Cigna Network Operations Sr. Analyst-CareAllies (Birmingham, AL) in Birmingham, Alabama
Job Location: Birmingham, Alabama
The Provider Engagement Senior Analyst role is the face of CareAllies Management Services Organization (MSO). In this role you will be responsible to provide financial, clinical and regulatory overviews to Physicians, Office Administration and/or clinical personnel in an office. This role directly interacts with matrix partners both internally and externally to influence and direct workflows for our clients.
Serves as primary contact for providers and provider staff to assist in contract management and provide supporting analyses for network and performance optimization. Develops and maintains positive relationships with physicians, providers, and practice managers within the network, including oversight and managing performance in various incentives based and/or value based programs.
Provide tactical operations support to assigned groups, including contracting, data integrity, communications, and relationship management.
Create and deliver materials to educate providers and provider staff on contracts, policies and procedures, quality and service line initiatives, and financial performance
Prepares and delivers presentations with providers, provider staff, and/or physician leadership during monthly operational meetings.
Understands, develops, tracks, monitors and reports on key program performance metrics, such as utilization, coding, and STARs/quality performance.
Perform root cause analyses and resolution related to provider concerns, grievances, claims and care delivery.
Assist in the STARS and (Medicare/Medicaid rating scale for providers and health insurance companies) clinical metrics data collection, and design plans for enhanced provider engagement in quality initiatives.
Prepare materials and participate in monthly financial review with senior leadership.
Partners with other internal departments, including but not limited to Health Services, Finance, Claims, and Coding in order to develop solutions for strategic business needs.
Work closely with internal representative for needs and support.
Requires at least 50% local travel to providers in Birmingham, Alabama
Bachelor’s degree preferred.
1-2 years related experience working with providers in a healthcare environment preferred.
Intermediate level of Excel strongly preferred (knowledge of pivot tables, VLOOKUP, etc.)
Strong analytical and problem-solving skills.
Detail oriented, with proven time management and organization skills (including the ability to engage in multiple tasks and meet deadlines/standards).
Experience in financial/trend analysis preferred.
Experience with public speaking is a preferred.
Positive role model with the ability to work independently & in conjunction with co-workers of all levels.
Excellent communication skills – verbal, written and presentation.
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 a 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 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.