Job Summary
As a Provider Relations Specialist you will be part of the Provider Services Organization, being responsible to manage the relationship with Health Care Providers of Africa network. You will work very closely with peers and stakeholders strategically positioned across the globe.
Key to the role will be the end-to-end journey, managing the partnership with health provider accounts, such as hospitals and clinics and support their journey from the on-boarding, supporting on the daily / monthly interactions with Cigna, educate them to navigate Cigna operating model, monitoring their performance, and driving engagement initiatives.
Your Role Includes
Accountable for enabling an effective and efficient collaboration with health providers in order to deliver a best in class customer experience through the partnership with our providers.
Conduct all aspects of health care professional education for existing and newly contracted health care professionals as pertinent in the region to remove potential roadblocks preventing a successful partnership.
Onboarding and training of healthcare providers in the legacy portal and into the new provider portal(PEXP), and overview of member identification and eligibility processes.
Responsible for monitoring and analyzing the results of the reconciliation of the accounts fulfilled by the Provider Reconciliation team and other Operational KPIs.
Conduct regular root cause analysis and consolidated feedback of the data obtained out of the Reconciliation outcome or other sources, striving for continuous service delivery improvement through BAU collaboration with different teams.
Manage the ongoing relationship an handling day-to-day operations directly with healthcare providers, including the follow up, negotiation and resolution of potential complaints, escalations, suspensions or threats and perform an active reconciliation and suspension management.
Strive for continuous service improvement via analyses of root causes and proactive implementation of initiatives driven by outcome obtained through data and feedback gathered through reconciliation results, complaints or other sources, continuous service delivery improvement through BAU collaboration with different teams;
Active communication and prompt follow up combined with regular meetings with your dedicated health care providers.
Support the PR Team to determine short and middle term solutions for smooth reconciliation process with Providers by continuously analyzing the intake of queries and complaints, as well as conducting reviews of the current processes for potential improvements.
Participation in coordination sessions with Network and Operations teams seeking for better practices in order to prevent service deficiencies and assure 5 star experience to health care providers.
Consolidated feedback to PSO management.
Continuous improvement and maintenance of provider communications channels taking into consideration the local habits and practices.
Provider visits as applicable.
YOUR PROFILE
If internal 1 years of Cigna experience, relevant experience in other functions/companies, and a strong performance track record.
If external, at least 2 years of experience in Operations, Data analysis, Marketing/Communications or Relationship Management, with operational and customer/provider-facing experience profile.
Must be proficient in English and French or Portuguese; any other additional language is a plus.
Strong analytical and problem-solving skills.
International mind-set able to work remotely with colleagues, partners and providers across Africa.
Striving for excellent service to our members, clients and providers is part of your DNA.
Strong can-do attitude, and high qualification in relationship management, including a broad understanding of multicultural behaviors.
Action-orientated problem-solving attitude
Excellent organization, planning and prioritization skills to meet deadlines.
Experience in complaint management - with a proven track record in improving customer service standards.
Ability to assess the situation/issue, carry out appropriate research, gather the relevant data and provide constructive feedback on the outcome.
Accountability – to assume ownership for achieving personal results and to contribute for collective team goals.
Excellent communication skills – verbal, written and presentation.
Be a positive role model and be able to work independently and in conjunction with co-workers of all levels.
Experience interpreting data, drafting reports.
Strong practical knowledge of MS Office applications, especially Excel.
Availability to travel 15% of your time (estimation)
