Program Management Senior Manager (Military One Source) - Evernorth Behavioral Health - Hybrid - The Cigna Group
Plano, TX
About the Job
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
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 123,800 - 206,300 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 Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. 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._
_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._
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
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 123,800 - 206,300 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 Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. 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._
_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._
Source : The Cigna Group