Contract Manager, Hospital Negotiations

• Manages complex contracting and negotiations for fee for service and value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups)
• Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy
• Initiates and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service
• Manages strategic positioning for provider contracting, develops networks and identifies opportunities for greater value-orientation and risk arrangements
• Contributes to the development of alternative network initiatives. Supports and provides direction to develop network analytics required for the network solution
• Works to meet unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position
• Creates and manages initiatives that improve total medical cost and quality
• Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist with total medical cost initiatives
• Prepares, analyzes, reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms
• Creates “HCP” agreements 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. Researches 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 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
• May provide guidance or expertise to less experienced specialists

• 3+ years Hospital contracting and negotiating experience involving complex delivery systems and organizations required
• Experience in developing and managing key provider relationships
• Knowledge of complex reimbursement methodologies, including incentive based models strongly preferred
• Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners
• Intimate understanding and experience with hospital, 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 both sales and provider audiences through strong written and verbal communication skills. Experience with formal presentations
• Customer centric and interpersonal skills are required
• Demonstrates managerial courage as well as an ability to maneuver effectively in a changing environment
• Superior problem solving, decision-making, negotiating skills, contract language and financial acumen
• Knowledge and use of Microsoft Office tools
• Should possess a bachelor’s degree
• preferably in the areas of Finance, Economics, Healthcare or Business related. Significant industry experience will be considered in lieu of a bachelor’s degree. MBA or MHA preferred

MBA or MHA preferred

• Annual bonus plan
• Health-related benefits including medical, vision, dental, and well-being and behavioral health programs
• 401(k)
• Company paid life insurance
• Tuition reimbursement
• A minimum of 18 days of paid time off per year
• Paid holidays