Network Operations Senior Advisors, Provider Performance Enablement- Cigna Healthcare- Hybrid
About the position
The Provider Performance Senior Advisor plays a crucial role in managing and enhancing the performance of the provider network within a specific market. This position involves collaboration across various departments to ensure effective performance management, particularly focusing on complex relationships with multi-site health systems and national primary care clinics. The advisor is responsible for driving quality and cost efficiency, overseeing financials related to value-based contracts, and leading initiatives to improve Stars & Risk Adjustment outcomes. The role requires strong relationship-building skills and strategic thinking to support the growth and profitability of the Medicare Advantage business.
Responsibilities
Develop and manage the local physician/provider network to drive high performance in quality and cost efficiency.
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Oversee provider group financials, including monthly action plans and reviews related to value-based incentive contracts.
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Provide feedback and recommendations regarding participation in agreements and address financial or operational issues with providers.
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Lead Stars & Risk Adjustment outcomes through local Provider Performance initiatives.
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Develop and implement programs for enhanced quality and affordability through physician education and analytics resources.
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Act as a government program knowledge leader for the local market.
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Maintain compliance with CMS and company policies and guidelines.
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Lead market initiatives and perform special projects as assigned by leadership.
Requirements
Bachelor's degree preferred.
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At least eight (8) years of direct experience with government-sponsored health plans.
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Ability to apply an enterprise mindset with business acumen to meet or exceed growth and profitability goals.
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Demonstrated strategic thinking and customer focus with strong relationship-building skills.
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Capacity for leading initiatives and influencing market teams, driving transparency and accountability.
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Effective communication skills and ability to develop relationships across multiple organizational levels.
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Proficient in Microsoft Outlook, Excel, PowerPoint, and Word.
Nice-to-haves
Benefits
Medical, vision, and dental insurance coverage starting on day one.
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Well-being and behavioral health programs.
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401(k) with company match.
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Company-paid life insurance.
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Tuition reimbursement.
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A minimum of 18 days of paid time off per year and paid holidays.
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