National Ancillary Provider Contractor - Medicare Advantage - Remote

This is a Medicare Advantage position

WORK LOCATION: REMOTE position

The National Ancillary Medicare Advantage (MA) Provider Contracting Senior Advisor is a critical contributor to Cigna's enterprise quality and affordability initiatives.  The National Ancillary MA team currently manages greater than 80 national contracts including clinical programs, MA Supplemental benefits, and direct provider agreements.

This role operates at a strategic level engaging directly with Senior Leadership from Legal, Compliance, Network, Product, Clinical and Strategic Sourcing; and is responsible for negotiating Medicare Advantage national contracts within specified service segments, drive operational efficiencies, evolve vendor / provider engagement model, supports implementation of strategic priorities, and ensure value realization.

This role collaborates with multiple key business partners across the organization to Identify and implement affordability initiatives, negotiate contracts, monitor performance, develop corrective action plans, drive business continuity, and ensure a successful Annual Enrollment.  This position is internally and externally facing and will directly oversee relationships and/or programs within the Medicare Advantage Segment.  This is a critical position on the NANPM Team and a direct report to the Senior Director of NANPM Medicare & Commercial Alignment.  Experience with Medicare Advantage and /or the Government Business is required for success. 

DUTIES AND RESPONSIBILITIES:

• Works directly with external strategic partners / vendors to negotiate, manage, retain cost effective and quality programs.

• Accountable for negotiation to deliver competitive reimbursement and drive financial performance of contracted vendor relationships

• Engages Markets, Product and Clinical leaders to understand business needs, drive improvements and create win-win scenarios in new and existing spend categories

• Responsible for advocating for external partnerships within Cigna MA while delivering on Cigna priorities.

• Accountable for conveying Cigna MA, regulatory and other compliance standards and ensuring effective implementation

• Collaborates with National Contracting Service & Operations team to create Corrective Action Plan (CAPs) and mitigation plans when needed.

• Leads strategy development, improve operational performance, internal/external relationships across assigned national ancillary segment.  Anticipates and mitigates downstream impacts to HCPs, Customers, and Clients. Removes barriers for service operations and improve vendor performance within assigned segments.  

• Serves as the Executive Liaison and single point of accountability for the programs impacting both the commercial and senior segments

• Leads annual business reviews and quarterly Joint Operating Committee (JOC) meetings to include vendors and internal business partners

• Monitors and understand Medicare Advantage policies, procedures, products, and strategies and how those impact or are impacted by national ancillary partners. 

• Contributes to national contracting strategy and collaborates with senior leadership both internally and externally to achieve total medical cost savings.

• Responsible for collecting, documenting, and sharing market intelligence relative to their national ancillary segment; use market intelligence to inform strategy.

• Provides oversight and management to assigned Book of Business (BoB) from implementation or re-implementation within required timelines and in accordance with regulatory requirements.

POSITION REQUIREMENTS:

• Bachelor’s degree or equivalent work experience; Master’s degree preferred. 

• 5+ years experience in Provider Contract negotiations, required

• 8+ years of experience in provider, client and customer relations, contracting or national ancillary account management environment.

• Experience with Medicare Advantage – Supplemental Benefits, CMS guidelines, FDR Operations, Clinical Programs, STARS ratings, etc.

• A broad, enterprise-wide view of the business and interdependencies across external national ancillary programs and internal cross organizational areas. 

• Previous experience in externally facing role in an account team management environment.

• Demonstrated excellent verbal, written, interpersonal, analytical, and negotiation skills.

• Strong presentation skills: ability to speak clearly and concisely to influence others.

• A strong leader able to influence others and operate effectively at all levels of an organization.

• Comfortable inter