Job Description

Job Objective:
CGHB Provider Negotiator 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.
+ Analyzes and determines in which countries, regions and cities our network of providers must grow.
+ Works with Network Leads in performing service area analysis and cost analysis to identify network development and network renegotiation opportunities.
+ 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).
+ Visits clients and manages 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 Senior Provider Negotiator or 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 (PIMS) 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.
+ Act as representative in the Outpatient Direct Payment project (OPDP)
+ Effectively communicates and interacts with other business units to achieve goals; e.g. Medical Management, CGHB Service Operations (NA, UK and Antwerp), Sales and Client Management (NA, UK, and Antwerp), and CGHB Strategy & Operations.
+ University degree or equivalent experience
+ With University degree, 2 – 3 years of relevant experience. Otherwise, 6 – 7 years.
+ Working knowledge of the Provider Network is an asset.
+ Good communication skills.
+ Good negotiation and convincing skills.
+ Analytical and critical mind.
+ Proficiency with MS Office programs including: Word, PowerPoint, Excel, Project, and Visio required.
+ Knowledge of high priority healthcare providers, third party administrators, CGHB competitor capabilities within the region of responsibility.
+ Excellent interpersonal, communication and motivational skills, including negotiation and presentation skills
+ Strong influencing skills and ability to work in a complex, highly matrixed, environment, including balancing priorities of multiple organizations to deliver end results.
For external applications, only candidates' direct applications will be considered
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.

More Jobs at Cigna Follow Company

See all jobs at Cigna

Some similar jobs