Provider Network Operations Advisor - Cigna Healthcare - Hybrid

Express Scripts

Hybrid
5+ years provider network management experience
Bachelor's degree or equivalent experience
Strong analytical and problem-solving skills
Cigna Healthcare is seeking a Provider Network Operations Advisor to enhance provider networks and ensure quality healthcare delivery. The role requires extensive experience in provider network management, analytical skills, and effective stakeholder communication, with a strong emphasis on compliance and regulatory knowledge

Job Summary

  • This role plays a key part in creating and maintaining provider networks that deliver quality, affordability, and access to care across a matrixed group of partners.
  • The advisor will troubleshoot provider data issues using Cigna systems like HCPM and Cognos while supporting accurate loading of contracts and reimbursement methodologies.
  • Candidates must partner with matrix teams to ensure accurate provider data for state filings and support recruitment efforts to address network adequacy gaps.

Matching Summary

Match Score: 85

Cigna Healthcare is seeking a Provider Network Operations Advisor to enhance provider networks and ensure quality healthcare delivery. The role requires extensive experience in provider network management, analytical skills, and effective stakeholder communication, with a strong emphasis on compliance and regulatory knowledge.

Skills & Requirements

Must-have

  • 5+ years provider network management experience
  • Bachelor's degree or equivalent experience
  • Strong analytical and problem-solving skills

Nice-to-have

  • Project management experience preferred
  • Knowledge of CMS regulations and NSA
  • Cigna systems experience preferred
  • Local market knowledge preferred

Key Requirements

  • Bachelor's degree required
  • 5+ years in provider network management or healthcare insurance
  • Proficiency in Microsoft Office

Work Rights

Not specified

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