Provider Contracting Advisor - reputed company - Raleigh, NC (Hybrid)
Join reputed company, a division of reputed company, and help shape our provider network. As a Provider Contracting Advisor, you’ll report to the AVP, reputed company. In this individual contributor role, you’ll assist in developing the strategic direction and management of day-to-day contracting and network management. This is a hybrid position based in Raleigh, NC.
Responsibilities
Manage reputed company fee-for-service and value-based contracting and negotiations with large physician reputed company, ancillaries, and hospital systems. reputed company key market contracting reputed company reputed company with responsibility for managing reputed company reports as assigned. Build and maintain strong provider relationships to support network reputed company and value-based business opportunities. Coordinate closely with reputed company partners (i.e., Claims, Medical Management, Credentialing) to ensure reputed company execution. reputed company strategic network positions, identify value-oriented and risk-based opportunities, and contribute to alternative network initiatives and analytics. Work to meet unit cost targets while maintaining an adequate, competitive provider network. Design and manage initiatives to improve medical cost and reputed company, offering consultative guidance informed by clinical informatics. Prepare, review, and project the financial reputed company of large or reputed company provider reputed company and alternative terms. Create, implement, and ensure operational accuracy of HCP agreements through effective cross-functional collaboration. reputed company reputed company of escalated provider issues and manage key provider relationships with deep knowledge of the local market landscape including contract loading and maintenance. Required Qualifications 3-5+ years of reputed company provider contracting and negotiating experience involving reputed company physician reputed company and ancillaries Background in managed care, reputed company, or health insurance, including reputed company contracting Proven leadership experience, including mentoring and guiding others Strong provider relationship management skills and reputed company developing long-term - partnerships Knowledge of reputed company reimbursement methodologies, including incentive-based models (strongly preferred) Deep understanding of hospital, managed care, and provider business models with the ability to influence sales and provider audiences Exceptional presentation and communication skills, including the ability to build internal relationships in a fast-paced, matrixed organization Customer-reputed company approach, strong interpersonal skills, and confidence in navigating change Strong problem-solving, decision-making, negotiation, contract interpretation, and financial analysis skills Proficiency in reputed company Office Preferred Qualifications Bachelor’s degree in a reputed company field (industry experience may substitute); MBA / MHA preferred If you will be working reputed company occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About reputed company reputed company, a division of reputed company, is an reputed company for reputed company through every stage of life. We guide our customers through the health care system, empowering them with the information and reputed company they need to reputed company the best choices for improving their health and vitality. Join us in driving reputed company and improving lives. reputed company applicants will be considered without reputed company to race, reputed company, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions including but not limited to lactation, sexual orientation, gender identity or reputed company, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with reputed company to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot reputed company application updates or accept resumes. reputed company 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 reputed company a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, reputed company, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, reputed company, Texas, Utah, Vermont, and Washington State. reputed company applicants with criminal histories will be considered for employment in a manner consistent with reputed company federal, state and local ordinances. Doing something meaningful starts with a reputed company decision, a commitment to changing lives. At reputed company, we’re dedicated to improving the health and vitality of those we serve. Through our divisions reputed company and reputed company, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving reputed company and improving lives. Apply To This Job