CrawlJobs Logo
The Cigna Group Logo The Cigna Group · -

Provider Contracting Advisor

United States of America, Pittsburgh Employment contract · Job Posted July 03, 2026
Apply Position
Job Link Share

Job Description

Join Cigna Healthcare, a division of The Cigna Group, and help shape our provider network in our Western PA and West Virginia markets! As Provider Contracting Advisor, you’ll serve as an important part of the Provider Contracting Team and report to the AVP, Provider Contracting. In this role, you’ll assist in developing our strategic direction and manage the day-to-day contracting and network management activities for the local market.

Job Responsibility

  • Manage complex fee-for-service and value-based contracting, reimbursements, and negotiations with hospitals and physician groups
  • Build and maintain strong provider relationships to support network growth and value-based business opportunities
  • Partner closely with matrix teams (e.g., Claims, Medical Management, Credentialing) to ensure aligned execution
  • Develop strategic network positions, identify value-based and risk-based opportunities, and contribute to alternative network initiatives and analytics
  • Meet unit cost goals while maintaining an adequate and competitive provider network
  • Design and manage initiatives to improve medical cost and quality, providing consultative guidance informed by clinical informatics
  • Prepare, review, and project the financial impact of complex contracts
  • Draft and manage healthcare provider (HCP) agreements through effective cross-functional collaboration
  • Lead the resolution of issues and manage key provider relationships, demonstrating deep knowledge of the local market landscape, including contract implementation and maintenance
  • Research problems and negotiate with partners and customers to resolve complex and escalated issues
  • Support less experienced staff as needed

Requirements

  • 3+ years of managed care contracting and negotiating experience involving complex delivery systems and organizations
  • Strong provider relationship management skills, with demonstrated success building long-term external partnerships
  • Knowledge of complex reimbursement methodologies, including incentive-based models (strongly preferred)
  • Deep understanding of hospital, managed care, and provider business models
  • Strong presentation and communication skills, including the ability to build internal relationships in a fast-paced, matrixed organization
  • Customer-centric approach with strong interpersonal skills and comfort navigating change
  • Strong problem-solving, decision-making, negotiation, contract interpretation, and financial analysis skills
  • Proficiency in Microsoft Office

Nice to have

  • Bachelor’s degree in a related field (industry experience may substitute)
  • MBA or MHA
The Cigna Group - All Job Offers

Looking for more opportunities?

Search for other job offers that match your skills and interests.

Suggested Tags: Frontend Developer Secretary Talent Manager Salesforce Administrator Data Analyst
Similar Jobs for

Provider Contracting Advisor

8 matching positions

Provider Contracting Advisor

Location
Location
United States of America , Cleveland
Salary
Salary:
92000.00 - 153300.00 USD / Year
thecignagroup.com Logo
The Cigna Group
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor's Degree preferred. Industry experience will be considered in lieu of a degree. MBA or MHA preferred.
  • 3+ years Managed Care 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 an ability to maneuver effectively in a changing environment.
Job Responsibility
Job Responsibility
  • Manages complex contracting and negotiations for fee for service and value-based reimbursements with hospitals and other providers
  • 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
  • Contributes to the development of alternative network initiatives
  • 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
  • Prepares, analyzes, reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms
  • Creates healthcare provider agreements that meet internal operational standards and external provider expectations
  • Assists in resolving elevated and complex provider service complaints
What we offer
What we offer
  • medical
  • vision
  • dental
  • 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
  • annual bonus plan
  • Fulltime
Read More
Arrow Right

