Provider Contracting Senior Analyst - Cigna Healthcare - Remote

This position can be located anywhere in the USA

Summary

This role delivers professional activities in the Provider Contracting job family.

The position is responsible for dental provider recruitment and contracting as well as managing contracted provider relationships for a specified territory.

Conducts daily outreach to dental offices or providers to develop and maintain positive relationships with the purpose of negotiating a contract for participation in our dental networks.

Ability and willingness to travel frequently within the US including overnight stays.

Conduct quality reviews of Practitioner and/or Facility/Ancillary contracts.

Conducts comparison of contract data relative to provider data and/or demographic and reimbursement data submitted for processing.

Assesses the accuracy of provider data processed in accordance with documented and standard operating policies and procedures.

Applies standard techniques and procedures to routine instructions that require professional knowledge in specialist areas.

Provides standard professional advice and creates initial reports/analyses for review.

May provide guidance, coaching, and direction to more junior members of the team in the Network Management Organization.

Responsibilities:


* Recruiting providers to join Cigna's dental networks (PPO & DHMO):
+ Field Recruitment: Candidates will visit offices in person(25-50% travel)
+ Outbound Calling: Candidates will follow up with visited offices via phone at home


* Identifying, recruiting, contracting, and retaining qualified health care professionals in geographic area within established guidelines to meet health plan needs


* Achieve competitive and cost-effective contracts in assigned areas or assigned client/customer needs


* Negotiate contracts and recruit dental providers to become a Cigna PPO and/or DHMO network provider.


* Explain plans, policies, and procedures to potential providers


* Maintain positive relationships with health care professionals and their office staff extending high quality service


* Conduct negotiations and ensure the smooth operation and administration of provider agreements


* Support and retention of offices in our dental networks


* Complete onsite quality assessments


* Respond to provider inquiries, concerns, complaints, appeals and grievances


* Provide ongoing product education to dentists and their staff


* Work to achieve contract discounts with new providers and current providers through thoughtful negotiation


* Use data and facts to identify and overcome objections


* Prioritize and organize own work to meet deadlines, and reach established personal and department goals


* Conduct ongoing support to contracted providers in our networks via telephone or by personal relationship visits.

Requirements:


* High School Diploma or equivalent required


* 1-3 year plus experience in healthcare administration or provide...