Provider Contract & Market Advisor (Liberty Valley Market) at Cigna in Bloomfield, Connecticut

Job Description:

Summary

We are seeking a highly motivated and innovative team member to join our growing and dynamic Global Data & Analytics team as a Provider Contract & Market Advisor for the Mid-Atlantic Market. In this role, you will assist contractors in creating network solutions and provider contracts to ensure Cigna's competitive position in the market and deliver unit cost results in line with trend/cost expectations to ensure competitive positioning within the marketplace.You will use financial models to evaluate the impact of proposed terms on profitability, trend and other metrics. You will also partner with network management, medical management, and sales units to understand resulting medical expense results and improve future negotiation strategy.

Responsibilities

• Analyze impact to trends for facility contract negotiations


• Leverage Hospital and Payer Transparency competitor data/insights in contract negotiation modeling


• Effectively influence contracting in a strategic fashion and offer meaningful options during negotiations with a provider


• Provide ad hoc analysis and deep dives into data as appropriate to support negotiation and provide value to our contracting partners


• Summarize and explain findings and recommendations


• Independently and effectively manage the planning process for assigned markets and drive the plan to meet overall corporate planning objectives


• Proactively identify opportunities for trend reduction and engage contracting to build these into plan where appropriate


• Keep management informed as to the progress of Plan and proactively identify risk and opportunities for meeting the plan results


• Work with Provider Contract Database (PCD) Analysts to oversee corrections and update to forecasting tools

Qualifications

• 3+ years' industry experience solving business problems through the application of analytic approaches, particularly in analyzing medical claims experience in TMC and/or Contract Underwriting for Fee for Service and Fee for Value contracts preferred


• Knowledge of standard medical coding: CPT, ICD10, HCPC


• Familiarity with various data mining and reporting tools, such as Microsoft Excel skills, Microsoft Access, or SAS/SQL language


• Strong analytical and problem solving skills with ability to independently perform analyses and apply statistical models to validate / interpret results


• Understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, and utilization management


• Strong communication skills to include written, oral and group presentation


• Ability to work independently while managing multiple tasks and meeting deadlines

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.

For this position, we anticipate offering an annual salary of 94,300 - 157,100 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.

We want you to be healthy, balanced, and feel secure. That's why 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) with company match, 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, visit Life at Cigna Group .

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

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.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.