Provider Relations Representative - Baltimore, MD

Cigna - Baltimore, MD3.7

Full-timeEstimated: $63,000 - $85,000 a year
EducationSkillsBenefits
Help influence the future of healthcare while using your analytical, financial and presentation skills . Work with the physician/provider population educating and influencing them to improve the lives of our members.

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.

SUMMARY:
Develops and maintains positive relationships with physicians, providers, and practice managers within the provider network, including oversight and managing performance in various incentives based and/or value based programs.
Requires up to 75% local travel to network providers
Coverage area – Baltimore, Washington, DC, and surrounding counties
Car & valid driver's license required (mileage reimbursement provided)

RESPONSIBILITIES:
Conducts regular provider visits to educate providers and office staff on topics including, but not limited to: health plan operations/policies and procedures, preventative and quality outcome metrics, risk adjustment, etc.
Educates providers on the performance requirements associated with value-based contracts
Understands, develops, tracks, monitors and reports on key program performance metrics, such as utilization, coding, and STARs/quality performance
Conducts root cause analysis and resolution of provider concerns
Participates in monthly financial review with senior management
Partners with other internal departments, including but not limited to Health Services, Medical Economics, Sales, and Coding in order to develop solutions for strategic business needs
Prepares for and participates in meetings with providers, provider staff, and/or physician leadership, and plans, creates and delivers presentations.
May provide guidance to others in the department

Qualifications

QUALIFICATIONS:
Bachelor’s Degree or equivalent work experience
Strong analytical and problem solving
Strong communication skills
Intermediate to Advanced proficiency in Microsoft Office products required – must be proficient in pivot tables, vlookup, ability to create Power Point presentations and creating letters.

Preferred Requirements:
Bachelors’ degree in Healthcare Administration or Business Administration
At least 2 years of experience in healthcare administration or provider relationship management.
Demonstrated knowledge of contracting process, Medicare fee schedules, financial terms, and metrics preferred
Qualified applicants will be considered for employment without regard to age, race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status. Need an accommodation? Email: SeeYourself@cigna.com