Develops and maintains positive relationships with Skilled Nursing and Custodial Nursing Facilities within the provider network.
Educating providers and office staff on contracts, policies, and procedures
Managing the contracting process
Root cause analysis and resolution of problems and issues
Managing monthly provider visits and calendar of event
Develop, maintain, and distribute incentive reports to facilities
Participate in meetings with facility's staff, and/or leadership, and plan, create and deliver presentations
Perform quality checks on provider communication material
Requires at least 30% external travel to network providers
May provide guidance to others in the department
This is a Work at Home position tied to McAllen, Tyler or Bedford, TX location
Ability to travel up to 30% (most travel will be local to the McAllen, Tyler or Bedford, TX locations)
High School Diploma or equivalent is required
Minimum 2-3 years of customer service claims, and/or payor related experience
Proficient in Microsoft Office products and learning reporting applications
Excellent communication skills
Minimum three years' experience in physician relations or Managed Care for Medicaid
Demonstrated knowledge of contracting process, Medicaid fee schedules, financial terms, and metrics
Proficient in Nursing Facility billing and able to resolve billing/payment inquiries
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 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 an accommodation based on your physical or mental disability please email: SeeYourself@cigna.com. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.