Maricopa County based - Provider Data Senior Representative provides broad support to Network Operations Representatives, Sr. Supervisor, Sr. Manager, Director.  Network Operations is responsible for the financial and operational activities of provider networks and this position involves extensive interaction with Network Operations staff as well as other Cigna Matrix Partners. Position is exposed to all aspects of a Coordinated Care Organization (financial understanding, provider network building, conflict/issue resolution, contracting, claim payment, meetings, training, etc.).

Duties and Responsibilities

• Responsible for System roster reconciliation and submission of provider data into the PDQ team
• Generate, format, quality check, and distribute network Independent Provider Network roster reporting.
• Generate, format, quality check, and distribute network IPN Annual Wellness Exam reporting. Collaborate with Manager to create leadership level presentations.
• Manage Network Letters of Interest from intake to decision communication.  Support Manager and contracting team for new contract initiation and respond with official communication for denials. 
• Assist with management of provider demographic loading into all systems in accordance with CMS regulations
• Conduct provider outreach via outbound calls for demographic validation
• Receive and direct grievances needing market review with the appropriate Network Operations team member
• Support reporting needs of Network Operations team including Financial performance reporting, Stars, Utilization, etc.

Qualifications

• High school degree required
• Knowledge of healthcare insurance industry, terminology, provider networks, contracting and credentialing
• Strong analytical and problem-solving skills
• Excellent communication skills – verbal, written and presentation
• Working knowledge of SharePoint, Microsoft Word, & Access
• Strong knowledge of Microsoft Excel.

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you’ll enjoy meaningful career experiences that enrich people’s lives. What difference will you make?

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.