Posted

30+ days ago

Location

Nashville, TN

Description

Job location: Nashville, TN

Summary:

The Network Operations Lead Analyst is responsible for all tactile support and serves as the primary contact for Independent Physician Associations (IPA) relationships. Works directly with providers and provider staff to assist in contract management and provide supporting analyses for network and performance optimization. This includes meeting with a physician board of directors, financial/bonus discussions, and quality management. The role will also be responsible to support Clinically Integrated Network (CIN) and Accountable Care Organization (ACO) functions in TN/AL/MS/NFL.

Responsibilities:

  • Develops and maintains positive relationships with physicians, providers, and practice managers within the network, including oversight and managing performance in various incentives based and/or value based programs. Including but not limited to management of provider network financials, pro-forma budget preparation and implementation, monthly action plans, reviews, and verification.
  • Create and deliver materials to educate providers and provider staff on contracts, policies and procedures, quality and service line initiatives, and financial performance.
  • Prepares and delivers presentations with providers, provider staff, and/or physician leadership during monthly operational meetings.
  • Understands, develops, tracks, monitors and reports on key program performance metrics, such as utilization, coding, and STARs/quality performance.
  • Perform root cause analyses and resolution related to provider concerns, grievances, claims and care delivery
  • Develops and provides guidance on IPA strategy, vision, and action plan development for the CareAllies Managed IPAs.
  • Responsible for partnering with Health plans on their network strategy and development. This includes but is not limited to network communications and expansion as well as promoting products offered by the Health plans that we support.
  • Prepare materials and participate in monthly financial review with senior leadership.
  • Partners with other internal departments, including but not limited to Health Services, Finance, Claims, and Coding in order to develop solutions for strategic business needs.

Requires at least 50% local travel to providers in Nashville, TN area and may be required to travel to out of state conferences and meetings 25% of the time.

Qualifications:

  • Bachelor's/Master's degree or equivalent work experience of 1- 2 years working in a matrix environment
  • 1-2 years related work experience working with providers in a healthcare environment preferred
  • Experience in physician relations or managed care highly preferred
  • Intermediate level of Excel preferred (knowledge of pivot tables, VLOOKUP, etc.)
  • Strong analytical and problem solving skills.
  • Excellent communication skills-verbal, written and presentation.
  • Must be an independent thinker; time management and organizational skills are a must.
  • Car & valid driver's license required (mileage reimbursement provided).

About Cigna

Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. We offer an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products. Together, with our 74,000 employees worldwide, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation.

When you work with Cigna, you'll enjoy meaningful career experiences that enrich people's lives while working together to make the world a healthier place. What difference will you make? To see our culture in action, search #TeamCigna on Instagram.

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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.