National Ancillary Provider Contractor Medicare Advantage Remote
This is a Medicare Advantage position
WORK LOCATION: REMOTE position
The National Ancillary Medicare Advantage (MA) Provider Contracting Senior Advisor is a critical contributor to Cigna's enterprise quality and affordability initiatives. The National Ancillary MA team currently manages greater than 80 national contracts including clinical programs, MA Supplemental benefits, and direct provider agreements.
This role operates at a strategic level engaging directly with Senior Leadership from Legal, Compliance, Network, Product, Clinical and Strategic Sourcing; and is responsible for negotiating Medicare Advantage national contracts within specified service segments, drive operational efficiencies, evolve vendor / provider engagement model, supports implementation of strategic priorities, and ensure value realization.
This role collaborates with multiple key business partners across the organization to Identify and implement affordability initiatives, negotiate contracts, monitor... performance, develop corrective action plans, drive business continuity, and ensure a successful Annual Enrollment. This position is internally and externally facing and will directly oversee relationships and/or programs within the Medicare Advantage Segment. This is a critical position on the NANPM Team and a direct report to the Senior Director of NANPM Medicare & Commercial Alignment. Experience with Medicare Advantage and /or the Government Business is required for success.
DUTIES AND RESPONSIBILITIES:
Works directly with external strategic partners / vendors to negotiate, manage, retain cost effective and quality programs.
Accountable for negotiation to deliver competitive reimbursement and drive financial performance of contracted vendor relationships
Engages Markets, Product and Clinical leaders to understand business needs, drive improvements and create win-win scenarios in new and existing spend categories
Responsible for advocating for external partnerships within Cigna MA while delivering on Cigna priorities.
Accountable for conveying Cigna MA, regulatory and other compliance standards and ensuring effective implementation
Collaborates with National Contracting Service & Operations team to create Corrective Action Plan (CAPs) and mitigation plans when needed.
Leads strategy development, improve operational performance, internal/external relationships across assigned national ancillary segment. Anticipates and mitigates downstream impacts to HCPs, Customers, and Clients. Removes barriers for service operations and improve vendor performance within assigned segments.
Serves as the Executive Liaison and single point of accountability for the programs impacting both the commercial and senior segments
Leads annual business reviews and quarterly Joint Operating Committee (JOC) meetings to include vendors and internal business partners
Monitors and understand Medicare Advantage policies, procedures, products, and strategies and how those impact or are impacted by national ancillary partners.
Contributes to national contracting strategy and collaborates with senior leadership both internally and externally to achieve total medical cost savings.
Responsible for collecting, documenting, and sharing market intelligence relative to their national ancillary segment; use market intelligence to inform strategy.
Provides oversight and management to assigned Book of Business (BoB) from implementation or re-implementation within required timelines and in accordance with regulatory requirements.
POSITION REQUIREMENTS:
Bachelor's degree or equivalent work experience; Master's degree preferred.
5+ years experience in Provider Contract negotiations, required
8+ years of experience in provider, client and customer relations, contracting or national ancillary account management environment.
Experience with Medicare Advantage - Supplemental Benefits, CMS guidelines, FDR Operations, Clinical Programs, STARS ratings, etc.
A broad, enterprise-wide view of the business and interdependencies across external national ancillary programs and internal cross organizational areas.
Previous experience in externally facing role in an account team management environment.
Demonstrated excellent verbal, written, interpersonal, analytical, and negotiation skills.
Strong presentation skills: ability to speak clearly and concisely to influence others.
A strong leader able to influence others and operate effectively at all levels of an organization.
Comfortable interacting with senior leaders both internally and externally
Strong account and project management skills; Ability to multitask across multiple initiatives of varying complexity, at any given time. Six sigma training helpful.
Strong analytical and problem-solving skills; must be able to systematically analyze and resolve complex problems cross organizationally.
Excellent organizational skills including proven ability to utilize resources, prioritize, manage and meet multiple deadlines.