Provider Contracting Advisor

The Provider Contracting Advisor serves as an integral member of the Provider Co...
Location
Location
United States of America , Columbus, OH
Salary
Salary:
92000.00 - 153300.00 USD / Year
thecignagroup.com Logo
The Cigna Group
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor's Degree preferred. Industry experience will be considered in lieu of a degree. MBA or MHA preferred.
  • 3+ years Managed Care 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 an ability to maneuver effectively in a changing environment.
Job Responsibility
Job Responsibility
  • 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.
  • 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 healthcare provider 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.
What we offer
What we offer
  • Annual bonus plan.
  • Health-related benefits including medical, vision, dental, and well-being and behavioral health programs starting day one.
  • 401(k)
  • Company paid life insurance
  • Tuition reimbursement
  • A minimum of 18 days of paid time off per year
  • Paid holidays.
Read More
Arrow Right

Provider Network Operations Advisor

Join our team as a Provider Network Operations Advisor, playing a key role in cr...
Location
Location
United States , Richmond
Salary
Salary:
Not provided
thecignagroup.com Logo
The Cigna Group
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor's degree or equivalent experience required
  • 5+ years of experience in provider network management or healthcare insurance
  • Project management experience preferred
  • Strong analytical, problem-solving, and critical-thinking skills
  • Excellent communication, stakeholder management, and organizational skills
  • Healthcare compliance and regulatory experience preferred
  • Knowledge of CMS regulations, NSA, and reimbursement structures preferred
  • Ability to work independently and manage multiple priorities
  • Proficiency in Microsoft Office
  • Cigna systems experience preferred
Job Responsibility
Job Responsibility
  • Support the management and implementation of provider, hospital, and ancillary networks by researching and resolving provider data issues, including demographic, claims, and system loading errors
  • Troubleshoot issues escalated by Market Network Advisors using Cigna systems such as HCPM, Cognos, and the Developer Database
  • Respond to questions from the Contracting team and matrix partners related to provider locations, policies, and data accuracy
  • Perform rate and fee schedule audits upon request
  • Support accurate loading of provider contracts and reimbursement methodologies
  • Create, manage, and maintain Market Guidebooks, including rate updates, provider inclusion/exclusion, and audit documentation
  • Advise Market leadership and the National Alternative Access Network Manager on market-specific network dynamics
  • Participate in quarterly reviews, identify corrections, and assist with provider terminations, additions, and updates
  • Serve as the market subject matter expert for Alternative Access Networks, including inclusion/exclusion criteria and anchor providers
  • Develop and maintain the AAN field guide for Contracting teams
  • Fulltime
Read More
Arrow Right
New

Upstream Commercial Advisor

You will join the Upstream business unit that develops a competitive and unique ...
Location
Location
Brazil , Rio de Janeiro
Salary
Salary:
Not provided
https://www.galp.com/ Logo
Galp
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Master's in law, economics and finance, engineering and/or others
  • Strong oral and written English communication skills with proficiency in Microsoft Office tools
  • Proven experience (+5 years) in upstream contracts negotiation
  • Attention to detail, curiosity and creativity with problem solving mindset
  • A great communicator and good at managing external and internal stakeholders
  • Available for occasional travelling
  • Ability to handle different projects simultaneously and provide deliverables under tight deadlines
  • The successful candidate is expected to have prior experience with and a strong working knowledge of the principal contractual and commercial arrangements used in the upstream oil and gas industry, including Joint Operating Agreements (JOAs), Unit Operating Agreements (UOAs), unitization agreements, redetermination processes, and other industry-standard governance and operating frameworks
Job Responsibility
Job Responsibility
  • Lead and support complex commercial negotiations with joint venture partners, regulatory agencies, government authorities, and other external stakeholders
  • Coordinate multidisciplinary teams and ensure alignment across technical, legal, finance, strategy, and operational functions throughout negotiation and decision-making processes
  • Manage key internal and external stakeholders, balancing commercial objectives with business, regulatory, and partnership requirements
  • Structure, negotiate, and implement commercial agreements supporting the Upstream portfolio across different jurisdictions
  • Contribute to the assessment of new business opportunities, supporting origination, business development, farm-in/farm-out processes, and strategic growth initiatives
  • Perform commercial and strategic analyses to support investment decisions, portfolio management, and value creation initiatives
  • Monitor market developments, regulatory changes, and industry trends to identify risks and opportunities for the business
  • Collaborate with teams across multiple geographies, supporting ongoing activities and future growth opportunities in Africa, South America, and other regions of strategic interest
What we offer
What we offer
  • Competitive salary and bonus
  • Health insurance for you and your family
  • Meal allowance
  • Fulltime
Read More
Arrow Right
New

