SummaryWe are seeking a highly motivated and innovative team member to join our growing and dynamic Global Data & Analytics team as a Provider Contract & Network Underwriting Advisor. In this role, you will conducts 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 our 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.ResponsibilitiesAnalyze impact to trends for facility contract negotiationsEffectively influence contracting in a strategic fashion and offer meaningful options during negotiations with a providerProvide ad hoc analysis and deep dives into data as appropriate to support negotiation and provide value to our contracting partnersSummarize and explain findings and recommendationsIndependently and effectively manage the planning process for assigned markets and drive the plan to meet overall corporate planning objectivesProactively identify opportunities for trend reduction and engage contracting to build these into plan where appropriateKeep management informed as to the progress of Plan and proactively identify risk and opportunities for meeting the plan resultsQualifications5+ years' of experience in health care/managed care work experienceStrong Experience with various data mining and reporting tools, such as Microsoft Excel skills Microsoft Access, or SAS/SQL languageExperience in TMC and/or Contract Underwriting preferredExperience working with claim data and familiarity with standard medical coding: CPT, ICD9, HCPC preferredUnderstanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, and utilization managementStrong analytical and problem solving skillsStrong communication skills to include written, oral and group presentationAbility to work independently while managing multiple tasks and meeting deadlinesIf 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 96,000 - 160,000 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 .About Cigna HealthcareCigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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.Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
