Provider Relations Representative jobs in North Carolina

Job summary

As a Provider Relations Specialist you will be part of the Provider Services Organization, being responsible to manage the relationship with Health Care Providers of European network. You will work very closely with peers and stakeholders strategically positioned across the globe.

Key to the role will be the end-to-end journey, managing the partnership with health provider accounts, such as hospitals and clinics and support their journey from the on-boarding, supporting on the daily / monthly interactions with Cigna, educate them to navigate Cigna operating model, monitoring their performance, and driving engagement initiatives.

Your role includes:

• Accountable to enable an effective and efficient collaboration with health providers in order to deliver a best in class customer experience through the partnership with our providers.

• Secure a smooth on-boarding and day-to-day operational maintenance of provider relationships.

• Conducts all aspects of health care professional education for existing and newly contracted health care professionals as pertinent in the region to remove potential roadblocks preventing a successful partnership, including but not limited to:

  • Onboarding and overview of member identification and eligibility process

  • Claims submission.

  • Cigna operating model

  • Training in legacy portal and on-board of selected providers into new provider portal

  • Communication channels

• Manage the ongoing relationship and handling day-to-day operations directly with health care providers, including the follow up, negotiation and resolution of potential complaints, escalations, suspensions or threats.

• Responsible to enable an effective and efficient collaboration with health providers through monitoring and analyzing the Operations KPIs, the results of the reconciliation of the accounts and others in order to provide a comprehensive support on their interpretation and assurance of further follow up if needed.

• Strive for continuous service improvement via analyses of root causes and proactive implementation of initiatives driven by outcome obtained  through data and feedback gathered through reconciliation results, complaints or other sources, continuous service delivery improvement through BAU collaboration with different teams;

• Active communication and prompt follow up combined with regular meetings with your dedicated health care providers.

• Consolidated feedback to PS management team

• Continuous improvement and maintenance of provider communications channels taking into consideration the local habits and practices.

• Proactive education to providers on the way to work with Cigna, including the roll out of new processes.

• Provider visits as applicable

YOUR PROFILE

• If internal 1 years of Cigna experience, relevant experience in other functions/companies, and a strong performance track record.

• If external, at least 2 years of experience in Operations, Data analysis, Marketing/Communications or Relationship Management, with operational and customer/provider-facing experience profile.

• Proficient in English and other European language (s) such as German/ French/ Portuguese/ Italian; additional language is a plus.

• Strong analytical and problem-solving skills.

• International mind-set able to work remotely with colleagues, partners and providers across the globe.

• Striving for excellent service to our members, clients and providers is part of your DNA.

• Strong can-do attitude, and high qualification in relationship management, including a broad understanding of multicultural behaviors.

• Action-orientated problem-solving attitude

• Excellent organization, planning and prioritization skills to meet deadlines.

• Experience in complaint management - with a proven track record in improving customer service standards.

• Ability to assess the situation/issue, carry out appropriate research, gather the relevant data and provide constructive feedback on the outcome.

• Accountability – to assume ownership for achieving personal results and to contribute for collective team goals.

• Excellent communication skills – verbal, written and presentation. 

• Be a positive role model and be able to work independently and in conjunction with co-workers of all levels.

• Experience interpreting data, drafting reports.

• Strong practical knowledge of MS Office applications, including Excel.

• Availability to travel 10% of your time (estimation)

About Cigna Healthcare

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: SeeYourselfEMEA@cigna.com for support. Do not email SeeYourselfEMEA@cigna.com for an update on your application or to provide your resume as you will not receive a response.