Provider Network Manager - Cigna Healthcare - Remote
This role is an individual contributor within the Nonpar Provider Contracting Team, supporting our enterprise strategy to deliver affordable, predictable, and simple health care. The position is responsible for prioritizing and negotiating nonpar single case agreements, ensuring compliance, and fostering strong partnerships with internal and external stakeholders.
Summary of Responsibilities
The Provider Network Manager (Provider Relations Sr. Analyst) skillfully navigates reimbursement conversations with nonpar health care professionals while providing exceptional service. Responsibilities include negotiating reimbursement rates for nonpar health care providers, utilizing excellent verbal and written communication skills, partnering with internal teams to resolve complaints and disputes, ensuring compliance with policies, procedures, and regulatory requirements, suggesting process improvements and fostering innovation, utilizing knowledge of medical terminology and standard reimbursement methodologies, and managing multiple priorities in a fast-paced environment.
Key Duties and Responsibilities
• Review and prioritize daily work assignments for timely single case agreement negotiation.
• Develop individual case pricing strategies and present to management and/or providers.
• Accurately document case outcomes in all systems and communicate results to stakeholders.
• Serve as team subject matter expert (SME) for highly complex cases.
• Support department goals contributing to organizational success.
• Communicate and collaborate effectively with internal and external partners.
• Adhere to all Compliance/Program Integrity requirements and HIPAA regulations.
• Promote professional growth through continuing education and skills development.
Qualifications
• Minimum 2+ years of experience in healthcare contracting, provider relations, or reimbursement negotiations required
• Demonstrated experience in interpreting and applying reimbursement methodologies.
• Proficiency in medical terminology and healthcare industry standards.
• Strong negotiation and conflict resolution skills.
• Advanced proficiency in Microsoft Office Suite (Excel, Word, Outlook).
• Ability to manage multiple priorities in a high-volume environment.
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 58,100 - 96,900 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.
At The Cigna Group, 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), 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, click here.
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 State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
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Summary of Responsibilities
The Provider Network Manager (Provider Relations Sr. Analyst) skillfully navigates reimbursement conversations with nonpar health care professionals while providing exceptional service. Responsibilities include negotiating reimbursement rates for nonpar health care providers, utilizing excellent verbal and written communication skills, partnering with internal teams to resolve complaints and disputes, ensuring compliance with policies, procedures, and regulatory requirements, suggesting process improvements and fostering innovation, utilizing knowledge of medical terminology and standard reimbursement methodologies, and managing multiple priorities in a fast-paced environment.
Key Duties and Responsibilities
• Review and prioritize daily work assignments for timely single case agreement negotiation.
• Develop individual case pricing strategies and present to management and/or providers.
• Accurately document case outcomes in all systems and communicate results to stakeholders.
• Serve as team subject matter expert (SME) for highly complex cases.
• Support department goals contributing to organizational success.
• Communicate and collaborate effectively with internal and external partners.
• Adhere to all Compliance/Program Integrity requirements and HIPAA regulations.
• Promote professional growth through continuing education and skills development.
Qualifications
• Minimum 2+ years of experience in healthcare contracting, provider relations, or reimbursement negotiations required
• Demonstrated experience in interpreting and applying reimbursement methodologies.
• Proficiency in medical terminology and healthcare industry standards.
• Strong negotiation and conflict resolution skills.
• Advanced proficiency in Microsoft Office Suite (Excel, Word, Outlook).
• Ability to manage multiple priorities in a high-volume environment.
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 58,100 - 96,900 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.
At The Cigna Group, 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), 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, click here.
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 State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
Apply tot his job
Apply To this Job