Latest Recruitment at Cigna Corporation

Provider Negotiator will be responsible for developing and executing negotiation strategies working directly with contracted providers such as clinics, outpatient facilities, pharmacies, among others, in order to deliver best in class service to CGHB’s providers, customers and clients and act as the Subject Matter Expert regarding the local market’s environment, healthcare delivery practices and pricing for the Africa region.

Key Responsibilities:

1. Manages the contracting and relations with medical facilities, including but not limited to: Hospitals, clinics, pharmacies and physicians.
2. Analyzes and determines in which countries, regions and cities our network of providers must grow.
3. Works with Network Leads in performing service area analysis and cost analysis to identify network development and network renegotiation opportunities.
4. Negotiate with clients and client managers the most appropriate network extension efforts in the allocated region.
5. Negotiates and discuss agreements (direct payment agreements and/or discounts fees and price agreements).
6. Visits clients and manages the relationship with the providers under agreement in allocated regions and monitor the quality of their services and execution of the agreements in conjunction with a more Senior Provider Negotiator or Network Lead.
7. Acts as an expert with regards to the medical landscape in the countries within your region and continuously monitor evolutions in that respect
8. Ensures the correct handling of all administrative aspects of the agreements with the providers,
9. Maintains the Provider Data Base (PIMS) and make overviews of provider networks for all providers within the assigned region.
10. Analyzes price lists and data, write clear conclusions and identify cost containment opportunities.
11. Act as the internal key person for all other Units and departments for issues relating to the providers in the allocated regions. Especially intensive communication with Clinical, Service OPS and Sales and Client Management.
12. Act as representative in the Outpatient Direct Payment project (OPDP)
13. Effectively communicates and interacts with other business units to achieve goals; e.g. Medical Management, CGHB Service Operations (NA, UK and Antwerp), Sales and Client Management (NA, UK, and Antwerp), and CGHB Strategy & Operations.

Qualifications:

1. University degree or equivalent experience
2. With University degree, 2 – 3 years of relevant experience. Otherwise, 6 – 7 years.
3. Working knowledge of the Provider Network is required.
4. Good communication skills.
5. Good negotiation and convincing skills.
6. Analytical and critical mind.
7. Proficiency with MS Office programs including: Word, PowerPoint, Excel, and Project required.
8. Experience/Knowledge Requirements:
9. Knowledge of high priority healthcare providers, third party administrators, CGHB competitor capabilities within the region of responsibility – Africa.
10. Excellent interpersonal, communication and motivational skills, including negotiation and presentation skills
11. Strong influencing skills and ability to work in a complex, highly matrixed, environment, including balancing priorities of multiple organizations to deliver end results.

Personal Competencies Required:

1. Fluent in written and spoken English, French is a must. Any other language skills (particularly Portuguese) are a plus
2. Results orientation – ability to define goals, establish plans and manage work to achieve desired outcomes. Creates meaningful business related metrics and tracks progress/results.  
3. Excellent interpersonal, verbal, and written communication skills
4. Ability to communicate own and/or company visions clearly while performing active listening to the message from the provider.
5. Comfortable working in a fast paced environment with shifting priorities
6. Energetic and enthusiastic
7. A team player
8. Willing to travel regularly (up to 20%)

go to method of application »

As a Provider Inquiry Coordinator (PIC) you will be part of the Inquiry Servicing Model embedded into the Provider Services department, being responsible to manage escalations and the outcome of the reconciliation process with Health Care Providers. You will work very closely with your peers and the rest of Provider services Team across the globe. Key to the role will be managing the fulfilled reconciliation of the accounts between Cigna and the health providers, such as hospitals and clinics in the region as well as managing escalations (Suspensions and Threat of suspensions) from HCP. In addition to this you will be in charge of the communication of the outcome to the facilities, support them in interpreting the feedback received from Cigna and close follow up on the further actions needed.

Your role includes:

• Responsible to enable an effective and efficient collaboration with health providers through monitoring and analyzing the results of the reconciliation of the accounts fulfilled by the Global Provider Reconciliation team and other Operational KPIs;  
• Comprehensive support on their interpretation and assurance of further follow up if needed;
• Conduct regular root cause analysis and consolidated feedback of the data obtained out of the Reconciliation  outcome or other sources ,striving for continuous service delivery improvement through BAU collaboration with different teams;
• Active communication and prompt follow up combined with regular meetings with your dedicated health care providers
• Participation in coordination sessions with Network and Operations teams seeking for better practices in order to prevent service deficiencies and assure 5 star experience to health care providers;
• Being a person of contact for providers and Provider Network in regards of Operational issues / queries 
• Support the PS management Team to determine short and middle term solutions for smooth reconciliation process with Providers by continuously analyzing the intake of queries and complaints, as well as conducting reviews of the current processes for potential improvements;
• Consolidated feedback to PS management team striving for continuous service delivery improvement through BAU collaboration with different teams;
• Deliver on operational KPI’s within the PS team in terms of production, quality, TAT, amongst others;

YOUR PROFILE

• If internal 2 years of Cigna experience, relevant experience in other functions/companies, and a strong performance track record;
• If external, at least 2 years of experience in Operations, Data analysis , Marketing/Communications or Relationship Management, with operational and customer/provider-facing experience profile.
• Proficient in English, additional language is a plus
• Strong analytical and problem-solving skills.
• International mind-set able to work remotely with colleagues, partners and providers across the globe;
• Striving for excellent service to our members, clients and providers is part of your DNA;
• Detail oriented
• Ability to engage in multiple tasks and meet deadlines
• Act with a sense of urgency to research questions or issues brought by different teams. Identify the right parties or resources to resolve these issues;
• Ability to assess the situation/issue, carry out appropriate research, gather the relevant data and provide constructive feedback on the outcome;
• Excellent communication skills – verbal, written and presentation. 
• Be a positive role model and have the ability to work independently and in conjunction with co-workers of all levels.
• Strong practical knowledge of MS Office applications, including Excel