Provider Contracting Advisor - Cigna Healthcare - Hybrid

Responsibilities

• Manage complex fee-for-service and value-based contracting and negotiations with large physician groups, ancillaries, and hospital systems.
• Lead key market contracting strategy projects with responsibility for managing direct reports as assigned.
• Build and maintain strong provider relationships to support network growth and value-based business opportunities.
• Coordinate closely with matrix partners (i.e., Claims, Medical Management, Credentialing) to ensure aligned execution.
• Develop strategic network positions, identif y value-oriented and risk-based opportunities, and contribute to alternative network initiatives and analytics.
• Work to meet unit cost targets while maintaining an adequate, competitive provider network.
• Design and manage initiatives to improve medical cost and quality, offering consultative guidance informed by clinical informatics.
• Prepare, review, and project the financial impact of large or complex provider contracts and alternative terms.
• Create, implement, and ensure operational accuracy of HCP agreements through effective cross-functional collaboration.
• Lead resolution of escalated provider issues and manage key provider relationships with deep knowledge of the local market landscape including contract loading and maintenance.
• Required Qualifications
• 3 -5 + years of healthcare provider contracting and negotiating experience involving complex physician groups and ancillaries
• Background in managed care, healthcare, or health insurance, including commercial contracting
• Proven leadership experience, including mentoring and guiding others
• Strong provider relationship management skills and success developing long-term - partnerships
• Knowledge of complex reimbursement methodologies, including incentive-based models (strongly preferred)
• Deep understanding of hospital, managed care, and provider business models with the ability to influence sales and provider audiences
• Exceptional presentation and communication skills, including the ability to build internal relationships in a fast-paced, matrixed organization
• Customer-centric approach, strong interpersonal skills, and confidence in navigating change
• Strong problem-solving, decision-making, negotiation, contract interpretation, and financial analysis skills
• Proficiency in Microsoft Office

Requirements

• Bachelor's degree in a related field (industry experience may substitute); MBA / MHA preferred
• 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
• 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.
• Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Benefits

Additional Information

Join Cigna Healthcare, a division of The Cigna Group, and help shape our provider network. As a Provider Contracting Advisor , you'll report to the AVP, Provider Network Management. In this individual contributor role, you'll assist in developing the strategic direction and management of day-to-day contracting and network management. This is a hybrid position based in Raleigh, NC.

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