Provider Relations Advisor - EviCore - Hybrid (Finance)
The Regional Provider Engagement Manager is a key member of the Provider Engagement team, supporting EviCore's solutions by working directly with the provider community and health plan partners across nine states: Arizona, New Mexico, Texas, California, Utah, Hawaii, Colorado, Alaska, and Nevada.
This position is responsible for training providers on EviCore's prior authorization processes, promoting process improvement, and supporting market readiness efforts. The role includes managing provider relationships, delivering educational outreach, and collaborating across internal departments to optimize the provider experience and ensure seamless implementation of our solutions/programs.
The Manager will support various programs, including Cardiovascular, Gastroenterology, Laboratory Management, Medical Oncology, Musculoskeletal, Radiation Oncology, Radiology, and Sleep, among others. The individual will serve as a subject matter expert and collaborate cross-functionally with teams such as Sales, Implementation, Program and Operations.
Duties and Responsibilities:
- Create and oversee market readiness strategy
- Collaborate with other departments to fulfill provider engagement duties that lead to a successful implementation
- Develop and lead in training sessions to providers, delivering effective verbal and written communications appropriate to the audience
- Conduct provider outreach activities as needed based on direction provided by our health plan partners, Client management team and other areas of the business
- Proactively identify and respond to issues and trends affecting multiple providers
- Lead and coordinate communication with providers, providing timely status of efforts to resolve escalated, complex, and sensitive provider issues in collaboration with other internal departments at EviCore
- Provide education to provider personnel to improve overall process efficiency that is patient-centric and educates providers on EviCore products and services
- Engage appropriate provider staff regarding eviCore initiatives to ensure optimal impact of overall project efforts and outcome
- Ensure knowledge of all solutions/programs across organization
- Facilitate meetings with provider groups that may include clinical discussion and follow-up to each meeting with applicable research and issue resolution
- Track and document all provider outreach interactions
- Assist with the development and management of policies and procedures relating to provider participation including management and production of online provider materials and production of provider newsletters
- Develop and manage relationships with providers, monitoring and reviewing key metrics and overall activity performance
- Generate and analyze reports to share with provider groups to deliver pertinent information to providers to assist with process efficiency
- Work with appropriate departments to develop and manage comprehensive provider reporting packages and issue tracking for assigned territory
- Interact with other internal staff members to provide support with special projects or assignments
Position Requirements:
- Bachelor's degree in Business, Healthcare, related field or equivalent work experience
- 5+ years of experience in provider relations or a similar role
- Strong oral, written, and interpersonal communication skills
- Proven ability to lead projects and present information effectively
- Strong organizational, analytical, and problem-solving skills
- Excellent project and time management capabilities
- Up to 25% travel required across assigned states; travel may be limited due to public health guidelines
- This is a hybrid role and will likely require the ability to work in-person.
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.
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.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
