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The Military OneSource (MOS) Program Management Senior Manager will have oversight of the Military OneSource network and lead a multi-specialty team in support of MOS. Responsibilities include but are not limited to reimbursement process and policies, contract solutions, provider relations, data load/management and network performance. The Manager will supervise a multi-specialty team who is accountable for network maintenance and performance. The Military OneSource Senior Manager will utilize in-depth contracting and network knowledge to mentor the team, identify trends as well as facilitate process improvements to positively impact participant quality of care, access as well as provider experience. This Senior Manager will collaborate with the other areas of the organization to develop action plans, align with enterprise processes and standards.
Role and Responsibilities
Lead multi-specialty team to ensure network performance and adequacy in accordance with internal and Department of Defense standards.
Utilize internal data such as claims, negotiations and network composition/adequacy to develop a comprehensive network strategy.
Coordinate with multiple matrix partners to develop and monitor the budget for new and existing providers as well as rate increases.
Guide provider partnerships/relationships and education to ensure success of Military OneSource network; meeting customer and provider expectations.
Lead strategic initiatives to monitor Military OneSource network needs, meeting all standards and implementing corrective action plans when necessary.
Identify and/or support provider experience improvement initiatives to increase provider satisfaction and adherence to Military OneSource network requirements.
Create and maintain metrics on Department and Team Monthly Operating Reports (MOR) identifying trend and highlighting successes as well as barriers to success.
Meet regularly with staff to mentor, guide and develop needed skills for their roles as well as assist with complex issues.
Qualifications:
Master’s degree strongly preferred
6 years of network/contracting experience.
Intimate knowledge of managed care operations (contracting and provider relations) and outpatient network management in behavioral and/or medical with experience with commercial and government products, such as Medicare, Medicaid and or Individual and Family Plans.
Strong strategic acumen, including strategic thought, creation, and execution.
Adept analytical, project management skill, superior problem solving and decision-making skills.
Excellent management and leadership skills.
Enterprise thinker with proven ability to influence across a matrix environment.
Ability to develop relationships across all levels of the organization, as well as externally.
Technical/Functional expertise: provider contracting, provider relations, negotiation, metric management, corrective action implementation and monitoring.
Exceptional service experience knowledge and skills.
Proficient writing and verbal communication skills and experience with formal presentations.
Capable of working independently and be self-directed.
Skilled in Project management
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.
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.Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.
Other | Full Time
$115k-157k (estimate)
07/04/2024
09/02/2024
cigna.com
CHASKA, MN
>50,000
1982
Public
LARRY SHAFRANSKI
>$50B
Cigna offers health, dental, Medicare and supplemental insurance plans to consumers and employers.