Provider Network Operations Advisor - Cigna Healthcare - Hybrid

Job description

Join our team as a Provider Network Operations Advisor , playing a key role in creating and maintaining provider networks that deliver quality, affordability, and access to care. This role shapes provider network strategy across a matrixed group of partners, using data to drive initiatives that support Cigna Enterprise goals and directly impact our clients and customers. Key Responsibilities: Provider Data Resolution: - Support the management and implementation of provider, hospital, and ancillary networks by researching and resolving provider data issues, including demographic, claims, and system loading errors. - Troubleshoot issues escalated by Market Network Advisors using Cigna systems such as HCPM, Cognos, and the Developer Database. - Respond to questions from the Contracting team and matrix partners related to provider locations, policies, and data accuracy. - Perform rate and fee schedule audits upon request. - Support accurate loading of provider contracts and reimbursement methodologies. Market Guidebooks: - Create, manage, and maintain Market Guidebooks, including rate updates, provider inclusion/exclusion, and audit documentation. - Advise Market leadership and the Nat...