Provider Contracting Advisor - Cigna Healthcare - Wisconsin

About the Role

The role entails working closely with cross-functional teams, including Claims, Medical Management, and Credentialing, to align execution and achieve business objectives. You will also be responsible for building and maintaining strong provider relationships, identifying value-oriented and risk-based opportunities, and contributing to alternative network initiatives and analytics.

The Provider Contracting Advisor will report to the AVP, Provider Network Management, and will be an individual contributor role. You will have the opportunity to work on key market contracting strategy projects, manage direct reports as assigned, and contribute to the development of strategic network positions.

What You Will Do

• 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 and maintain strong provider relationships to support network growth and value-based business opportunities
• Coordinate closely with matrix partners to ensure aligned execution
• Develop strategic network positions, identify value-oriented and risk-based opportunities, and contribute to alternative network initiatives and analytics
• Work to meet unit cost targets while maintaining an adequate, competitive provider network
• Design and manage initiatives to improve medical cost and quality, offering consultative guidance informed by clinical informatics
• Prepare, review, and project the financial impact of 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
• Maintain current knowledge of hospital, managed care, and provider business models, and apply this knowledge to influence sales and provider audiences

What We Are Looking For

• 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
• Deep understanding of hospital, managed care, and provider business models
• 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
• Proficiency in Microsoft Office

Nice to Have

• Bachelor's degree in a related field (industry experience may substitute)
• MBA / MHA preferred
• Experience with value-based care models and alternative payment arrangements
• Knowledge of healthcare regulations and compliance requirements

Benefits and Perks

• Competitive salary and benefits package
• Opportunity to work remotely with a flexible schedule
• Professional development and growth opportunities
• Comprehensive health insurance and wellness programs
• Retirement savings plan and matching contributions
• Paid time off and holidays
• Access to cutting-edge technology and tools
• Collaborative and dynamic work environment
• Recognition and reward programs for outstanding performance
• Employee discounts and perks
• Opportunities for career advancement and professional growth

• Be prepared to discuss your experience with complex contract negotiations and provider relationships in your interview.
• Make sure to highlight your knowledge of value-based care models and alternative payment arrangements in your application.
• Showcase your strong problem-solving and decision-making skills by providing specific examples from your previous experience.
• Emphasize your ability to build strong internal relationships and navigate complex organizational structures.
• Be ready to discuss your experience with Microsoft Office and other relevant software tools.
• Consider obtaining certifications or training in healthcare contracting and negotiations to increase your competitiveness for the role.
• Be prepared to negotiate your salary and benefits package, and make sure to research the market rate for the position beforehand.