Provider Contracting Director-West Region; Remote

Position: Provider Contracting Director-West Region (Remote)
** Regional Director, Contract Management-West Region*
* *
* Position Overview:

*
* · Overall accountability for ensuring that field contractors comply with contracting standards, including use

of current core contracts, reimbursement standards, network and contract policy, and the provider

contract escalation and review process.

· Provide guidance and support to field contractors on national standards and use of the Contract

Management System

· Supports field contractors on non-standard issues and works closely with the National Contracting

Standards & Policy team on policy, language, and "ability to administer" issues as well as on reporting

and compliance with the exception review process.

** Contract Review and Escalation Process:*
* · Work with contractor to develop appropriate response and/or contractual language that does not

jeopardize Cigna's contracts with employers, internal policies or standards. Any language request

which could have adverse impact to Cigna is brought to Contracting Regional Vice President (RVP) for discussion and intervention with

the provider, if necessary.

· Ensure required documentation is complete prior to signature by RVP or Market Lead.

· Facilitate internal and external audit requirements.

** Training/Contract Standards:*
* · Ensures members of field contracting team receive appropriate and continuous training in all aspects of

contracting standards, including use of current, appropriate, core contract templates; preferred

reimbursement standards; national network and contracting policy; and the standard contract process.

· Ensures understanding and compliance by field contractors with the standard contract process and review

of all exceptions to "ability to administer", financial objectives, policies, and language.

· Provides consultative support to field contractors on contracting, policy and procedural issues as needed.

** Contract Management System:*
* · Supports field contracting in maximizing use of system.

· Ensure all new employees receive the appropriate training.

· Monitors Contract Manager usage in accordance with the established guidelines.

· Develop contract language and rate exhibit options for field use.

** Administration :*
* · Collaborates with other RDs, Network Analytics Unit and other national functions such as claim

operations, medical management, and legal to share best practices and devise creative solutions to

complex problems.

· Works with national groups to continually review and improve the SARU (Satisfactory, Acceptable, Review
- able and Unacceptable) contract standards for all contract types.

· Partners closely with US Medical Network Contracting Readiness  to ensure policies and

standards are communicated to the field staff appropriately.

** Policy:*
* · Works closely with Standards & Policy Committee to identify and resolve issues requiring cross
- functional solutions, policy making and communication.

· Provides input and support to national projects (e.g. new product roll-outs, regulatory compliance initiatives,

etc.) requiring contract content reviews, language compliance assessments and/or network participation

assessments. Works with local contract teams on language remediation initiatives.

*
* Qualifications:

*
* + 7+ years in Medical Contracting, Negotiating and Provider Services

+ Ability to foster collaboration, value others perspectives and gain support and buy-in for organizational proposals

+ Matrix management skills.

+
· Ability to drive and lead an organization through change.

+ Excellent interpersonal and relationship management skills.

+ Excellent oral, written and presentation skills required.

+ Strong collaboration, negotiation and leadership skills.

+ Strong organizational and analytical skills that result in conclusive recommendations.

+ Ability to think critically with respect to improvement of end-to-end business process

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10

Mbps download/5

Mbps upload.

For this position, we anticipate offering an annual salary of 156, USD / yearly, depending on relevant factors,…