Job Closed

This listing is no longer active.

Senior Analyst, Provider Contracting – Voluntary Out-of-Network Pricing

AnalystAnalystOtherRemoteSeniorTeam 10,001+Since 1982H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

122 days ago

Salary

$59.9K - $99.8K / year

Seniority

Senior

Bachelor Degree3 yrs expExperience acceptedEnglish

Job Description

Senior Analyst, Provider Contracting – Voluntary Out-of-Network Pricing

The Cigna Group

• Lead the execution of pricing dispute resolution activities within Voluntary Out-of-Network cost containment programs • Conduct thorough investigations of pricing disputes to determine appropriate next steps, involved vendors, and resolution pathways • Ensure timely follow-up and resolution in alignment with established turnaround time standards • Maintain accurate, detailed documentation and tracking of all dispute cases • Support external claims pricing dispute resolution by working directly with vendors, providers, and internal stakeholders to ensure accurate pricing methodologies are applied and disputes are resolved efficiently • Serve as a knowledgeable point of contact for internal stakeholders, vendors, and providers • Provide guidance and feedback to Claims and Call Center teams related to dispute resolution processes • Demonstrate professionalism and a strong commitment to customer satisfaction in all interactions • Compile and analyze data to identify trends, gaps, and opportunities for improvement • Support the development of reports and tools used to monitor program performance • Contribute to process improvement initiatives and support operational change efforts

Job Requirements

  • Bachelor’s degree preferred but not required; equivalent experience in healthcare operations, claims, provider contracting, or analytics will be considered
  • Minimum of 3 years of experience in claims, call center operations, healthcare analytics, or provider contracting
  • Strong written and verbal communication skills
  • Advanced proficiency in Microsoft Excel and other data analysis tools
  • Ability to work independently while managing multiple priorities effectively
  • Customer-focused mindset with a strong commitment to quality and timeliness
  • Strong analytical, critical-thinking, and problem-solving skills
  • Ability to influence peers and support operational change initiatives

Benefits

  • medical, vision, dental, and well-being and behavioral health programs
  • 401(k)
  • company paid life insurance
  • tuition reimbursement
  • a minimum of 18 days of paid time off per year
  • paid holidays

Related Categories

Related Job Pages

More Analyst Jobs

Interwell Health logo

Medical Economics Analyst I

Interwell Health

Reimagining kidney care to help patients live their best lives.

Analyst122 days ago
OtherRemoteTeam 501-1,000H1B No Sponsor

• Ensures data integrity is maintained throughout the reporting lifecycle. • Implements reporting and reconciliation workflows and document processes. • Responsible for experience studies and medical trend studies. • Responsible for running queries and providing required analysis to understand related drivers (such as medical cost and utilization), as well as providing insightful commentary and sensitivity modeling analysis. • Actively supports efforts to continually improve data capabilities and quality of department analysis and reporting. • Reports production to support financial reporting and operations activities. • Performs research and collection of data, including data mining and reporting, which is provided to various customers inside and outside the department. • May refer to senior level staff for assistance with higher level problems that may arise. • Performs in-depth claims analysis of baseline and ongoing contract monthly data. • Conducts profitability analysis and drill down analysis into actual expected variances. • Pulls ad-hoc reporting as needed.

United States
Job Closed
Cleveland Clinic logo

IT Process Analyst III – Change Management

Cleveland Clinic

Your source for health news, tips and information from one of the nation’s top hospitals.

Analyst122 days ago
OtherRemoteTeam 10,001+H1B Sponsor

• Help define and manage one or more ITIL process areas—such as Incident Management, Service Level Management, Change Management, Configuration Management, or other IT enterprise processes • Support for the Epic Data Courier application and become a Data Courier Administrator • Assist caregivers with system changes, troubleshoot issues, and review related processes to ensure efficiency and compliance • Define current state processes in areas where process is vague, weak, or undocumented • Document future state processes or next iterations of current processes • Define and document design requirements to support all process implementations using Agile Scrum SDLC and/or Waterfall methodologies • Champion organizational change and adoption of service management best practices by providing coaching and training until processes become engrained into the culture • Provide guidance and input to stakeholders, leaders, developers and quality assurance testers throughout the ITSM program • Conduct research, develop, and recommend solutions to integrate people, processes, and technology to improve IT process principles

Ohio
Job Closed
Analyst122 days ago
Full TimeRemoteTeam 10,001+Since 1999H1B No Sponsor

• Implement Global Change Coordination process via corporately mandated change coordination tools. • Support change coordination meetings and process. • Enforce change coordination process. • Hold business owners accountable for delivering their inputs/deliverables/approvals. • Alert about late tasks to business owners with due dates. • Facilitate (and document) change timing agreement between suppliers, Engineering, Finance, Manufacturing, and Program coordination. • Own timing of change control steps, inputs, and approvals in line with agreed program/change timing. • Schedule all change coordination tasks to achieve overall change approval/release timing.

Mexico
Job Closed
OtherRemoteTeam 10,001+Since 1954H1B Sponsor

• Support Army Training SME capabilities with expertise in simulation tools supporting Army Mission Training Complexes (MTCs) • Perform analytical tasks regarding assessments of current models and simulations; system and database maintenance; hardware and software configuration in support of operational use • Compile and analyze observations with customer generated feedback • Resolve technical and non-technical issues through interaction and communication with other team members • Integrate training systems to meet customer requirements • Integrate new Army simulations to meet commanders training objectives • Collaborate with team members during capture and solution working groups • Support the technical Solution Architect in developing staffing and technical solutions • Support Proposal Technical Writing as assigned • Support Bottom-Up analysis in support of staffing and technical solutions • Participate in Special Projects as required

United States
$23.8K - $32.2K / year
Job Closed