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Portuguese Speaking Provider Network Manager

Portuguese Speaking Provider Network Manager

CignaWorkFromHome, KwaZulu-Natal, South Africa
1 day ago
Job description

Overview

As a Provider Network Manager you will be part of the Provider Services Organization, responsible for developing and managing relationships with Health Care Providers in Africa. You will work with peers and stakeholders across the globe to deliver best-in-class service to CGHB’s providers, customers and clients.

Key to the role is managing providers’ end-to-end journey, from on-boarding, enquiries, training, performance monitoring, complaints resolution and driving engagement initiatives.

Key Responsibilities

  • Manages contracting and relations with healthcare providers including Hospitals, clinics, pharmacies and physicians.
  • Collaborates with respective teams in performing service area analysis and cost analysis to identify network development and renegotiation opportunities.
  • Acts as an expert with regards to the medical landscape in the countries within your region and continuously monitor evolutions in that respect.
  • Conducts smooth on-boarding and all aspects of health care professional education for existing and newly contracted health care professionals in the region.
  • Manages day-to-day operational maintenance of provider relationships including resolution of potential complaints, escalations, suspensions or threats.
  • Monitors and analyzes data such as Operations KPIs and reconciliation results to provide comprehensive support to providers on their interpretation.
  • Strives for continuous service improvement via analyses of root causes and proactive implementation of data-driven initiatives.
  • Proactive communication with providers and maintenance of provider communications channels taking into consideration local habits and practices.
  • Provide consolidated feedback to PSO management team.
  • Conduct provider visits as applicable and regular meetings with your dedicated health care providers.

Your profile

  • Internal : 2 years of Cigna experience or relevant experience in other functions with a strong performance track record.
  • External : at least 3 years of experience in provider relations, network management or network operations with a customer / provider-facing profile.
  • Proficient in English and Portuguese. Any other additional language is a plus.
  • Strong analytical and problem-solving skills.
  • International mindset able to work remotely with colleagues, partners and providers across the globe.
  • 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 broad understanding of multicultural behaviors.
  • Action-oriented, problem-solving attitude.
  • Excellent organization, planning and prioritization skills to meet deadlines.
  • Experience in complaints management with a proven track record in improving customer service standards.
  • Ability to assess the situation, carry out appropriate research, gather relevant data and provide constructive feedback on outcomes.
  • Accountability – to assume ownership for achieving personal results and to contribute to collective team goals.
  • Excellent communication skills – verbal, written and presentation.
  • Be a positive role model and able to work independently and with co-workers at all levels.
  • Experience interpreting data and drafting reports.
  • Strong practical knowledge of MS Office applications, including Excel.
  • Availability to travel approximately 10% of your time.
  • About Cigna Healthcare

    Cigna Healthcare, a division of The Cigna Group, advocates for better health through every stage of life. We guide customers through the health care system, empowering them with information to make the best choices for improving their health and vitality. 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 : for support. Do not email for an update on your application or to provide your resume as you will not receive a response.

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    Network Manager • WorkFromHome, KwaZulu-Natal, South Africa

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