Cigna Healthcare is seeking a Provider Network Operations Advisor for a hybrid role that focuses on creating and maintaining provider networks to enhance quality and accessibility of care. Candidates should have a strong background in provider network management and healthcare compliance, with excellent analytical and communication skills
Job Summary
Join Cigna Healthcare as a Provider Network Operations Advisor to create and maintain provider networks that deliver quality, affordability, and access to care.
Key responsibilities include provider data resolution, managing market guidebooks, serving as an SME for Alternative Access Networks, and facilitating affordability calls.
The role also involves ensuring network adequacy, supporting state filings, and maintaining regulatory compliance with various healthcare laws and guidelines.
Matching Summary
Match Score: 85
Cigna Healthcare is seeking a Provider Network Operations Advisor for a hybrid role that focuses on creating and maintaining provider networks to enhance quality and accessibility of care. Candidates should have a strong background in provider network management and healthcare compliance, with excellent analytical and communication skills.
Skills & Requirements
Must-have
Provider data resolution
Market guidebook management
Alternative Access Network expertise
Affordability initiatives
Network adequacy and state filings
Nice-to-have
Strong analytical and problem-solving skills
Excellent communication and stakeholder management
Ability to work independently
Key Requirements
5+ years of experience in provider network management or healthcare insurance
Bachelor's degree or equivalent experience
Project management experience preferred
Healthcare compliance and regulatory experience preferred
Knowledge of CMS regulations, NSA, and reimbursement structures preferred