Provider Contracting Lead Analyst

at  The Cigna Group

JOB OBJECTIVE:

APAC Provider Network Manager will be responsible for developing and executing negotiation strategies working directly with contracted providers such as clinics, outpatient facilities, pharmacies, among others, in order to deliver best in class service to CGHB’s providers, customers and clients and act as the Subject Matter Expert regarding the local market’s environment, healthcare delivery practices and pricing.

JOB DESCRIPTION:

• Manages the contracting and relations with medical facilities, including but not limited to: Hospitals, clinics, pharmacies and physicians.
• Works with Network Leads in performing service area analysis and cost analysis to identify network development and network renegotiation opportunities to meet affordability target.
• Analyzes and determines in which countries, regions and cities our network of providers must grow.
• Negotiate with clients and client managers the most appropriate network extension efforts in the allocated region.
• Negotiates and discuss agreements (direct payment agreements and/or discounts fees and price agreements).
• Manage the relationship with the providers under agreement in allocated regions and monitor the quality of their services and execution of the agreements in conjunction with Network Lead.
• Acts as an expert with regards to the medical landscape in the countries within your region and continuously monitor evolutions in that respect
• Ensures the correct handling of all administrative aspects of the agreements with the providers.
• Maintains the Provider Data Base and make overviews of provider networks for all providers within the assigned region.
• Analyzes price lists and data, write clear conclusions and identify cost containment opportunities.
• Act as the internal key person for all other Units and departments for issues relating to the providers in the allocated regions. Especially intensive communication with Clinical, Service OPS and Sales and Client Management.
• Effectively communicates and interacts with other business units to achieve goals.

Please refer the Job description for details