LOCATION: REMOTE position aligned to the Northeast and Central USA market.
The Business Project Senior Analyst serves as an integral member of the Network Development and Competitive Insights Team within Network Operations and Provider Contracting and reports to the Regional Network Access Lead.
This role leads regional product specific projects and/or components of larger national projects for a given territory. Manages the hospital/large group and/or significant provider termination management process in assigned markets for Commercial, IFP and Medicare Advantage products. Works closely with Contracting, Network Solutions, Network Operations, Provider Services, Sales and Compliance to meet termination process management guidelines/state requirements. Manages client specific and/or product specific recruitment efforts as well as compiling competitive network benchmarking and industry comparative analysis to support Commercial, IFP and Medicare products. This individual is involved in the evaluation of system requirements, the development of procedures/processes/policy solutions to address the complex business needs for projects and may direct one or more teams of business matrix partners to achieve project goals. For assigned projects, the role is responsible for determining project requirements, outlining project objectives, ensuring state contracting and compliance guidelines are adhered to, directing business matrix partners to meet project timelines and produces timely accurate reporting for senior management on project status.
Responsibilities:
Lead as Project Manager for National Account Recruitment Requests, Middle Market and Local Sales recruitment initiatives; coordinating recruitment efforts with the market Contracting/Provider Services teams, Sales, Medical Recruitment Team and national vendor specialty teams as required.
Review datasets to identify recruitment universe; Review potential recruits against Cigna systems to check for current/previous par status, approved specialty recruitment in specific geographies and validate if the provider is currently in recruitment under a separate initiative. Meet with the market Contracting/Provider Services teams to review and approve the final recruitment universe, appropriate fee schedule/contract paper and identify market contact to be aligned with the project.
Provide analytic and reporting support for regional provider network access build initiative projects.
Manage the recruitment tracking tool: project data uploads and provider record maintenance for duration of the project. Manage project reporting and distribution to matrix partners and senior management.
Partner with Contracting and Sales/Service organizations to manage the review of providers identified as non-participating through the Regional Support Unit provider review process in support pre-sale activities and current client non-par inquiries.
Lead regional market research relating to competitor provider network participation status, competitor product development, regulatory developments and other market developments as appropriate.
Lead Hospital/Large and/or Significant Provider Termination weekly workgroup meetings. Manage/Coordinate data reporting needs for all segments; including Commercial, IFP and Medicare pending terminations within the region.
Lead separate and/or additional termination management meetings as needed to discuss segment specific activities or enhanced termination tactics to support high visibility/challenging negotiations.
Manage the creation and distribution of the weekly term management workgroup notes. Create and submit network change alerts for posting to Cigna’s internal tool, Knowledge Xchange, to communicate external notifications and changes for active potential hospital/large group or significant terminations. Coordinate Sales Effectiveness email process to all Sales opportunity owners with impacted clients. Manage all Sales requests for client specific data for impacted clients approved to receive PHI.
Strive to become the subject matter expert (SME) for all assigned states and segments in your Region in support of all role activities; termination management, recruitment initiatives and competitive analysis.
Manage/facilitate ongoing targeted recruiting and expansion projects for assigned markets for all segments.
Work collaboratively with resources within the region, other regions and nationally to ensure projects are consistently managed, tracked and reported.
Special projects as required.
Qualifications:
College degree preferred or equivalent work experience
3+ years’ experience working in the health care industry, required
Strong Project Management experience, required
Strong Microsoft Excel and Access skills to support the ability to analyze large datasets, required
Understanding of medical insurance products
Strong critical thinking skills
Strong interpersonal, analytical, and written/oral communication skills
Team player with proven ability to work independently and collaboratively by developing strong working relationships within a fast paced matrix organization
Detail oriented with the ability to prioritize workload
Ability to use PC software; i.e., Outlook, WebEx, One Note, Power Point
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.
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: 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.
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.
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