Note: The job is a remote job and is open to candidates in USA. Cigna Healthcare is an advocate for better health through every stage of life. The Provider Relations Lead Analyst plays a crucial role in managing provider relations and contract management while collaborating with senior DSO leadership and internal stakeholders.
Responsibilities
• Engage and present to senior DSO leadership, including at times CEOs and CFOs.
• Build and maintain strong relationships with day-to-day contacts within assigned DSO groups.
• Demonstrate knowledge of DPPO and DHMO products, including compensation structures and administrative processes.
• Respond to provider inquiries, concerns, complaints, appeals, and grievances within designated timeframes.
• Collaborate with internal and external partners to resolve complex, escalated, or sensitive issues.
• Provide ongoing education on dental products to assigned groups.
• Promote and support enrollment in delegated credentialing, Electronic Data Interchange (EDI), and Electronic Funds Transfer (EFT) programs.
• Analyze financial data and communicate practice needs to internal finance teams to develop mutually acceptable compensation arrangements.
• Develop and evaluate financial proposals using strong analytical skills.
• Manage budgets and monitor financial performance of contracts to ensure compliance with contracting guidelines.
• Perform other duties and projects as assigned.
Skills
• Engage and present to senior DSO leadership, including at times CEOs and CFOs.
• Build and maintain strong relationships with day-to-day contacts within assigned DSO groups.
• Demonstrate knowledge of DPPO and DHMO products, including compensation structures and administrative processes.
• Respond to provider inquiries, concerns, complaints, appeals, and grievances within designated timeframes.
• Collaborate with internal and external partners to resolve complex, escalated, or sensitive issues.
• Provide ongoing education on dental products to assigned groups.
• Promote and support enrollment in delegated credentialing, Electronic Data Interchange (EDI), and Electronic Funds Transfer (EFT) programs.
• Analyze financial data and communicate practice needs to internal finance teams to develop mutually acceptable compensation arrangements.
• Develop and evaluate financial proposals using strong analytical skills.
• Manage budgets and monitor financial performance of contracts to ensure compliance with contracting guidelines.
• Perform other duties and projects as assigned.
• Bachelor’s degree or equivalent experience.
• 3+ years of dental industry experience required.
• Background in dental insurance, with knowledge of PPO and DHMO products.
• Experience in customer service or provider relations.
• Self-starter with strong organizational skills.
• Ability to manage multiple priorities independently.
• Proficiency in Microsoft Excel and ability to learn specialized systems quickly.
• Strong skills in analytics, negotiation, financial analysis, reporting, presentations, and both written and verbal communication.
• Detail-oriented with a high level of accuracy.
• Willingness and ability to travel is needed.
• Clinical or dental office experience is a plus.
Benefits
• Medical
• Vision
• Dental
• Well-being and behavioral health programs
• 401(k) with company match
• Company paid life insurance
• Tuition reimbursement
• A minimum of 18 days of paid time off per year
• Paid holidays
Company Overview
• We are a health benefits provider that advocates for better health through every stage of life. It was founded in 1982, and is headquartered in Bloomfield, CT, US, with a workforce of 10001+ employees. Its website is http://www.cigna.com.
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