National Contracting Medicare Senior Advisor

National Contracting Medicare Senior Advisor

14 Oct 2024
Connecticut, Bloomfield, 06002 Bloomfield USA

National Contracting Medicare Senior Advisor

The National Ancillary & Non-par Management (NANPM) Senior Advisor role is a critical in driving Cigna's affordability programs. Cigna contracts with over 150 national ancillary relationships representing over 40% of Cigna's total medical cost savings. The NANPM Medicare Senior Advisor is responsible for negotiating Medicare Supplemental contracts, drive operational efficiencies by designing a commercial /senior segment engagement model, establish NANPM Management Process, supports implementation of strategic priorities, and provides data and information to maximize value.This role collaborates with Vendor Segment Leads, Service & Operations, Compliance, Legal, etc. to develop Corrective Action Plans, Business Continuity Plan, Annual Bid process planning and participation. This position is internally and externally facing and will directly oversee relationships between the Commercial and Medicare Advantage Segment encompassing Supplemental vendor relationships including but not limited to Vision, Hearing, Transportation, Dental, Fitness, and Over the Counter supplemental programs. This is a critical position on the NANPM Team and a direct report to the Senior Director of NANPM Medicare & Commercial Alignment. Experience with Medicare Advantage and /or the Government Business is required for success.This is a high functioning leadership role encompassing matrix management, account team engagement, relationship management, strategic planning, corrective action planning, project management, contracting and service delivery, overall service quality (STARS), and business project management responsibilities.DUTIES AND RESPONSIBILITIES

Works directly with Medicare Supplemental partners to negotiate, manage, retain cost effective and quality programs.

Accountable for negotiation and financial performance of contracted vendor relationships

Engages Markets, Product and Clinical partners to understand business needs, drive improvements and create win-win scenarios in new and existing spend categories

Responsible for advocating for external partnerships within Cigna MA

Accountable for conveying Cigna MA, regulatory and other compliance standards and ensuring effective implementation

Collaborates with National Contracting Service & Operations team to mitigate Corrective Action Plan (CAPs) and create when needed.

Leads strategy development, improve operational performance, internal/external relationships across assigned national ancillary segment. Anticipates and mitigates downstream impacts to HCPs, Customers, and Clients. Removes barriers for service operations and improve vendor performance within assigned segments.

Serves as the Executive Liaison and single point of accountability for the programs impacting both the commercial and senior segments

Leads quarterly strategic business review meetings to include vendors and internal business partners and to review vendor / program performance

Monitors and understand Cigna HealthSpring programs, policies, procedures, products, and strategies and how those impact or are impacted by national ancillary partners

Understands and mitigates Supplemental program impacts to the providers, client, and customers in balance with overall program requirements. Responsible for on-going identification of improvement opportunities to the provider and customer experience.

Works closely with National Contracting to understand and contribute towards overall affordability program strategy specific to each segment.

Responsible for ensuring Supplemental Programs are in compliance with CMS guidelines in partnership with FDR Operations and Cigna-HealthSpring matrix partners.

Contributes to national contracting strategy and collaborates with senior leadership both internally and externally to achieve total medical cost savings.

Advocate and educate on Medicare Supplemental Programs and ensure alignment with broader team strategy and goals.

Responsible for collecting, documenting, and sharing market intelligence relative to their national ancillary segment; use market intelligence to inform strategy.

Provides oversight to Supplemental Program implementation or re-implementation within required timelines and in accordance with regulatory requirements.

Supports the project prioritization process, MOR and service reporting processes with a focus on successful delivery of the highest value projects. Engages key leadership both internally and externally to drive both short and longer term, sustainable solutions POSITION REQUIREMENTS

Bachelor’s degree or equivalent work experience; Master’s degree preferred.

8-10 years of experience in provider, client and customer relations, contracting or national ancillary account management environment.

Experience with Medicare Advantage, Cigna HealthSpring Operations and Supplemental programs

A broad, enterprise-wide view of the business and interdependencies across external national ancillary programs and internal cross organizational areas

Previous experience in Provider Contract negotiations highly desired

Previous experience in externally facing role in an account team management environment highly desirable.

Demonstrated excellent verbal, written, interpersonal, analytical, and negotiation skills.

Strong presentation skills; ability to speak clearly and concisely to influence others.

A strong leader able to influence others and operate effectively at all levels of an organization.

Comfortable interacting with senior leaders both internally and externally

Strong account and project management skills; Ability to multi task across multiple projects, of varying complexity, at any given time. Six sigma training helpful.

Strong analytical and problem solving skills; must be able to systematically analyze and resolve complex problems cross organizationally.

Excellent organizational skills including proven ability to utilize resources, prioritize, manage and meet multiple deadlines.

National travel required (25-30%)

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 106,400 - 177,300 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 Cigna HealthcareCigna 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.Qualified applicants with criminal histories will be considered for employment in a mannerconsistent with all federal, state and local ordinances.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.

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