Provider Contracting Specialist Job at The Cigna Group (Antwerp)

Government Contracting Specialist

As a Government Contracting Specialist at Air Space Intelligence, you will overs...

Location

United States , Boston

Salary:

Not provided

Air Space Intelligence

Expiration Date

Until further notice

Requirements

7+ years of experience in federal government contracting, procurement, or contract administration
Strong knowledge of FAR/DFARS and federal acquisition processes
Experience supporting contracts with agencies such as the DoD, FAA, NASA, DHS, or related organizations
Familiarity with software, SaaS, aerospace, aviation, or defense technology environments
Experience with a wide range federal contract vehicles
Excellent organizational and project management skills
Strong written communication and proposal coordination abilities
Ability to manage multiple concurrent deadlines in a fast-paced environment
A bias for action and the ability to operate independently
Intellectual curiosity and a desire to continuously learn and improve

Job Responsibility

Oversee and support the full lifecycle of government contracting activities across a portfolio of federal customers and strategic partners
Play a critical role in helping Air Space Intelligence navigate and grow within the defense, aerospace, and federal technology ecosystem
Work closely with business development, engineering, finance, legal, and executive leadership teams to support contract execution, proposal development, compliance, and strategic customer engagement across agencies including the DoD, FAA, DoT, NASA, DHS, and the U.S. Coast Guard
Advocate for advantageous contracting and acquisition solutions with government customers
Support pricing strategy development and proposal structuring
Assist with pricing documentation, representations and certifications, and compliance matrices
Support RFP, RFQ, and RFI responses, teaming agreements, and proposal submissions
Provide contracting expertise to shape competitive and compliant proposal strategies
Manage the lifecycle of federal contracts, subcontracts, task orders, and contract modifications
Ensure compliance with FAR, DFARS, agency supplements, OTAs, and contractual requirements

Fulltime

Provider Contracting Advisor

Location

United States of America , Cleveland

Salary:

92000.00 - 153300.00 USD / Year

The Cigna Group

Expiration Date

Until further notice

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

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

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

Provider Contracting Advisor

The Provider Contracting Advisor serves as an integral member of the Provider Co...

Location

United States of America , Columbus, OH

Salary:

92000.00 - 153300.00 USD / Year

The Cigna Group

Expiration Date

Until further notice

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

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

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.

Senior Contracting Specialist

We are in search of a highly motivated candidate who possesses a decade of prove...

Location

United States , San Diego

Salary:

80000.00 - 125000.00 USD / Year

Tecolote Research

Expiration Date

Until further notice

Requirements

10 years of demonstrated experience in DoD Program Management contracting processes throughout the entire lifecycle
Experience executing DoDD 5000.01, DoDI 5000.02, SECNAVINST 5000.2 series governing acquisition programs in the DoD Components, and other acquisition management policies addressed in DoD 5000 series
Experience with executing statutory and policy procurement-related requirements (FAR, DFARS, NMCARS, DoD 5000 series)
Experience developing contract strategies to incentivize industry performance
conduct market research
acquisition planning
cost and price analysis, solicitation and selection of sources
and perform all phases of contract administration
Must be able to work autonomously and within a team collaborative environment
Experience developing contract documents, e.g. Request for Proposals, Statements of Work, Contract Data Requirements Lists (CDRL), Contract Line Item Numbers (CLIN), DD-254’s, Acquisition Plans, Source Selection Plans, Justifications, Approvals, Determinations and Findings

Job Responsibility

Provide methods, processes, and tools to strive for cost, schedule, and performance efficiencies as related to procurement strategies
Identify and correct problems and make recommendations as they relate to programmatic contract management
Develop and update documentation to support the above such as briefs, training packages, Standard Operating Procedures (SOP), policy updates, and guidebooks
Provide administrative and advisory support as required during Government
Provide overarching assistance with programmatic contract related matters
Advise the Government on areas such as PWS development, CLIN structure, evaluation criteria
Interpret and provide expert advice on contracting policy, regulation and statute when requested
Support contract strategies, planning, coordinating, developing, analyzing, and issue resolution
Develop, collect, analyze, and prepare metrics data for wide contract planning and actions
Assist the Government in maintaining a conformed contract, including exhibits, appendices, award fee payments, security requirements and any other changes due to contract modifications

What we offer

Company Paid Major Medical Insurance for employees and family members
Dental Insurance for employees and family members
Vision Insurance for employees (employee-paid for family members)
Group Life Insurance
Accidental Death and Dismemberment Insurance
Travel Accident Insurance
Long-Term Disability
Voluntary Short-Term Disability
Supplemental Life Insurance
Flexible Spending Account (pre-tax deferrals for health care expenses)

Fulltime

Provider Information Specialist I

Summary: Compile appropriate information to make requested credentialing, contra...

