AVP, Provider Contract - Western PA and West Virginia markets - Cigna Healthcare - Hybrid
About the position
The Assistant Vice President (AVP) of Provider Contracting for the Western PA and West Virginia markets at Cigna Healthcare plays a crucial role in the Provider Contracting Team. This position is responsible for leading contracting and network management activities across multiple local geographies, ensuring strategic alignment and effective provider partnerships. The AVP will manage a team, oversee complex contract negotiations, and drive initiatives that enhance value-based care and improve medical costs and quality.
Responsibilities
Directly manage a contracting team or geography, providing leadership, mentoring, and development opportunities to direct reports.
,
Accountable for managing contracting and network management activity supporting Commercial, Medicare Advantage, and other products/initiatives.
,
Manage complex contracts and negotiations for fee-for-service and value-based reimbursements with hospitals and providers across Western PA and West Virginia.
,
Lead cross-market and cross-functional initiatives as needed.
,
Build and nurture provider partnerships to support local market strategy and seek broader value-based business opportunities.
,
Maintain effective communication with matrix partners including Claims Operations, Medical Management, Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing, and Service.
,
Develop networks and identify opportunities for greater value-orientation and risk arrangements in provider contracting.
,
Meet unit cost targets while preserving an adequate network to maintain Cigna's competitive position.
,
Identify and manage initiatives that improve total medical cost and quality.
,
Prepare, analyze, review, and project financial impacts of complex provider contracts and alternate terms.
,
Manage key provider relationships and interface with providers and business staff.
,
Ensure accurate and timely contract loading and submissions, interfacing with matrix partners for network implementation and maintenance.
Requirements
Bachelor's degree strongly preferred in Finance, Economics, Healthcare, or Business; significant industry experience may substitute for a degree.
,
Minimum of 5 years of Provider Contracting and Negotiating experience with complex delivery systems and organizations required.
,
Prior experience managing direct reports and leading project teams in a non-centralized work environment preferred.
,
Experience in developing and managing key provider relationships, including senior executives.
,
Knowledge of complex reimbursement methodologies, including incentive models.
,
Demonstrated experience in building and nurturing strong external relationships with provider partners.
,
Intimate understanding of larger, complex integrated delivery systems, managed care, and provider business models.
,
Proven ability to develop strong working relationships within a fast-paced, matrix organization.
,
Strong written and verbal communication skills to influence sales and provider audiences.
,
Demonstrated managerial courage and change leadership in a dynamic environment.
,
Superior problem-solving, decision-making, negotiating skills, contract language, and financial acumen.
,
Knowledge and use of Microsoft Office tools.
Nice-to-haves
MBA or MHA preferred.
,
Experience in a hybrid work environment.
Benefits
Flexible work schedule with hybrid options.
,
Opportunities for professional development and career growth.
,
Comprehensive health insurance coverage.
,
Retirement savings plan options.
Apply Now
The Assistant Vice President (AVP) of Provider Contracting for the Western PA and West Virginia markets at Cigna Healthcare plays a crucial role in the Provider Contracting Team. This position is responsible for leading contracting and network management activities across multiple local geographies, ensuring strategic alignment and effective provider partnerships. The AVP will manage a team, oversee complex contract negotiations, and drive initiatives that enhance value-based care and improve medical costs and quality.
Responsibilities
Directly manage a contracting team or geography, providing leadership, mentoring, and development opportunities to direct reports.
,
Accountable for managing contracting and network management activity supporting Commercial, Medicare Advantage, and other products/initiatives.
,
Manage complex contracts and negotiations for fee-for-service and value-based reimbursements with hospitals and providers across Western PA and West Virginia.
,
Lead cross-market and cross-functional initiatives as needed.
,
Build and nurture provider partnerships to support local market strategy and seek broader value-based business opportunities.
,
Maintain effective communication with matrix partners including Claims Operations, Medical Management, Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing, and Service.
,
Develop networks and identify opportunities for greater value-orientation and risk arrangements in provider contracting.
,
Meet unit cost targets while preserving an adequate network to maintain Cigna's competitive position.
,
Identify and manage initiatives that improve total medical cost and quality.
,
Prepare, analyze, review, and project financial impacts of complex provider contracts and alternate terms.
,
Manage key provider relationships and interface with providers and business staff.
,
Ensure accurate and timely contract loading and submissions, interfacing with matrix partners for network implementation and maintenance.
Requirements
Bachelor's degree strongly preferred in Finance, Economics, Healthcare, or Business; significant industry experience may substitute for a degree.
,
Minimum of 5 years of Provider Contracting and Negotiating experience with complex delivery systems and organizations required.
,
Prior experience managing direct reports and leading project teams in a non-centralized work environment preferred.
,
Experience in developing and managing key provider relationships, including senior executives.
,
Knowledge of complex reimbursement methodologies, including incentive models.
,
Demonstrated experience in building and nurturing strong external relationships with provider partners.
,
Intimate understanding of larger, complex integrated delivery systems, managed care, and provider business models.
,
Proven ability to develop strong working relationships within a fast-paced, matrix organization.
,
Strong written and verbal communication skills to influence sales and provider audiences.
,
Demonstrated managerial courage and change leadership in a dynamic environment.
,
Superior problem-solving, decision-making, negotiating skills, contract language, and financial acumen.
,
Knowledge and use of Microsoft Office tools.
Nice-to-haves
MBA or MHA preferred.
,
Experience in a hybrid work environment.
Benefits
Flexible work schedule with hybrid options.
,
Opportunities for professional development and career growth.
,
Comprehensive health insurance coverage.
,
Retirement savings plan options.
Apply Now