Job description

The Behavioral Provider Relations Representative is responsible for the overall servicing and quality oversight of the behavioral network. This role coordinates with various departments to educate all provider types and to facilitate resolution to any issue. The Provider Relations Representative’s goal is to improve the provider experience and increase provider satisfaction.

Role & Responsibilities

Work with clinics and individual providers to help educate, assist with administrative questions, facilitate resolution with any issue and help provider to navigate resources.
Address provider requests received from the provider services call center on complex issues within 48 hours
Drive use and adoption of provider website resources and tools.
Resolve customer complaints/concerns surrounding provider’s; working closely with national complaint/appeals team to ensure compliance including the Medicare network.
Assist with directory accuracy by working closely with providers to update demographics as well as specialties
Perform administrative review of provider treatment records.
Identify providers for onsite EAP requests
Assist with sending termination letters to Medicare network members
Foster relationships and collaborate with key internal matrix partners within the behavioral network department, the entire behavioral organization, the connected care provider organization as well as the markets.
Identify and participate in process improvement activities to improve provider experience and increase provider satisfaction.
Actively participate in the behavioral network communication strategy through generating ideas for planned communications and authoring monthly newsletter article.

Minimum Requirements
Bachelor's degree with 3-5 years of experience within the behavioral provider services/relations and/or contracting/network development
Knowledge of managed care (network design, products, customer service, provider communities, etc.).
Ability to work independently, think creatively and solve complex problems in a collaborative and inclusive manner.
Strong organizational, analytical and prioritization skills.
Act with sense of urgency to research questions or issues and assist in identifying the right parties or resources to resolve these issues.
Excellent oral, written, and presentation skills
Ability to think strategically while understanding how specific decisions impact overall vision/mission.
Detail oriented, with proven time management and organization skills (including the ability to engage in multiple tasks and meet deadlines/standards)
Comfortable with raising questions, issues, ideas or suggestions across all levels of the organization.
Knowledge of Policy & Procedures, Behavioral Network Operations, and supporting operating systems.

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.

For this position, we anticipate offering an annual salary of 55,600 - 92,600 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group .

About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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.

offroadmanagementgroup.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, offroadmanagementgroup.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, offroadmanagementgroup.com is the ideal place to find your next job.