Sorry, this job is no longer accepting applications. See below for more jobs that match what you’re looking for!

Provider Relations Administrator - Orlando, FL

Expired Job

Cigna Lake Mary , FL 32795

Posted 2 months ago

SUMMARY:

Develops, manages, and drives the performance of the physician/provider networks, Including MSOs, IPAs, Independent Primary Care and Specialists, and Facility owned physicians. Develops and implements programs to recruit, service, train, and reimburse physicians and providers. Designs and implements programs to maintain positive relationships between the health plan, physician, providers, and practice managers. Leads as liaison for provider network with internal health plan personnel and initiatives.

Let us tell you a little more. We're a global health service company dedicated to helping people improve their health, well-being and sense of security. But we don't just care about your well-being, we care about your career health too. That's why when you work with us, you can count on a different kind of career - you'll make a difference, learn a ton, and share in changing the way people think about healthcare.

RESPONSIBILITIES:

  • In conjunction with Market Leadership, develop Cigna-HealthSpring into the business partner of choice within the Orlando service area.

  • Drive performance and be the key business interface, with physician/provider networks in the Orlando service area.

  • Detail understanding of the HealthSpring P&L and the operational drivers that affect the results.

  • Generate, analyze, and articulate / communicate complex data in a meaningful and succinct manner with both internal and external business partners.

  • Develop action plans that improve business partner performance and strengthen relationships.

  • Responsible for network development, including physician contracting, rate negotiations, physician network relationships, physician network communication, physician recruitment, and network partners.

  • Responsible for general oversight of provider network financials, including monthly action plans, reviews, and verification.

  • Provides guidance to network business partners and leadership on strategic plans, vision, action plan development and implementation for the networks.

  • Participates in network and company meetings, internal and external, including physician board of directors, quality management, financial analysis.

  • Analyzes builds and reports to Executive Committee monthly business development of the networks including current status, action plans, successes, fails, and future initiatives and expectations.

  • Responsible for CMS network maintenance including network adequacy reporting, provider directory data, HSD tables, summary grids, analytics, and/or other regulatory or business requirements.

  • Maintains collaborative relationship with Cigna Commercial Representatives in overlying geographies/networks.

  • Responsible for maintaining compliance to CMS and company policies and guidelines.

  • Responsible for execution of key initiatives, such as CMS STARS.

  • Build and develop a high performing Network Operations organization and own the career development of team.

Works directly with Chief Operating Officer, Medical Directors, Sales, Marketing, Finance, Medical Economics, Billing, Coding, Health Services, Contracting and Legal to accomplish objectives.

  • Primarily local travel. Early morning and evening meetings with Physician Networks as needed.

  • Overnights 8-10 times a year (i.e. Tampa, Nashville, Birmingham).

  • Valid driver's license, vehicle, and insurance required (mileage reimbursement)

QUALIFICATIONS:

  • Relationship management and building trust

  • High degree of financial acumen

  • Ability to develop win/win scenarios between Cigna HealthSpring and business partners

  • Ability to use available IT systems to generate meaningful insight to drive business performance

  • Proven program implementation skills

  • Possess strong business acumen

  • Process-oriented with strong organization and planning skills

  • Strong time management, project management and organization skills with the ability to manage/support multiple projects and priorities

  • Demonstrated ability to work in a highly-matrixed environment and with all levels

  • Excellent verbal and written communication skills

  • Competent in data management, strategic planning/goal setting, and conflict resolution

  • Technical: Computer skills: Excel, Power Point, Word

Minimum: Bachelor's degree. At least three years related healthcare experience. Previous management experience.

Preferred: Master's Degree & MSO/IPA experience as well as experience in Medicare Advantage, physician relations, managed care, and/or hospital/facility management.


See if you are a match!

See how well your resume matches up to this job - upload your resume now.

Find your dream job anywhere
with the LiveCareer app.
Download the
LiveCareer app and find
your dream job anywhere
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Personal Banker Orlando Northwest Market FL

Jpmorgan Chase & Co.

