Job Description

This role delivers professional activities in the Provider Contracting job family. The position is responsible for dental provider recruitment and contracting as well as managing contracted provider relationships for a specified territory. Conducts daily outreach to dental offices or providers to develop and maintain positive relationships with the purpose of negotiating a contract for participation in our dental networks. Ability and willingness to travel frequently within the US including overnight stays. Conduct quality reviews of Practitioner and/or Facility/Ancillary contracts. Conducts comparison of contract data relative to provider data and/or demographic and reimbursement data submitted for processing. Assesses the accuracy of provider data processed in accordance with documented and standard operating policies and procedures. Applies standard techniques and procedures to routine instructions that require professional knowledge in specialist areas. Provides standard professional advice and creates initial reports/analyses for review. May provide guidance, coaching, and direction to more junior members of the team in the Network Management Organization.

Responsibilities:

• Identifying, recruiting, contracting, and retaining qualified health care professionals in geographic area within established guidelines to meet health plan needs
• Achieve competitive and cost-effective contracts in assigned areas or assigned client/customer needs
• Negotiate contracts and recruit dental providers to become a Cigna network provider
• Explain plans, policies, and procedures to potential providers
• A point of contact for Providers who are contracted within a specified target market (Florida, Puerto Rico & Virgin Islands)
• Maintain positive relationships with health care professionals and their office staff extending high quality service
• Conduct negotiations and ensure the smooth operation and administration of provider agreements
• Support and retention of offices in our dental networks
• Complete onsite quality assessments
• Respond to provider inquiries, concerns, complaints, appeals and grievances
• Provide ongoing product education to dentists and their staff
• Work to achieve contract discounts with new providers and current providers through thoughtful negotiation
• Use data and facts to identify and overcome objections
• Prioritize and organize own work to meet deadlines, and reach established personal and department goals
• Conduct ongoing support to contracted providers in our networks via telephone or by personal relationship visits.

Requirements:

• High School Diploma or equivalent
• 1-3 year experience in healthcare administration or provider relationship management, preferably experience working with Dental offices
• Strong skill set required in the following areas: analytical, negotiations, financials, presentation skills, written and oral communication skills
• Strong negotiation and communication skills
• Self-Starter and organized
• Intermediate proficiency in Microsoft Office products
• Valid drivers license  
• The person in this position will report virtually and should be located within the territory of FL,PR, &VI

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.

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: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.

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.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Job Tags

Ongoing contract, Contract work, Work at office, Local area, Remote work, Work from home, Night shift,

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