Job Description

This role is Work from Home but must be located in the Greater Phoenix area and able to travel within this area.Overview:The Consultant, Network Relations will be responsible for building and maintaining effective health plan relationships. Under the direction of the Contracting Leader, this individual will collaborate with their network operations counterpart at each contracted health plan to ensure the overall health of relationship. This entails facilitation of new payer onboarding, ownership of regular partnership touchpoints (examples include: monthly performance meetings, quarterly joint operating committee meetings, etc.), and issue resolution as directed by the business. The incumbent will interface regularly with both internal and external leaders to effectively establish and maintain a positive partnership experience and resolve escalated issues in a timely manner.Responsibilities:

• Enhance account relationships by investigating, documenting, and resolving issues for internal and external stakeholders, in a timely manner
• Serve as the primary contact for health plan network operations counterparts, while acting as a liaison between both organizations
• Partner with the Contracting Leader to facilitate fact finding for new payer implementations
• Establish and maintain excellent relationships with all contracted health plan partners
• Ownership of regular partnership touchpoints, including monthly performance meetings and quarterly joint operating committee meetings
• Creation of materials to drive meaningful conversations during scheduled leadership touchpoints with health plan partners, via partnership with internal stakeholders
• Supports monitoring of cost and quality performance versus contractual agreements
• Coordinates data extracts and data analysis interpretation
• Manages all SFTP data exchanges with health plans
• Supports internal company initiatives that further improve the experience of Evernorth Care Group staff/clinicians with partner health plans
• Maintain an understanding of the Evernorth Care Group model of care and any prioritized strategic initiatives. Ability to clearly articulate this information to health plan partners.
• Provide additional support to the contracting leader, as needed.
• Partners with contracting leader to hold health plans accountable for agreed upon contractual terms
• Creation and management of contracting department\xe2\x80\x99s renegotiation calendar
• Oversight of the contracting department team email inbox and associated correspondence

Qualifications:

• Bachelor\xe2\x80\x99s Degree preferred
• 2+ years of relevant Network Relations experience
• Knowledge of provider and insurer terminology
• Knowledge of health plan or provider contracting terminology
• Strong quantitative, written, and oral communication skills, including presentations
• Ability to travel within the Greater Phoenix area to meet with partner health plans (Maricopa County)
• Ability to present in group settings and independently drive issues to resolution
• Strong multi-tasking and organizational skills with minimal supervision
• Ability to collaborate with across multiple departments and stakeholders, both internally and externally
• Knowledge of the primary care and health insurance competitive landscape in the Arizona market
• Takes personal accountability for contributions to team and organizational results
• Proficiency with Microsoft Word, Excel, PowerPoint, and Outlook.

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.For this position, we anticipate offering an annual salary of 58,100 - 96,900 USD / yearly, depending on relevant factors, including experience and geographic location.This role is also anticipated to be eligible to participate in an annual bonus plan.We want you to be healthy, balanced, and feel secure. That\xe2\x80\x99s why you\xe2\x80\x99ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you\xe2\x80\x99ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit .About Evernorth Health ServicesEvernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. 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 require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.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.

The Cigna Group