Provider Relations Representative, Sr. jobs in Philadelphia, PA

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SUMMARY:

This position is an external provider facing role with account management responsibilities for a medium to low complex book of business. The territory for this role is Delaware and Pennsylvania, and the candidate MUST sit in one of those two states. The role is accountable for the overall provider experience by working in collaboration with matrix partners to drive on-going service improvements, understand, articulate and resolve service impacts, and drive the overall provider strategic planning solutions. This individual is empowered within their scope to make decisions as it pertains to the experience with Cigna, is required to have local market knowledge and visibility, builds and continuously improve the relationship between Cigna and the provider.

*A note to internal candidates:

This role is set to convey and is open to all Cigna employees, including those already designated to move with HSCS. Please contact recruiter Betsy DeFelice with any questions.

DUTIES AND RESPONSIBILITIES:

• Accountable for the end-to-end provider experience and overall service delivery for assigned Book of Business aligned to medium to low complex providers
• Leads, collaborates, and supports local market direction as it relates to improving the provider experience
• Creates and maintains individual provider strategic action plans
• Proactively identify new opportunities and risks for providers at market or national level and drives resolution
• Exercises good judgment and discretion to support the provider experience
• Responsible for capturing, documenting, and sharing market intelligence; use market intelligence to develop and drive strategic improvements
• External facing with providers in assigned BOB
• Collect, analyze, interpret, translate and distribute provider informatics, reports, dashboards
• Track and monitor performance guarantees for assigned BOB
• Promotes Provider Index score improvement through proactive and effective service and support of network
• Review provider reports/dashboard with individual providers                                            
• Proactively educate providers on Cigna's business objectives, standard operating procedures, policies and programs to influence behavior and how to work with Cigna
• Serve as a provider advocate both internally and externally
• Understands and applies service culture principles and methodology
• Serves as a provider advocate both internally and externally
• Serves in a consultative role or subject matter expert to key matrix partners
• Develops and participates in presentations to existing and prospective providers and/or clients
• Serves as advocate in external community, representing CIGNA to medical societies and external provider associations.
• Manage joint operating committees, including agenda development, facilitating appropriate meeting participation and follow up activities

PREFERRED QUALIFICATIONS:                                                                            

• College degree preferred or equivalent work experience.
• 5 years of experience in provider relations or health care
• Demonstrated excellent oral, written, interpersonal, analytical, and negotiation skills.
• Ability to use PC software and multiple Cigna systems.
• Understanding of medical insurance products and associated provider issues
• Ability to lead an account management team
• Ability to work in a matrix environment.
• >25% travel  

Please note that you must meet our posting guidelines to be eligible for consideration.  Policy can be reviewed at this link.