Develops network strategy, leads APAC Network team, and is responsible for the output of multiple disciplines within provider contracting, network configurations, provider relations, TPA partnerships, provider collaborations, and network performance and cost management.
whilst benchmark against APAC country market norms and leverage knowledge of medical cost trends.
Builds relationships that nurture provider and / or TPA partnerships, and seeks broader value-based business opportunities to support the local and global market strategy.
Develops strategic positioning for Cigna network capabilities, including but not limited to the development of alternative network initiatives, value or risk-orientation arrangement with strategic provider partners.
Works to guide and meet unit cost targets, while preserving an adequate network to achieve and maintain Cigna’s competitive position.
Creates and manages initiatives that improve total medical cost and quality, ensures network performance, and tracks medical cost savings ratio against plan and target.
Drives change with external provider partners by assessing clinical informatics, utilization performance, medical economics analytics, and offering consultative expertise to assist with total medical cost initiatives.
Initiates and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management, Medical Economics, Compliance, Sales, Client Management, Marketing and Service.
Assist in resolving elevated and complex provider service complaints. Researches problems and negotiates with internal / external partner / customers to prevent and resolve escalated issues.
Manages key provider relations in APAC region and is accountable for critical interface with providers and business staff.
Demonstrates knowledge of providers in APAC geographic region through understanding the interrelationships as well as the competitive landscape.
Partners with cross-regional network and payment integrity teams for projects impacting multiple regions and / or markets.
May also be responsible for providing policy administration for contracting networks and assuring contractual compliance with government regulations.
Contributes to establishing strategic goals across the function. Possesses significant freedom to act in the short term.
Makes decisions, often based on limited information, that have a long-term impact across the function.
Bachelor’s degree required; MBA or Master’s degree in Healthcare Administration or a health-related advanced degree is strongly preferred.
10+ years of experience in successful provider contracting (involving complex delivery systems and organizations), additional expertise in health economics preferred.
Experience in developing and managing key provider relationships.
Experience and expertise in high priority healthcare providers, third party administrators, Cigna competitor capabilities and healthcare systems within major markets across the globe.
Knowledge of complex reimbursement methodologies, including incentive based models strongly preferred.
Team player with proven ability to develop strong working relationships within a fast-paced matrix organization.
Strong influencing skills and proven ability to work collaboratively in a complex, highly matrixed environment, including balancing priorities of multiple organizations to deliver results.
Linguistic fluency. Ability to speak, write and read multiple languages
Strong interpersonal, networking and negotiations skills is a must
Ability to influence without authority