Encore Provider Contracting Support – Remote

This role is open to retirees only.

This position is responsible for supporting the Florida Network Management, Contracting Department associates regarding network development, contracting, and relationship management with hospital, physician and ancillary providers.

Responsibilities:

• Support Provider Contracting administrative tasks that occur in the new contract lifecycle. 

• Confirm provider demographics during prospect phase and contract loads during installation phase.

• Request, receive and send final fee schedule to/from providers.

• Convert partially/fully executed agreements to PDF.

• Generate provider change & acquisition reports on a monthly basis or as needed.

• Process contract amendments that do not materially impact the network (including TIN/Name changes).

• Create SharePoint folder and upload executed contracts

• Send request for provider credentialing and facilitate the administrative components until completion.

• Host Contracting Team meetings, including contract review meeting.

• Coordinates Projects, to include assistance in creation & maintaining project trackers, hosting project meetings & status report out.

• Creates PowerPoints decks, graphs, excel spreadsheet, to include v-lookups & advanced excel formulas, as needed for special projects &/or team request.

• Data extraction & scrubbing from various databases.

• Receive communications from providers (or business partners), including but not limited to negotiated contract request from PSU, signed contracts, etc.

• Monthly review & assignment of contract affordability opportunities.

• Help coordinate provider terminations of Hospital, Ancillary & Professional groups.

• Conducts comparison of contract data relative to provider data and/or demographic and reimbursement data submitted for processing.

• Assists in the analysis and trending of audit findings.

• Responsible for data management, including data support for strategic initiatives and performance metrics.

• Prepares and reviews outgoing correspondence, minutes, policies, letter, and reports.

• May provide guidance, coaching, and direction to more junior members of the team in Provider Contracting.

• Follow prescribed guidelines for filing company documents and handling proprietary information.

• Review and corrective actions for accuracy of provider directories and listings

• Serves as the office liaison to schedule meetings, obtain conference rooms.

• Respond to requests for printing/shipping projects in a timely manner

• Other project work and duties as assigned.

Qualifications:

• High school diploma or GED required, or equivalent work experience.

• 1+ year experience of administrative experience

• Proficient with creating PowerPoint Presentations and reports in Excel, required.

• Very strong organizational skills with ability to perform and prioritize multiple tasks with excellent attention to detail.

• Data Analytical Skills.

• Expert/Advanced Skill set in Microsoft Excel (formulas, graphs, charts, etc.)

• Proficient in Microsoft Office PowerPoint, Word and Outlook.

• Excellent written and oral communication skills.

• Possess a strong sense of urgency and the ability to work in a very high-paced environment with the ability to managed multi tasks.

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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance.  Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

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.