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Home » Cigna Internships Summer 2023 – Provider Contracting Lead Analyst In Hartford

Cigna Internships Summer 2023 – Provider Contracting Lead Analyst In Hartford

    Website Cigna

    Job Description:

    Negotiate physician/large group/ancillary provider contracts for assigned territory. Responsible for contract management with assigned providers as well as executing with provider on health plan initiatives.

    Job Responsibilities:

    • Responsible for assisting with the general oversight of provider network in assigned territory, to include financial performance, provider data accuracy and trend analysis.
    • Responsible for collaborating with management on strategic plans on growth, development, and vision for assigned territory.
    • Expected to assist in managing key partner relationships for assigned territory.
    • Educate providers on health plan updates and policies
    • Responsible for ensuring provider updates are processed correctly and communicated back to necessary provider groups, as well as assistance with provider questions, grievances, and issues (claims, referrals, etc.).
    • Creates and manages initiatives that improve total medical cost and quality.
    • Drives change with health system by assessing clinical informatics and offering consultative expertise to assist with total medical cost initiatives.
    • Assist in reviews, and projects with financial impact of larger or complex issues arising from contract terms.
    • Assists in resolving elevated and complex provider service complaints. Researches problems and negotiates with internal/external partners/customers to resolve highly complex and/or escalated issues.
    • Responsible for accurate and timely contract loading and submissions and interface with matrix partners for network implementation and contract maintenance.

    Job Requirements/Qualifications:

    • Bachelor’s Degree or equivalent, relevant work experience.
    • At least three years related experience. Demonstrated knowledge of contracting process
    • At least 3 years provider contracting, provider relations and/or payor related experience.
    • Proficient at Microsoft Office products, particularly Excel and PowerPoint.
    • Excellent communication skills.

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