Provider Contracting Advisor - Cigna Healthcare - Raleigh, NC (Hybrid)

Join Cigna Healthcare, a division of The Cigna Group, and help shape our provider network. As aProvider Contracting Advisor,you’llreport to the AVP,ProviderNetwork Management. In this individual contributor role,you’llassistin developing the strategic direction and management of day-to-day contracting and network management.

This is a hybrid position based in Raleigh, NC.

Responsibilities

• Manage complex fee-for-service and value-based contracting and negotiations with large physician groups, ancillaries, and hospital systems.

• Lead key market contracting strategy projects with responsibility for managing direct reports as assigned.

• Build andmaintainstrong provider relationships to support network growth and value-based business opportunities.

• Coordinate closely with matrix partners (i.e., Claims, Medical Management, Credentialing) to ensure aligned execution.

• Develop strategic network positions,identifyvalue-oriented and risk-based opportunities, and contribute to alternative network initiatives and analytics.

• Work to meet unit cost targets whilemaintainingan adequate, competitive provider network.

• Design and manage initiatives to improve medicalcostand quality, offering consultative guidance informed by clinical informatics.

• Prepare, review, and project thefinancial impactof large or complex provider contracts and alternative terms.

• Create, implement, and ensure operational accuracy of HCP agreements through effective cross-functional collaboration.

• Lead resolution of escalated provider issues and manage key provider relationships with deep knowledge of the local market landscape including contract loading and maintenance.

Required Qualifications

• 3-5+years of healthcare provider contracting and negotiating experience involving complex physician groups and ancillaries

• Background in managed care, healthcare, or health insurance, including commercial contracting

• Proven leadership experience, including mentoring and guiding others

• Strong provider relationship management skills and success developing long-term-partnerships

• Knowledge of complex reimbursement methodologies, including incentive-based models (strongly preferred)

• Deep understanding of hospital, managed care, and provider business models with the ability to influence sales and provider audiences

• Exceptional presentation and communication skills, including the ability to build internal relationships in a fast-paced, matrixed organization

• Customer-centric approach, strong interpersonal skills, and confidence in navigating change

• Strong problem-solving, decision-making, negotiation, contract interpretation, and financial analysis skills

• Proficiencyin Microsoft Office

Preferred Qualifications

• Bachelor’s degree in a related field (industry experience may substitute); MBA / MHA preferred