- Defined point of contact for health plan/provider relationship regarding contract administration, data integrity, financial performance, HEDIS and STARs performance, data sharing, operational improvements, and other areas as they relate to provider performance, provider experience and operational excellence.
- Ensures contracts are operationalized from contracting through implementation, leveraging standardized tools and overseeing operational processes end to end.
- Acts with urgency to research questions or procedural issues; identifies the right resources to resolve concerns and follows up to drive resolution. Provides on-going feedback across organizational levels to ensure seamless adoption of procedures and policies.
- Prepares and presents executive level materials for Joint Operations Committee meetings, Health System Senior Leadership meetings, and Cigna Medicare and Commercial leaders.
- Expert proficiency in value-based performance and concepts to drive increased provider performance.
- Coordinates heavily with local market enablement teams to ensure operational consistency for national agreements and in providing service excellence for national partners. Provides day-to-day direction to local market network operations and contracting support roles for national agreements.
- Individual contributor, able to work in a highly matrixed role with only need for expert-level technical support. Must work by influence/building relationships with others and ensuring effective and positive relationship across Cigna organization.
- Bachelor's degree strongly preferred
- 4+ years relevant experience with managed Medicare and provider engagement
- Experience in provider performance & enablement (PPE). Knowledge of value-based reimbursement structures and payment methodologies for providers is required.
- An influential team player with experience navigating complex environments to build consensus among divergent interests and competing organizational needs. Able to share knowledge and coach individuals with varying levels of experience.
- Exemplifies organizational agility; is skilled at identifying solutions and solving translational problems.
- Possesses excellent written and verbal communication skills, spanning providers to system leaders.
- Preferred: Expertise in provider group settings, ability to create presentations based on data analysis, familiar with health plan sales schedule, capability to interpret and present on matrix partner functions
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Medicare National Value-Based Account Owner - Remote, United States - The Cigna Group
Description
The job profile for this position is Network Operations Lead Analyst, which is a Band 3 Senior Contributor Career Track Role.Excited to grow your career?
We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply
Our people make all the difference in our success.
What You'll Do
The National Value-Based Contracting Account Owner position is an integral member of the National Network team and will be responsible for ensuring smooth end-to-end administration of contract operations for Cigna Medicare's most advanced value-based provider partnerships and health systems. You must possess the energy to mobilize a matrixed team responsible for complex engagement of full risk providers. Role will serve as liaison between provider partners and Cigna organization. Commitment to providing excellent provider experience is required.
Where You'll Focus Your Time:
Qualification:
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.
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.Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.