Posted 3 days ago

VIEW JOBS 11/16/2018 12:00:00 AM 2019-02-14T00:00 Apply Now Personal Banker - Orlando Northwest Market, FL Req #: 180114896 Location: Lake Mary, FL,US Job Category: Branch Banking Job Description: At JP Morgan Chase, we have an obsession for helping our customers, taking care of our employees, a strong commitment to diversity and inclusion, building relationships, and delivering extraordinary customer service. Using the latest banking solutions combined with cutting edge financial technology you'll be front and center representing our brand, and providing superior customer service, to offer our customers the best solutions for their financial needs. If you are passionate about people, helping to improve the lives of our customers through financial solutions, education and advice, and want to join an exemplary team, then join us at JP Morgan Chase. Do you have a passion for helping customers, building relationships and delivering extraordinary customer service? We are looking for energetic, enthusiastic people to be the face of Chase to our retail branch customers. From a personal standpoint, you will also have the opportunity to take ownership of your career development through a variety of cross-training opportunities. Job Description: As a Personal Banker at Chase, you are at the forefront of delivering an exceptional customer experience. You'll maintain long-lasting, meaningful relationships with customers, resolving customer issues, engaging them to understand their financial needs and providing thoughtful solutions that make a real difference in making their lives more convenient. Additionally, you will be part of an organization where collaboration and partnership are of utmost importance for our clients to bank and invest when, where and how our customers want. We give access to solutions, strategies and expertise when our customers need them. Responsibilities: You'll contribute significantly to the success of the branch and helping customers by: * Engaging the client by welcoming them with a warm friendly smile, pleasant demeanor, using the client name, whenever possible, and thanking them for doing business with Chase * Having a passion for helping customers and making clients feel appreciated * Be an advocate for our clients * Listen carefully to the client and be willing to assists with any questions or issues the client has * Show initiative and proactively prevent problems for our clients * Exhibits strong customer service skills, presenting products and services while proactively educating clients on utilizing available access channels * You will also collaborate with our partners in Chase Wealth Management, Business Banking and Home Lending to provide a seamless experience for our customers * Opening new accounts and assisting with Teller transactions as needed * Making their lives easier by sharing and setting up self-service options to access their accounts 24 hours a day/ 7 days a week Dodd Frank and Safe Act: This position is subject to the Dodd Frank/Truth in Lending Act qualification requirements for Loan Originators. As such, an employment offer for this position is contingent on JPMC's review of your criminal conviction history, credit report, information available through NMLS, and any other information relevant to a determination by JPMC that you demonstrate financial responsibility, good character, and general fitness for the position. Note that any felony conviction within the last seven years will disqualify you from consideration for this position. Your continued employment in this position would be contingent upon compliance with Truth in Lending Act/Dodd Frank Loan Originator requirements. In addition, this position requires National Mortgage Licensing System and Registry (NMLS) registration under the SAFE Act of 2008. As such, upon active employment with JPMorgan Chase, you will be required to either register on NMLS, or to update your existing registration as necessary to grant access to and reflect your employment with JPMorgan Chase. Your continued employment in this position with JPMorgan Chase is contingent upon compliance with the SAFE Act, including successful registration immediately after your start date, and timely completion of annual renewal and required updates thereafter. Any information obtained during the registration, update, and renewal processes or through NMLS notifications may impact your employment with the firm. Any of the completed information you provide during the Chase on-line application process may be transferred, on your behalf, to NMLS by JPMorgan Chase. Please carefully review the information you provide to Chase for accuracy and consistency and with any current NMLS record, if applicable, before submitting. Further information about NMLS and registration requirements of registration can be found at: http://mortgage.nationwidelicensingsystem.org/SAFE/Pages/default.aspx. Desired Skills: * Delivers exceptional customer experience by acting with a customer first attitude * Ability to make personal connections, engage customers and always be courteous and professional in a team environment and proactively collaborates with others to help customers * Exudes confidence with clients when sharing product knowledge and solutions * Possesses drive, initiative and knowledge to provide financial options for customers using a consultative approach * Partnering with your branch team and Specialists to connect them to experts who can help with specialized financial needs * Strong desire and ability to influence, educate and connect customers to technology * Operates within established risk parameters/tolerances, and meets internal/external risk and compliance obligations, including completion of required training * Professional, thorough and organized with strong follow-up skills * Excellent interpersonal communication skills * Engage and partner with team members and other LOBs to offer most appropriate products * Ability to learn products, services and procedures quickly and accurately; delivers solutions that make our One Chase products work together * Minimum 6 months customer service experience is required * College degree or military equivalent strongly preferred; High school degree, GED or foreign equivalent required Jpmorgan Chase & Co. Lake Mary FL

Provider Relations Administrator - Orlando, FL

Expired Job

Cigna