It's fun to work in a company where people truly BELIEVE in what they are doing!
We're committed to bringing passion and customer focus to the business.

SUMMARY:

Develops and maintains positive relationships with physicians, providers, practice managers, hospitals and/or ancillaries within the provider network.

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.

RESPONSIBILITIES:

• Prepares documentation for meetings, schedules meetings, visit PCP/specialist officers for relationship building and performance insight.
• Educates providers regarding member benefits and referral process.
• Responsible for assisting with the general oversight of provider network financials, including monthly action plans, reviews, trend analysis, and verification
• Provides internal support to Network team.
• Researches and resolves provider issues.
• Develops, maintains, and distributes reports.
• Performs quality checks on provider communication material.
• Maintains provider contract files and system information.
• May assist with physician bonus distribution.
• May be responsible for support of the Ancillary Network team through problem resolution and researching appeals for facilities (hospital and ancillaries) through claims review, pricing, and authorization requirements.
• May research MSM inquiries through the claims systems to resolve discrepancies and draft letters to send to providers for resolution to issues.
• Primarily local travel. Early morning and evening meetings with Physician Networks as needed.
• Valid driver’s license, vehicle, and insurance required (mileage reimbursement)
• Must live in the Tampa area

QUALIFICATIONS:

• Relationship management and building trust
• High degree of financial acumen
• Ability to develop win/win scenarios between Cigna HealthSpring and business partners
• Ability to use available IT systems to generate meaningful insight to drive business performance
• Possess strong business acumen
• Strong time management, project management and organization skills with the ability to manage/support multiple projects and priorities
• Demonstrated ability to work in a highly-matrixed environment and with all levels
• Excellent verbal and written communication skills
• Competent in data management
• Technical: Computer skills: Excel, Power Point, Word

Minimum: Bachelor’s degree preferred

Experience in physician relationship management

Managed care setting preferred

At least one year customer service, claims, and/or payor related experience

Bilingual in Spanish preferred

Preferred: Master’s Degree & MSO/IPA experience as well as experience in Medicare Advantage, physician relations, managed care, and/or hospital/facility management.

Qualified applicants will be considered for employment without regard to age, race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status.

If you require an accommodation based on your physical or mental disability please email: [email protected] Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.