Cigna
CareAllies Network Operations Senior Analyst: Houston, Texas - Hybrid - Cigna He
Cigna, Houston, Texas, United States, 77246
Serves as primary contact for providers and provider staff to assist in contract management and provide supporting analyses for network and performance optimization. Develops and maintains positive relationships with physicians, providers, and practice managers within the network, including oversight and managing performance in various incentives based and/or value based programs.
Requires up to 30-50% local travel to providers in the Houston, TX market areaTwo in office days per week required, remaining three field based/work from homeCar & valid driver's license required (mileage reimbursement provided)RESPONSIBILITIES:
Provide tactical operations support to assigned groups, including contracting, credentialing, data integrity, communications, and relationship management
Complete orientation/onboarding of new physicians
Create and deliver materials to educate providers and provider staff on contracts, policies and procedures, quality and service line initiatives, and financial performance
Visit all PCPs monthlySchedule recurring monthly meetings with key staff with PCPs on a performance improvement planInclude all support team members including performance improvement teamVisit capped specialists every other monthVisit fee for service specialists quarterly
Ensures all provider interactions are documented in SalesforcePrepares and delivers presentations with providers, provider staff, and/or physician leadership during monthly operational meetings
Collaborate and present at office staff meetings
Understands, develops, tracks, monitors and reports on key program performance metrics, such as utilization, coding, and STARs/quality performancePerform root cause analyses and resolution related to provider concerns, grievances, claims and care deliveryPrepare materials and participate in monthly financial review with senior leadershipPartners with other internal departments, including but not limited to Health Services, Finance, Claims, and Coding in order to develop solutions for strategic business needsWork closely with internal representatives for needs and supportOther Duties as assignedQualifications:
Bachelor's degree preferred (with a Healthcare concentration),2+ years of experience in healthcare administration or provider relationship management preferred.Detail oriented, with proven time management and organization skills (including the ability to engage in multiple tasks and meet deadlines/standards).Be a positive role model and have the ability to work independently and in conjunction with co-workers of all levels.Strong analytical and problem-solving skills.Excellent communication skills - verbal, written and presentation.Strong analytical and problem solvingBasic to Intermediate level of Excel preferred (knowledge of pivot tables, VLOOKUP, etc.)
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Requires up to 30-50% local travel to providers in the Houston, TX market areaTwo in office days per week required, remaining three field based/work from homeCar & valid driver's license required (mileage reimbursement provided)RESPONSIBILITIES:
Provide tactical operations support to assigned groups, including contracting, credentialing, data integrity, communications, and relationship management
Complete orientation/onboarding of new physicians
Create and deliver materials to educate providers and provider staff on contracts, policies and procedures, quality and service line initiatives, and financial performance
Visit all PCPs monthlySchedule recurring monthly meetings with key staff with PCPs on a performance improvement planInclude all support team members including performance improvement teamVisit capped specialists every other monthVisit fee for service specialists quarterly
Ensures all provider interactions are documented in SalesforcePrepares and delivers presentations with providers, provider staff, and/or physician leadership during monthly operational meetings
Collaborate and present at office staff meetings
Understands, develops, tracks, monitors and reports on key program performance metrics, such as utilization, coding, and STARs/quality performancePerform root cause analyses and resolution related to provider concerns, grievances, claims and care deliveryPrepare materials and participate in monthly financial review with senior leadershipPartners with other internal departments, including but not limited to Health Services, Finance, Claims, and Coding in order to develop solutions for strategic business needsWork closely with internal representatives for needs and supportOther Duties as assignedQualifications:
Bachelor's degree preferred (with a Healthcare concentration),2+ years of experience in healthcare administration or provider relationship management preferred.Detail oriented, with proven time management and organization skills (including the ability to engage in multiple tasks and meet deadlines/standards).Be a positive role model and have the ability to work independently and in conjunction with co-workers of all levels.Strong analytical and problem-solving skills.Excellent communication skills - verbal, written and presentation.Strong analytical and problem solvingBasic to Intermediate level of Excel preferred (knowledge of pivot tables, VLOOKUP, etc.)
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.