Provider Network Manager
Cigna
Madrid, Spain
hace 3 días

JOB DESCRIPTION

We're looking for a Provider Network Manager to join our team. You will be responsible for developing and executing negotiation strategies working directly with contracted providers in order to deliver best in class service to Cigna Global Health Benefit’s (CGHB) providers, customers and clients and act as the Subject Matter Expert regarding the local market’s environment, healthcare delivery practices and pricing.

Key Responsibilities :

  • Manages the relations with the top medical facilities based on medical spend and financial impact for the organization.
  • Provides coaching and support to the Jr. Provider Negotiators in the market cost analysis development and negotiations within the designated territory.
  • Identifies growth opportunities for expanding the network of providers in the regions and / or countries you are responsible for.
  • Performs service area analysis and cost analysis to identify network expansion, development and network renegotiation opportunities.
  • Reviews, negotiates and discusses existing agreements and contracts with regards to the content (direct payment agreements, fees, pricing and procedures)
  • Identifies cost containment opportunities and (re)negotiate favorable conditions with Health care providers.
  • Manages the relationship with existing and new Third Party Vendors
  • Monitor the quality of the services provided by the medical providers and the correct execution of the agreements
  • Acts as the expert for the providers with regards to the agreements, fees and pricing in the region for which you are responsible.
  • Acts as an expert with regards to the medical landscape in the countries within your region and continuously monitor evolutions in that respect.
  • Key Challenges / Anticipated Changes in Environment

  • Effectively communicates and interacts with other business units to achieve goals; Medical Management, CGHB Service Operations (NA, UK and Antwerp), Sales and Client Management (NA, UK, and Antwerp), and CGHB Strategy & Operations.
  • Qualifications :

  • Language skills - fluent in Italian and English.
  • University degree
  • 3 to 4 years of relevant experience
  • Good communication skills.
  • Excellent negotiation and influencing skills.
  • Analytical and critical mind.
  • Data mining competency
  • Proficiency with MS Office programs including : Word, PowerPoint, Excel, Project, and Visio required.
  • Experience / Knowledge Requirements :

  • Knowledge of high priority healthcare providers, third party administrators, CGHB competitor capabilities within the region of responsibility.
  • Excellent interpersonal, communication and motivational skills, including negotiation and presentation skills
  • 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 :

  • Results orientation ability to define goals, establish plans and manage work to achieve desired outcomes. Creates meaningful business related metrics and tracks progress / results.
  • Ability to work closely with the other department members, matrix partners and various CGHB departments with a time and distance disadvantage.
  • Excellent interpersonal, verbal, and written communication skills
  • Mature, with the ability to effectively communicate and influence individuals at different levels
  • Comfortable working in a fast paced environment with shifting priorities
  • Energetic and enthusiastic
  • A team player
  • Willing to travel regularly (up to 20%)
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