and status.

  • Serve as the point of contact for internal partners (Sales and Account Management, Network Implementation, Provider Compliance etc.) on escalated client issues, managing ad-hoc inquiries and other provider requests.

QUALIFICATIONS


  • Bachelor’s degree in related field or 3 to 5 years of relevant work experience.

  • Knowledge of the health-care, PBM industry and products.

  • Excellent oral, written communication and presentation skills.

  • Problem solving and analytical skills.

  • Project Management/organizational skills.

  • Ability to work cross-functionally to research and resolve complex client/provider issues on a daily basis.

  • External Relationship building a must.

  • Strong focus on customer service.

  • Ability to manage simultaneous escalated issues with tight timelines.

  • Excellent PC skills including Microsoft Office and internet experience.

  • Ability to adapt in a dynamic work environment, learn quickly, solve problems and make decisions with minimal supervision.

  • Demonstrated ability managing projects, utilizing proven project management processes.

  • Strong leadership skills and the ability to effectively engage with cross functional leadership.

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.





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