Regional Medicare Provider Contracting Senior Manager - Midwest - Cigna Healthcare - Hybrid

The Regional Medicare Provider Contracting Senior Manager - Midwest serves as an integral member of the Network Development and Solutions Team and reports to the Medicare Provider Contracting Regional Vice President.  This role is a key contributor to the development of the strategic direction of assigned markets and is accountable for the management of value-based and fee-for-service contracting and network management activities for multiple local geographies.

DUTIES AND RESPONSIBILITIES

• Directly manages a contracting team and geography, providing leadership and mentoring to their direct reports.
• Manages increasingly complex contracts and negotiations for fee-for-service and sophisticated value-based reimbursements with hospitals and other providers for Cigna’s  Medicare product lines (e.g., Hospital systems, ancillaries, and large physician groups) for one or more geographies.
• Proactively builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
• Initiates, nurtures, and maintains effective channels of communication with matrix partners including but not limited to, local market provider engagement, claims operations, clinical, Legal, analytics, compliance, sales, and provider relations.
• Manages strategic positioning for provider contracting, develops networks, and identifies and acts upon opportunities for greater value-orientation.
• Identifying and implementing alternative network initiatives. Supports and provides direction to develop network analytics required for the network solution.
• Responsible for meeting unit cost targets, while preserving an adequate and marketable network, to achieve and maintain Cigna's competitive position.
• Identify and manages initiatives that improve total medical cost and quality.
• Prepares, analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms.
• Creates and/or oversees the development of Provider agreements (ie: Hospital systems, ancillaries, and physician groups) that meet internal operational standards and external provider expectations. Ensures the accurate implementation, and administration through matrix partners. 
• Assists in resolving elevated and complex provider service complaints. Research problems and negotiates with internal/external partners/customers to resolve highly complex and/or escalated issues.
• Manages key provider relationships and is accountable for critical interface with providers and business staff.
• Demonstrates comprehensive knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape.
• Responsible for accurate and timely contract loading and submissions and interface with matrix partners for network implementation and maintenance

POSITION REQUIREMENTS

• Location: Individual must be located in Illinois or Missouri (or surrounding states, open to travel).
• Should possess a bachelor’s degree; preferably in the areas of Finance, Economics, Healthcare or Business related. MBA or MHA preferred.
• 5+ years Contracting and negotiating experience involving complex delivery systems and organizations required. Medicare Advantage experience required.
• Experience with Physician, Hospital and Ancillary group contracting and negotiations.
• Prior experience managing direct reports.
• Experience in developing and managing key provider relationships including senior executives.
• Knowledge of complex reimbursement methodologies, including incentive based models required.
• Demonstrated experience in seeking out, building, and nurturing strong external relationships with provider partners.
• Intimate understanding and experience with larger, more complex integrated delivery systems, managed care, and provider business models.
• Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization.
• The ability to influence provider audiences through strong written and verbal communication skills. Experience with formal presentations.
• Customer centric and interpersonal skills are required.
• Demonstrates managerial courage and change leadership in a dynamic environment.
• Superior pro