Provider Contract Analyst - WORK AT HOME - Evernorth
Cigna is seeking a highly motivated and innovative team member to join our growing and dynamic Digital & Analytics team as a Provider Contract & Network Underwriting Advisor concentrating on Individual & Family Plans (IFP) & Medicare Advantage. In this role, you will conduct hospital and professional provider contract underwriting/analysis, partnering with Contracting to deliver unit cost results in line with trend/cost expectations to ensure competitive positioning within the marketplace, assist contractors in creating network solutions and provider contracts to ensure Cigna’s competitive position in the market. You will use financial models to evaluate the impact of proposed terms on profitability, trend and other metrics. You will also partner with network management, medical management, and sales units to understand resulting medical expense results and improve future negotiation strategy.
This position is with Evernorth, a new business within the Cigna Corporation.
* Analyze impact to medical cost trends for facility contract negotiations
* Effectively influence contracting in a strategic fashion and offer meaningful options during negotiations with a provider
* Manage the contract analysis pipeline across all established markets ensuring analytics are completed promptly and accurately
* Partner with the Market Presidents, BFOs, and contracting teams to quantify the impact of changes to provider contracts and networks
* Provide ad hoc analysis and deep dives into data as appropriate to support negotiation and provide value to our contracting partners
* Summarize and explain findings and recommendations to drive decision making
* Independently and effectively manage the planning process and drive the plan to meet overall corporate planning objectives
* Proactively identify opportunities for trend reduction and engage contracting to build these into plan where appropriate
* Keep management informed as to the progress of Plan and proactively identify risk and opportunities for meeting the plan results
* Work with PCD and Pro fee analysts to oversee corrections and update to forecasting tools
* At least 3+ years of experience in health care/managed care work experience
* Basic to Intermediate level SQL knowledge preferred
* Experience in TMC and/or Contract Underwriting preferred
* Prior Medicare Advantage experience and familiarity with Medicare payment methodologies strongly preferred
* Strong analytical and problem solving skills
* Can independently perform analyses and apply statistical models to validate / interpret results
* Strong communication skills to include written, oral and group presentation
* Understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, and utilization management
* Ability to work independently while managing multiple tasks and meeting deadlines
* Experience working with claim data and familiarity with standard medical coding such as CPT, ICD9, HCPC and/or DRG
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 94,300 - 157,100 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.
Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you’ll enjoy meaningful career experiences that enrich people’s lives. What difference will you make?
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.
Cigna 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.