Provider Engagement Representative-CareAllies-Houston, TX at Cigna in Houston, Texas

Job Description:

Job Location: Houston, Texas

SUMMARY:

The Provider Engagement Representative serves as the primary contact for providers and provider staff to assist in contract management and provide supporting analyses for network and performance optimization. Develops and maintains positive relationships with physicians, providers, and practice managers within the network, including oversight and managing performance in various incentives based and/or value based programs.

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  Must be in Houston office on every Thursday for meetings. Work from home/field based remainder of the week
  
  


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  Requires up to 50% local travel to providers in the Houston, TX market area (once travel is permitted due to Covid)
  
  


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  Car & valid driver's license required (mileage reimbursement provided)
  
  

RESPONSIBILITIES:

• Provide tactical operations support to assigned groups, including contracting, data integrity, communications, and relationship management
  
  


• Create and deliver materials to educate providers and provider staff on contracts, policies and procedures, quality and service line initiatives, and financial performance
  
  


• Prepares and delivers presentations with providers, provider staff, and/or physician leadership during monthly operational meetings
  
  


• Understands, develops, tracks, monitors and reports on key program performance metrics, such as utilization, coding, and STARs/quality performance
  
  


• Perform root cause analyses and resolution related to provider concerns, grievances, claims and care delivery
  
  


• Assist in the STARS and clinical metrics data collection, and design plans for enhanced provider engagement in quality initiatives
  
  


• Prepare materials and participate in monthly financial review with senior leadership
  
  


• Partners with other internal departments, including but not limited to Health Services, Finance, Claims, and Coding in order to develop solutions for strategic business needs
  
  


• Work closely with internal representative for needs and support
  
  

Qualifications:

• Bachelor's degree preferred (with a Healthcare concentration), HS Diploma or GED required
  
  


• At least 2 years of experience in healthcare administration or provider relationship management preferred.
  
  


• Detail oriented, with proven time management and organization skills (including the ability to engage in multiple tasks and meet deadlines/standards).
  
  


• Be a positive role model and have the ability to work independently and in conjunction with co-workers of all levels.
  
  


• Strong analytical and problem-solving skills.
  
  


• Excellent communication skills - verbal, written and presentation.
  
  


• Strong analytical and problem solving
  
  


• Basic to Intermediate level of Excel preferred (knowledge of pivot tables, VLOOKUP, etc. a plus)
  
  


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  This role requires 50% travel. You will need to be fully vaccinated in order to travel & meet the requirements for this position.
  
  

This role is Flex (1-3 days a week) which allows most work to be performed at home. Employees must be fully vaccinated if they choose to come onsite.

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, 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 us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives. What difference will you make?

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.