Job Description
- Key Responsibilities:
- Perform regular network review to optimize cost and maximize value.
- Lead the savings program to identify new opportunities for cost improvement in line with yearly target.
- Collaborate with TPA to Build and manage the referral network.
- Build new opportunities to secure discounts and rebates (network and customer based) in partnership with TPA.
- Highlight strategic opportunities to Cigna Senior Management on new opportunities or expanding on existing opportunities with new or existing providers
- Manage the reconciliation process with providers to ensure delivery in line with target.
- Control risk cost, bend the claims curve and utilization/volume though regular utilization review.
- Promote quality of healthcare by monitoring conversion/readmission rates, LOS, medical outcome, preventative healthcare.
- Collaborate with TPA
- Facilitate with TPA for the constructive handling or resolution of conflict with providers
- Adherence to scope management and change control processes; assess and evaluate scope changes for feasibility and impacts on commitments
- Experienced at identifying risks, issues, and mitigation plans and working with leadership to drive to resolution
- Builds an environment of trust, collaboration, and openness among peers and other team members. Shares lessons learned, perceptions, and best practices openly with an eye towards continuous process improvement
- Proposes recommendations and adjustments to project delivery and related solutions throughout the life of the initiative
- Communicates clearly with all levels of stakeholders to ensure deliverables are hit. Can articulate tradeoffs and impacts with the big picture in mind to enable strategic and tactical decision making as well as mitigate risk.
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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: SeeYourselfEMEA@cigna.com for support. Do not email SeeYourselfEMEA@cigna.com for an update on your application or to provide your resume as you will not receive a response.
