Provider Engagement Senior Advisor - Evernorth Health Services - Hybrid at Cigna in Scottsdale, Arizona

Job Description:

Job Summary:

Evernorth Accountable Care (ENAC) is a newly launched business unit within Evernorth that is growing its Provider Enagement team. As part of the team you will play a critical role in building the business, shaping Evernorth's partnership with VillageMD and other partners, and advancing ENAC's mission to create new value-based care models and networks that drive value and improved outcomes for patients, providers and clients.

As a Provider Engagement Senior Advisor, you will work closely with providers to accelerate their transition to value-based care and to help them manage the long-term health of their patients. ENAC's consultative approach emphasizes physician engagement, delivery system organization and culture change, actionable data and analytics, as well as patient engagement to support treatment plans. We collaborate with providers to drive change and ensure success in a value-based market.

This role will sit within Evernorth Accountable Care's Network and Provider Engagement group, reporting to the Director of Provider Engagement. The ideal candidate will succeed at operating across the organization to create solutions, is energized by a "start from scratch" opportunity, curious, an analytical and strategic thinker, comfortable shaping structure from ambiguity, able to inspire and mobilize others, and passionate about creating innovative solutions that expand access to high quality care and improve affordability.

Summary

Engages with client/providers who have entered into value based agreements with various payers and seek services from ENAC to improve performance in value based agreements. Emphasis on value-based arrangements with specialty providers in a commercial context, but conversant with all lines of business (ASO, fully insured, Medicare, Medicare Advantage, Individual and Family Plans) and all provider types (PCP, specialists, ancillary, institutional). As a shared service across Evernorth, this role supports all Evernorth Care in their network strategy needs and is integral in the development of those strategies. Uses deep professional knowledge and acumen to advise functional leaders and matrix partners. Creates an Evernorth competitive advantage by becoming partner of choice for providers and supporting a differentiated patient experience.

Key responsibilities :

• Responsible for general oversight and management of client relationships. Including but not limited to management of provider network financials, pro-forma budget preparation and implementation, monthly action plans, reviews, and verification.


• Develops and provides guidance on value-based care strategy, vision, and action plan development for clients.


• Responsible for network development, including network relationships, network communication, physician recruitment, and network partnerships as well as expansion of network and products offered by Health plan partners.


• Participates in network and Company meetings, including physician board of directors, quality management, financial/bonus and interdisciplinary team meetings and other committees and projects as necessary.


• Be an advocate for both providers and Evernorth in regulatory matters concerning value-based programs and other proposed regulations impacting providers.


• Collaborate across Evernorth product lines to optimize provider and patient experience and leverage Evernorth resources in a cost-effective manner.


• In coordination with Data & Analytics, create and propose new value-based methodologies for deployment to specialists and other providers.


• Working with business line Network Strategy leads in Evernorth Care, create strategies to address network recruitment and contracting needs. Engage directly and be responsible for the contracting effort to meet those needs, which may be either value-based or fee-for-service relationships.


• Ensure that the network strategies of the Evernorth Care entities appear congruent to the provider and are aligned in the resulting contractual documents.


• In coordination with Value Based Contractors, Data & Analytics, and Business Development, identify targeted providers for re-contracting opportunities.


• Manage team member work plans for provider engagement and client improvement activities and provide on-going status of activities to appropriate Evernorth Care Leadership.


• Prioritize departmental improvement efforts and facilitate organizational design and change management efforts; supports staffing, workflow, and training efforts; optimizes operational and administrative processes.


• Instill and support a culture of rapid prototyping to quickly determine program ROI - drive a 'fail fast' mentality.


• Assist in resolving elevated and complex complaints. Research problems and negotiate with internal/external partners to resolve highly complex and/or escalated issues.


• Assist in a variety of projects related to the analysis of claims, clinical and financial data, with a focus on improving financial performance and health outcomes for managed populations.


• Assist with additional Value Based strategic priorities that best meet needs of the Client.

Qualifications

• Bachelor's Degree strongly preferred.


• Eight (8) or more years applicable health care experience.


• Relevant industry experience operating in value-based reimbursement methodologies.


• Experience recruiting and leading high performing and engaged teams. Success leading remote teams preferred.


• Ability to communicate complex concepts and insights to senior business leaders and providers in a relevant and actionable manner.


• Demonstrated thought leadership on challenging problems.


• Experience managing high degree of change and complexity across organization and portfolio.


• Extensive experience in the healthcare industry with out-of-network specific experience a plus


• Combination of analytical, technical, and business acumen


• Proven ability to work collaboratively in in complex matrix organizations, external partners, and agile teams.


• Self-motivated, ability to work independently.


• Creative thinker, ability to think outside the box.


• Driver of change that will improve results and/or improve efficiencies of existing processes.


• Ability to travel as required and meet with clients after hours (~30-50%, mostly local)

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.

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. 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.