Provider Relations Sr. Analyst - Remote at Cigna in Bloomfield, Connecticut

Job Description:

This role is an integral part of Provider Relations & Operations aligned in supporting the Medicare Advantage provider community driving an improved provider experience for providers in an assigned market. Primary responsibilities include providing issue resolution for escalated inquiries in accordance with standard operating procedures, to include, thorough research and investigation of the issue, tracking interactions, collaborating with matrix partners, and performing critical thinking methodologies for root cause analysis and prevention of recurrence. In addition this role will have external provider facing responsibilities communicating and education providers.

RESPONSIBILITIES:

• Supports an intake process to review and resolve provider inquiries for an aligned market(s) includes research, root cause, resolution and/or triage to appropriate team in timely manner


• Accountable to servicing the provider to include face to face education, root cause analysis, and resolution.


• Initiates and maintains effective channels of communication with internal matrix partners.


• Manage regulatory and escalated matters to defined service level agreements


• Effectively engage in face-to-face, virtual and written communication


• Collaborate internally to share provider feedback and assist with strategies to help mitigate downward trends and expand momentum on positive trends


• Educate providers on Cigna's business objectives, standard operating procedures, policies and programs available through tools such as Cigna Network Newsletter, vendor updates, coverage policies and digital solutions


• Participates, collaborates, and supports strategic projects as determined by Medicare Provider Relations Operations Manager


• Serves as a provider advocate both internally and externally


• Participate in market and team meetings to share findings.


• Monitors and tracks all service issues and inquiries in the appropriate tools.


• Responsible for meeting internal metrics around service goals


• Other duties as assigned

QUALIFICATIONS:

• Bachelor's degree or higher strongly preferred or equivalent work experience required


• 3+ years of Medicare Claims, Network Operations, or Contracting experience highly preferred


• Knowledgeable in Medicare contracts and associated provider issues


• QNXT and ONBASE experience preferred


• Experience with MS Office - Word, Excel, Outlook


• Ability to effectively work within a heavily matrixed and culturally diverse environment


• Ability to problem solve


• Ability to manage multiple priorities


• Ability to learn and apply quickly


• Strong collaboration, communication and listening skills


• Strong planning and organization skills


• Flexibility as we grow new tools and implement process improvement


• Up to 15% travel may be required

CORE COMPETENCIES:

Collaboration

Plans and Aligns

Manages Complexity

Courage

Communicates Effectively

Interpersonal Savvy

Tech Savvy

Demonstrates Self-Awareness

Ensuers Accountability

Drive Results

Customer Focus

Optimize Work Processes

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.

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 The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com 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.