Medicare Advantage Provider Contracting Senior Advisor – TX, CO, UT, AZ & NV – Cigna Healthcare – Remote

The Provider Contracting Senior Advisor is a key contributor to the development of the strategic direction and is accountable for the management of value based contracting and network management activities in the assigned market. The West Market includes Texas, Colorado, Utah, AZ and Nevada.

Core Responsibilities

Successfully execution of standard MA value-based provider contracts and the funds flow within these arrangements, supporting prior and post contract signature.

Experience with leading complex contract negotiations for value-based and fee for service agreements with hospitals, PCPs, ancillary, and other provider types

Proactively builds relationships in existing and expansion markets to support the local market strategy and network development and management needs.

Drives effective communication with matrix partners including but not limited to, Market Leaders, Provider Relations, Claims Operations, Medical Management, Credentialing, Legal, Medical Economics, Compliance, Sales/ Marketing.

Identify and manages initiatives that meet network adequacy requirements, service accessibility, total medical cost, and quality

Prepares and analyzes the impact and/or trade-offs of complex provider contracts and alternate contract terms.

Assists in resolving elevated and complex provider service complaints. Researches problems and negotiates with internal/external partners/customers to resolve highly complex and/or escalated issues.

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

Minimum Requirements

Degree in Health Administration, Business Administration, or another related field (Master’s Degree desirable) and/or equivalent relevant experience in progressively responsible leadership roles focused on managed Medicare and provider engagement.

Experience from a large, complex managed care organization, health plan, or provider system with at least (5) five years of innovative Medicare risk, value-based, and/or fee-for-service contracting experience required

Strong financial and analytical skills.

In-depth knowledge of value-based reimbursement structures and payment methodologies is required.

Experience in developing and managing relationships across a cross-functional and matrixed environment

Effective communicator to both executives and external audiences, with strong interpersonal skills

Superior problem solving, decision-making, negotiating skills, contract language and financial acumen.

Knowledge and use of Microsoft Office tools

A team player with experience in complex environments with the ability to build consensus among competing interests and organizational needs.

Preferred: specialized knowledge and experience with configuration, claims, and downstream service and operating systems.

Location: Ideal candidate be located in or near the aligned market: Texas, Colorado, Utah, Arizona, Nevada or California.

If 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 106,400 – 177,300 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 Life at Cigna Group .

About Cigna Healthcare

Cigna 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.

Qualified applicants with criminal histories will be considered for employment in a manner

consistent with all federal, state and local ordinances.

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.