As a Provider Network Manager you will be part of the Provider Services Organization, being responsible for developing and managing relationships with Health Care Providers in Africa. You will work very closely with peers and stakeholders strategically positioned across the globe to deliver best in class service to CGHB’s providers, customers and clients.
Key to the role will be managing providers’ end-to-end journey, from on-boarding, enquiries, training, performance monitoring, complaints resolution and driving engagement initiatives.
Key Responsibilities:
- Manages contracting and relations with healthcare providers including but not limited to Hospitals, clinics, pharmacies and physicians.
- Collaborates with respective teams in performing service area analysis and cost analysis to identify network development and renegotiation opportunities.
- Acts as an expert with regards to the medical landscape in the countries within your region and continuously monitor evolutions in that respect.
- Conducts smooth on-boarding and all aspects of health care professional education for existing and newly contracted health care professionals in the region.
- Manages day-to-day operational maintenance of provider relationships including resolution of potential complaints, escalations, suspensions or threats.
- Monitors and analyzes data such as Operations KPIs and reconciliation results to provide a comprehensive support to providers on their interpretation.
- Strive for continuous service improvement via analyses of root causes and proactive implementation of data-driven initiatives.
- Proactive communication with providers and maintenance of provider communications channels taking into consideration the local habits and practices..
- Provide consolidated feedback to PSO management team
- Conduct provider visits as applicable and regular meetings with your dedicated health care providers.
Your profile
- If internal 2 years of Cigna experience, relevant experience in other functions, and a strong performance track record.
- If external, at least 3 years of experience in provider relations, network management or network operations with a customer/provider-facing experience profile.
- Proficient in English and Portuguese. Any other additional language is a plus.
- Strong analytical and problem-solving skills.
- International mind-set able to work remotely with colleagues, partners and providers across the globe.
- Striving for excellent service to our members, clients and providers is part of your DNA.
- Strong can-do attitude, and high qualification in relationship management, including broad understanding of multicultural behaviors.
- Action-oriented, problem-solving attitude
- Excellent organization, planning and prioritization skills to meet deadlines.
- Experience in complaints management - with a proven track record in improving customer service standards.
- Ability to assess the situation/issue, carry out appropriate research, gather the relevant data and provide constructive feedback on the outcome.
- Accountability – to assume ownership for achieving personal results and to contribute for collective team goals.
- Excellent communication skills – verbal, written and presentation.
- Be a positive role model and be able to work independently and in conjunction with co-workers of all levels.
- Experience interpreting data, drafting reports.
- Strong practical knowledge of MS Office applications, including Excel.
- Availability to travel 10% of your time (estimation).
About Cigna Healthcare
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: SeeYourselfEMEA@cigna.com for support. Do not email SeeYourselfEMEA@cigna.com for an update on your application or to provide your resume as you will not receive a response.