Business Lead

The Business Lead is responsible for the preparation and analysis of financial s...
Location
Location
India , Bengaluru
Salary
Salary:
Not provided
amentum.com Logo
Amentum
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Knowledge of General Accepted Accounting principles (GAAP) required
  • Good oral and written communication skills
  • working knowledge of word-processing and integrated software applications
  • organizational skills and ability to perform detail-oriented work are required
  • Advanced knowledge of Microsoft Excel
  • Ability to organize and prioritize multiple work assignments, work with little supervision, and work well under pressure
  • Good interpersonal and communication skills with the ability to communicate effectively with all levels throughout the organization
  • Ability to perform data extraction and manipulation, analyze financial data, and generate reports
  • Demonstrate proficiency in finance and accounting relational databases and Microsoft applications
  • Bachelor’s degree in finance, business administration or demonstrated equivalent
Job Responsibility
Job Responsibility
  • The Business Lead is responsible for the preparation and analysis of financial studies and reports and act as a strategic partner providing timely and concise reporting & recommendations to improve results and performance to ensure successful contract & operational management and execution
  • Applies knowledge of accounting principles to activities associated with maintaining ledger accounts and developing financial statements and reports
  • Updates and reviews monthly account reconciliations
  • Ensure that the internal financial reporting requirements of the company are met
  • Ensure contract invoices are accurate and reconciled for monthly payment
  • Responsible for monthly close and adjusting journal entries
  • Point of contact for site and customer support for the financial management organization
  • Audits and prepares reports on the status of the contract and identifies areas for remediation
  • Review work prepared by others and provide constructive comments and/or suggestions to foster efficiencies and improvements for the department
  • Conduct studies and submit recommendations for improving the organization’s accounting processes
  • Fulltime
Read More
Arrow Right
New

Bpo Configuration Analysis Advisor

NTT DATA Services is Hiring! At NTT DATA, we know that with the right people on ...
Location
Location
India , Chennai
Salary
Salary:
Not provided
nttdata.com Logo
NTT DATA
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Over all 5+ years’ experience in US healthcare Claims Payer
  • 8 + year(s) experience in Configuring client System for Pricing (Provider Contract) and UAT testing – 2+ Years
  • High school diploma or equivalent required
  • Ability to work within a project-oriented environment
Job Responsibility
Job Responsibility
  • Configuring client System for Pricing (Provider Contract) as per the requirement and according to defined business rules of new claims processing platform
  • Evaluation of Configuration Requirement and Formulation of Configuration Approach and Effectively include advanced configuration and additional functionality based on best practices
  • Based on the business requirements and business rules gathered, evaluate and create rules and complete the configuration activities
  • Participate in problem solving of Health Plan benefit, provider, pricing, reporting, operational and system issues
  • Perform a variety of tasks related to the resolution of production support issues based on client configurations with the core administrative system
  • Support activities to update configuration within the core claims processing system, typically within the areas of Provider Pricing
  • Support fee schedule changes including terms, affiliations and contract maintenance
  • Enable User Analysis Testing (UAT) and implement the modifications as suggested by the business owners and/or analyst
  • Creating manual test cases from Use cases, Functional specs and other requirement documents
  • Resolve coding/QA issues by managing Master Issue Logs and Fixing the high priority change requests which require immediate attention
  • Fulltime
Read More
Arrow Right
New

