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Medicare Provider Relations Analyst - Remote image - Rise Careers
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Medicare Provider Relations Analyst - Remote

Supports the Service Model through data review and provider demographic changes and updates. Takes the lead in researching system data set up errors and provides appropriate education internally to correct errors. Routinely engages, consults and influences matrix partners to achieve service improvements and minimize provider service interruptions.Duties And Responsibilities• Serves as a member of the account management team responsible for provider data review• Intake of provider rosters and coordinates update with appropriate business partners• May perform roster audits to ensure all systems are updated appropriately with provider data• Provides updated effective dates and updated rosters to our provider contacts• Participates in internal audits for directory and HSD updates• Engages with appropriate provider relations lead to support with roster education• Collaborates with matrix partners to identify, resolve and improve provider data errors• Drives root cause analysis, trending related to data updates• Communicates recommendation for changes to improve service as identified through root cause analysis• Utilizes critical thinking to identify root cause and issues resolution for provider submissions• Understands internal provider systems and how they should be set up as it relates to provider data• Understands sense of urgency and proper escalation channels• Participates in internal meetings as needed to act as the SME for provider data reconciliation issues• May send out letters related to provider onboarding• May participate in special project initiatives• Other tasks as assignedPosition Requirements• High School Diploma or GED required.• Bachelor’s degree preferred• 1+ year of data management experience required• QNXT experience preferred• Detail oriented, with proven time management and organization skills• Act with a sense of urgency to research questions or issues brought by the team, and identify the right parties or resources to resolve the issues• Ability to work independently and in conjunctions with co-workers of all levels• Strong analytical and problem solving skills• Excellent communication skills – verbal, written and presentation• Working knowledge of Microsoft Word, Excel, and PowerPointCORE COMPETENCIES• Organizational agility, Resourceful, Sense of urgency• Business Acumen• Priority setting and time management• Decision quality• Drive for results, Functional/Technical knowledge and Customer Centric EnvironmentIf 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 hourly rate of 23 - 34 USD / hourly, 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 The Cigna GroupDoing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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.
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CEO of The Cigna Group
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David Cordani
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Cigna Healthcare is a world renowned, American multinational company dedicated to improving health and wellness. They are based in Bloomfield, Connecticut and offers Medicare and Medicaid products and health, life and accident insurance coverages.

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Full-time, remote
DATE POSTED
August 29, 2024

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