Cigna Healthcare is seeking a Remote Provider Relations Specialist to join our dynamic team. This remote position offers the flexibility to work from home while playing a vital role in enhancing the relationship between Cigna and its network of healthcare providers. As a Provider Relations Specialist, you will be responsible for developing and maintaining positive, productive relationships with healthcare providers, ensuring they are supported in delivering high-quality care to Cigna members.

This is an exciting opportunity to make a significant impact by improving the provider experience, facilitating communication, and driving operational efficiencies that contribute to better healthcare outcomes.

Key Responsibilities:

• Provider Engagement: Build and maintain strong, effective relationships with healthcare providers, including physicians, hospitals, and other medical professionals, ensuring their needs are met and any concerns are addressed promptly.
• Issue Resolution: Serve as the main point of contact for providers, addressing and resolving any issues related to claims, billing, policies, or network participation in a timely and efficient manner.
• Training & Education: Provide training and support to healthcare providers regarding Cigna policies, processes, and tools, ensuring they understand how to navigate our systems and maximize their partnership with Cigna.
• Contract Management: Assist in the negotiation and execution of provider contracts and amendments, ensuring compliance with Cigna network standards and guidelines.
• Data Analysis & Reporting: Analyze provider performance data to identify trends, issues, and opportunities for improvement. Prepare reports and present findings to leadership and other internal teams.
• Collaboration with Internal Teams: Work closely with internal departments such as claims, customer service, and network management to ensure smooth processes and alignment with organizational goals.
• Provider Support: Address provider inquiries regarding reimbursement rates, claims status, and operational procedures, ensuring high satisfaction levels.
• Market Expansion: Assist in expanding Cigna provider network by identifying and recruiting new providers to join the network, helping to meet the growing needs of our members.

Required Qualifications:

• Bachelor degree in healthcare administration, business, or a related field (or equivalent experience).
• 2+ years of experience in provider relations, network management, or a similar healthcare-related role.
• In-depth understanding of healthcare reimbursement models, claims processes, and provider networks.
• Strong communication, negotiation, and interpersonal skills, with the ability to foster strong relationships with diverse provider groups.
• Proficiency in using Microsoft Office Suite, and familiarity with provider management and CRM tools.
• Excellent problem-solving skills with a focus on delivering solutions to providers needs.
• Ability to work independently in a remote work environment, managing time effectively and meeting deadlines.

Preferred Qualifications:

• Experience working with health insurance carriers or within managed care.
• Knowledge of healthcare regulations, HIPAA compliance, and industry best practices.
• Experience with telehealth, value-based care, and digital health solutions.

Why Cigna?

• Remote Work Flexibility: Enjoy the benefits of a fully remote position while working for a global leader in healthcare services.
• Career Development: Cigna offers numerous opportunities for career growth, continuing education, and professional development.
• Comprehensive Benefits: Cigna provides competitive health benefits, dental, vision, retirement plans, and wellness programs to promote a balanced work-life experience.
• Diversity & Inclusion: Cigna is committed to fostering an inclusive workplace where diversity is celebrated, and all employees are empowered to reach their full potential.

How to Apply:If you are passionate about improving provider relationships and delivering exceptional service, apply now to become a Remote Provider Relations Specialist at Cigna Healthcare!