Sap Sc Functional Analyst

This senior role acts as a critical strategic bridge between business stakeholde...
Location
Location
Canada , Calgary
Salary
Salary:
Not provided
https://www.randstad.com Logo
Randstad
Expiration Date
August 13, 2026
Flip Icon
Requirements
Requirements
  • University degree in Supply Chain, Business, Engineering, Information Systems, or a related discipline (or equivalent professional experience)
  • 8+ years of dedicated SAP Supply Chain experience
  • Direct participation in at least one major ERP implementation or transformation program, paired with substantial IS Support and Enhancement work
  • Deep functional expertise in SAP S/4HANA Supply Chain, with specific specializations across Materials Management (MM), Extended Warehouse Management (EWM), and Integrated Business Planning (IBP)
  • Comprehensive understanding of end-to-end supply chain lifecycles, including Procure-to-Pay, Inventory & Logistics, Order-to-Cash, and demand/supply planning
  • Proven ability to apply fit-to-standard rules to minimize customization and support long-term SAP upgradeability
  • Working knowledge of integrated platforms (Ariba, Fieldglass) and related ecosystem tools like OpenInvoice and VIM
  • Solid understanding of critical master and transactional data sets (materials, vendors, pricing, contracts) alongside familiarity with SAP reporting landscapes (embedded analytics, BDC)
Job Responsibility
Job Responsibility
  • Guide the end-to-end design and validation of SAP S/4HANA Supply Chain processes to maintain alignment with business objectives
  • Provide strong functional oversight and governance for assigned Supply Chain domains across the SAP landscape
  • Translate complex business requirements into clear, fit-to-standard SAP functional designs
  • Identify legacy process inefficiencies and recommend SAP-enabled improvements that drive simplification, standardization, and automation
  • Facilitate and lead targeted fit-to-standard workshops, confirming standard feature adoption and documenting justified deviations
  • Evaluate functional gaps and recommend appropriate resolutions—such as configuration, standard extensions, or governed customizations—in alignment with Clean Core principles
  • Ensure all Supply Chain technical designs remain upgrade-safe, scalable, and supportable for long-term operations
  • Collaborate tightly with project functional and technical teams to ensure seamless end-to-end process alignment
  • Validate and confirm complex integration requirements between the S/4HANA core and external platforms (e.g., Ariba, Fieldglass, OpenInvoice, VIM, logistics, and analytics software)
  • Partner directly with the system integrator to review and approve functional designs while ensuring high-quality solution delivery
Read More
Arrow Right
New

Program Analyst

As a Program Analyst, you know the complexities of supporting a project from con...
Location
Location
United States , Fort Meade
Salary
Salary:
86900.00 - 198000.00 USD / Year
boozallen.com Logo
Booz Allen Hamilton
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • 12+ years of experience working in a professional environment
  • Experience with project management on technical projects
  • Experience creating project management plans
  • Experience assisting and supporting the development of recommended and required program documentation according to DoD regulations and directives
  • Experience serving as an advisor to upper-level management
  • Experience planning, coordinating, and developing comprehensive reports to improve the overall development and execution of organizational programs
  • Experience conducting quantitative or qualitative analysis and evaluation of programs and providing management with information about improving initiatives and strategic plans
  • TS/SCI clearance
  • Bachelor's degree
Job Responsibility
Job Responsibility
  • Implement and maintain organizational programs in support of our client's strategy
  • Work with key stakeholders to review contracts and project cost accounting
  • Help with tactical planning using resources like Microsoft tools and regular interactions with SMEs, technical directors, engineers, and contracting officers
  • Ensure the program achieves its goals and meets our quality standards
  • Influence a meaningful mission while learning how to develop and maintain program strategy
  • Ensure our customer accomplishes its program goals within budget as we improve warfighter communications
What we offer
What we offer
  • Health
  • Life
  • Disability
  • Financial
  • Retirement benefits
  • Paid leave
  • Professional development
  • Tuition assistance
  • Work-life programs
  • Dependent care
  • Fulltime
Read More
Arrow Right