Provider Contracting Manager, Eastern PA market - Cigna Healthcare - Philadelphia, PA

Provider Contracting Manager

The Provider Contracting Manager serves as an integral member of the Provider Contracting Team and reports to the AVP, Provider Contracting. This role assists in developing the strategic direction and management of the day to day contracting and network management activities for a local given territory.

Duties and responsibilities include :

• Managing complex contracting and negotiations for fee for service and value-based reimbursements with hospitals and other providers.
• Building relationships that nurture provider partnerships and seeking broader value-based business opportunities to support the local market strategy.
• Initiating and maintaining effective channels of communication with matrix partners.
• Contributing to the development of alternative network initiatives.
• Working to meet unit cost targets while preserving an adequate network.
• Creating and managing initiatives that improve total medical cost and quality.
• Driving change with external provider partners.
• Preparing, analyzing, reviewing, and projecting financial impact of larger or complex provider contracts.
• Creating healthcare provider agreements.
• Assisting in resolving elevated and complex provider service complaints.
• Managing key provider relationships.
• Demonstrating knowledge of providers in an assigned geographic area.
• Responsible for accurate and timely contract loading and submissions.
• May provide guidance or expertise to less experienced specialists.

Position requirements include :

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.