Location

United States , Baton Rouge

Salary:

Not provided

NTT DATA

Expiration Date

Until further notice

Requirements

Two years of customer service, credentialing, enrollment and billing, claims and/or insurance operations experience is required
One year experience in of insurance services and operations
High School diploma or equivalent is required
Prefer an Associate or Bachelor’s degree in business or health related field

Job Responsibility

Accurately setups providers in provider systems of record to ensure appropriate claims payment in accordance with contractual language
Compiles, analyzes, and verifies the required information for provider enrollment, contracts, and maintenance for completeness and accuracy, and enter it into the systems of record
Communicates, orally and in writing, directly with providers to resolve questions and issues regarding updates and changes in the systems of record
Researches, responds to, analyzes and resolves complex claims issues related to provider setup and provider eligibility on a daily basis
Creates resolution documents to address provider issues and increase provider satisfaction
Utilizes probing and problem solving methods to resolve all inquiries/requests
Identifies, understands and anticipates providers unexpressed needs and concerns
Provides cross functional support and serves as subject matter resource or second tier resolution to internal and external provider teams (i.e., Contracting, Provider Relations, etc)
Manage timely responses to external provider inquiries and requests
Evaluate new service requests from providers to determine appropriate actions for recording into the systems of record

Growth Specialist, Solution Provider

The Growth Specialist, Solution Provider plays a crucial role in driving the sig...

Location

United States , Various

Salary:

99500.00 - 179400.00 USD / Year

T-Mobile

Expiration Date

Until further notice

Requirements

High School Diploma/GED
Bachelor's Degree General Business
4-7 years Business to business (B2B) sales experience in technology
4-7 years Technologically proficient in IoT, and/or related industry
Knowledge Management Experience with large multi-year complex deals
Superior verbal and non-verbal skills, confident communicator
Efficient organization skills, ability to prioritize and respond to incoming activity/tasks with a sense of urgency and accuracy
effective collaborator
goal setting
Business acumen skills such as Leadership (trustworthiness, time management, cheerful outlook, self-motivation)

Job Responsibility

Manages customer deployment schedules to forecast and secure projected activations throughout the lifecycle of the contract
Collaborate closely with cross-functional team members to ensure objectives are met
Cultivates and closes new sales opportunities throughout the contract lifecycle by identifying new use cases and/or net new solutions
Builds deployment strategy with customer considering contract terms such as unit commitment levels & pricing, required technical requirements and customer business models
Maintains SalesForce.com management of deployment and activations forecast
Reports on progress against contract terms

What we offer

Competitive base salary and compensation package
Annual stock grant
Employee stock purchase plan
401(k)
Access to free, year-round money coaches
Medical, dental and vision insurance
Flexible spending account
Employee stock grants
Employee stock purchase plan
Paid time off

Fulltime

Provider Credentialing Specialist

Work with the New Ventures team to complete health plan credentialing accurately...

Location

United States

Salary:

55000.00 - 75000.00 USD / Year

Pomelo Care

Expiration Date

Until further notice

Requirements

2-4 years of experience in a high volume, credentialing specialist role
Deep expertise with commercial health plan credentialing processes, including health plan portals & CAQH
Highly organized with a strong attention to detail
A proactive and resourceful problem-solver who is comfortable navigating ambiguity and independently seeks out answers and solutions
An accountable and collaborative team player with excellent communication skills, both written and verbal
An expert at prioritization & time management, who proactively shares deliverable timelines and roadblocks

Job Responsibility

Complete group & practitioner health plan credentialing on behalf of Pomelo’s telehealth clinic & care team
Track applications from submission to approval, contracting, and agreement, ensuring cross-functional visibility into key milestones & timelines
Proactively mitigate application delays & denials
Rigorously follow up on any delays and/or denials to right-size
Collaborate with Pomelo licensing, credentialing, and enrollment team to ensure proper clinician licensure & up-to-date CAQH profiles, to help expedite health plan credentialing
Collaborates with care team of nurses, nurse practitioners, doctors, therapists & registered dietitians to support navigation & answer questions about clinician credentialing applications

What we offer

Competitive healthcare benefits
Generous equity compensation
Unlimited vacation
Membership in the First Round Network (a curated and confidential community with events, guides, thousands of Q&A questions, and opportunities for 1-1 mentorship)

Provider Enrollment Specialist II - HP Enrollment Eligibility

Coordinates Medicare and Medicaid enrollment/re-enrollment and managed care cred...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

High School Diploma
1-3 years of Payer Enrollment experience
Solid knowledge and utilization of PC applications to include WORD, EXCEL, ACCESS
Excellent written and verbal communication skills
Excellent organization and planning skills with demonstrated teamwork skills
Proven ability to interact with all levels of management and other Associates

Job Responsibility

Collects and maintains data on providers for Medicare and Medicaid enrollment
Prepares and submits applications to Medicare and Medicaid for new provider enrollments and existing provider updates
follows up by telephone or in writing, with carriers regarding application status
Complies with Medicare and Medicaid provider enrollment guidelines
Requests NPI numbers for providers and clinics as necessary and maintains NPI files
Follows up, either by telephone or in writing, with insurance companies and patients regarding the processing of outstanding claims and/or appeals
Generates various reports to identify outstanding claims issues with provider numbers and non-payment
Communicates information to appropriate personnel
Educates staff on corrections, e.g.. front-end entry errors in a positive, constructive manner
Collects and reviews managed care contracts for correct billing and payment terms

Fulltime

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Provider Contracting Specialist

Job Description

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