National travel required (25-30%)
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 106,400 - 177,300 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 Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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: [email protected] for support. Do not email [email protected] 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 StateCheck More Finance & Banking Jobs
Apply Now
WORK LOCATION: REMOTE position
The National Ancillary Medicare Advantage (MA) Provider Contracting Senior Advisor is a critical contributor to Cigna's enterprise quality and affordability initiatives. The National Ancillary MA team currently manages greater than 80 national contracts including clinical programs, MA Supplemental benefits, and direct provider agreements.
This role operates at a strategic level engaging directly with Senior Leadership from Legal, Compliance, Network, Product, Clinical and Strategic Sourcing; and is responsible for negotiating Medicare Advantage national contracts within specified service segments, drive operational efficiencies, evolve vendor / provider engagement model, supports implementation of strategic priorities, and ensure value realization.
This role collaborates with multiple key business partners across the organization to Identify and implement affordability initiatives, negotiate contracts, monitor... performance, develop corrective action plans, drive business continuity, and ensure a successful Annual Enrollment. This position is internally and externally facing and will directly oversee relationships and/or programs within the Medicare Advantage Segment. This is a critical position on the NANPM Team and a direct report to the Senior Director of NANPM Medicare & Commercial Alignment. Experience with Medicare Advantage and /or the Government Business is required for success.
DUTIES AND RESPONSIBILITIES:
Works directly with external strategic partners / vendors to negotiate, manage, retain cost effective and quality programs.
Accountable for negotiation to deliver competitive reimbursement and drive financial performance of contracted vendor relationships
Engages Markets, Product and Clinical leaders to understand business needs, drive improvements and create win-win scenarios in new and existing spend categories
Responsible for advocating for external partnerships within Cigna MA while delivering on Cigna priorities.
Accountable for conveying Cigna MA, regulatory and other compliance standards and ensuring effective implementation
Collaborates with National Contracting Service & Operations team to create Corrective Action Plan (CAPs) and mitigation plans when needed.
Leads strategy development, improve operational performance, internal/external relationships across assigned national ancillary segment. Anticipates and mitigates downstream impacts to HCPs, Customers, and Clients. Removes barriers for service operations and improve vendor performance within assigned segments.
Serves as the Executive Liaison and single point of accountability for the programs impacting both the commercial and senior segments
Leads annual business reviews and quarterly Joint Operating Committee (JOC) meetings to include vendors and internal business partners
Monitors and understand Medicare Advantage policies, procedures, products, and strategies and how those impact or are impacted by national ancillary partners.
Contributes to national contracting strategy and collaborates with senior leadership both internally and externally to achieve total medical cost savings.
Responsible for collecting, documenting, and sharing market intelligence relative to their national ancillary segment; use market intelligence to inform strategy.
Provides oversight and management to assigned Book of Business (BoB) from implementation or re-implementation within required timelines and in accordance with regulatory requirements.
POSITION REQUIREMENTS:
Bachelor's degree or equivalent work experience; Master's degree preferred.
5+ years experience in Provider Contract negotiations, required
8+ years of experience in provider, client and customer relations, contracting or national ancillary account management environment.
Experience with Medicare Advantage - Supplemental Benefits, CMS guidelines, FDR Operations, Clinical Programs, STARS ratings, etc.
A broad, enterprise-wide view of the business and interdependencies across external national ancillary programs and internal cross organizational areas.
Previous experience in externally facing role in an account team management environment.
Demonstrated excellent verbal, written, interpersonal, analytical, and negotiation skills.
Strong presentation skills: ability to speak clearly and concisely to influence others.
A strong leader able to influence others and operate effectively at all levels of an organization.
Comfortable interacting with senior leaders both internally and externally
Strong account and project management skills; Ability to multitask across multiple initiatives of varying complexity, at any given time. Six sigma training helpful.
Strong analytical and problem-solving skills; must be able to systematically analyze and resolve complex problems cross organizationally.
Excellent organizational skills including proven ability to utilize resources, prioritize, manage and meet multiple deadlines.
National travel required (25-30%)
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 106,400 - 177,300 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 Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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: [email protected] for support. Do not email [email protected] 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 StateCheck More Finance & Banking Jobs
Apply Now