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From Home Provider Network Development Jobs in Virginia

Amazon

Network Development Eng II, ADC Networking

Arlington, VA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

From the top of rack to the network core and everything in between, you'll work with best-in-class ... When we feel supported in the workplace and at home, there's nothing we can't achieve in the cloud.

Navtech, Inc.

Network Engineer Specialist

Mclean, VA · On-site

The candidate will be part of the network development team. * The main responsibility is to ... Playbooks will need to be written from scratch. * Must have experience in JSON and Pandas. * CISCO ...

GDIT

Provider Relations Supervisor

Falls Church, VA

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Lead, coach, and develop Provider Network Representatives; set performance goals, conduct evaluations, provide ongoing coaching, and promote professional development. * Establish governance for ...

New

GDIT

Network Engineer Senior

Langley, VA

$105K - $144K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Performs complex network development and design work. * Participates in the upgrading of operating systems and design of network enhancements. * Provides input for documentation on new or existing ...

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All JobsProvider Network Development JobsFrom Home Provider Network Development JobsFrom Home Provider Network Development Jobs in Virginia

From Home Provider Network Development information

What are the key skills and qualifications needed to thrive as a from home provider network development professional, and why are they important?

To excel as a Provider Network Development professional working remotely, you need a solid understanding of healthcare provider relations, contract negotiation, and network management, often supported by a degree in healthcare administration or a related field. Familiarity with provider databases, CRM software, and managed care systems is typically required. Strong communication, relationship-building, and self-motivation are vital soft skills for effective remote collaboration and provider engagement. These abilities ensure efficient network growth, quality provider relationships, and organizational success in a virtual environment.

How does a from home provider network development professional typically collaborate with healthcare providers and internal teams?

As a remote Provider Network Development professional, you will regularly coordinate with healthcare providers through virtual meetings, emails, and phone calls to negotiate contracts and ensure compliance with network standards. Internally, you will work closely with credentialing, legal, and provider relations teams using collaboration tools such as shared databases and project management software. Effective communication and proactive outreach are essential to overcome the challenges of remote work and maintain strong professional relationships. You may also participate in regular virtual team meetings to align on goals, share updates, and resolve issues collaboratively.

What is a from home provider network development professional?

A From Home Provider Network Development job involves building and maintaining relationships with healthcare providers, such as doctors and hospitals, to expand or improve a healthcare network. Professionals in this role typically work remotely and are responsible for recruiting providers, negotiating contracts, and ensuring compliance with regulations. Their goal is to create a strong, accessible network that meets the needs of health plan members. This position requires skills in communication, negotiation, and knowledge of healthcare systems. Remote work allows for flexibility while still achieving important network development goals.

What is the difference between From Home Provider Network Development vs From Home Provider Relations Specialist?

AspectFrom Home Provider Network DevelopmentFrom Home Provider Relations Specialist
CredentialsHealthcare administration, network management certificationsCustomer service, healthcare communication certifications
Work EnvironmentRemote, healthcare provider offices, corporate officesRemote, healthcare provider offices, corporate offices
Employer & Industry UsageHealth insurance companies, managed care organizationsHealth insurance companies, healthcare providers
Search & Comparison IntentBuilding and managing provider networksMaintaining provider relationships and resolving issues

From Home Provider Network Development focuses on creating and expanding healthcare provider networks, requiring skills in network management and healthcare administration. In contrast, From Home Provider Relations Specialist emphasizes maintaining provider relationships and addressing provider concerns. Both roles are essential in healthcare organizations but differ in their primary focus and responsibilities.

What are the most commonly searched types of Provider Network Development jobs in Virginia?

The most popular types of Provider Network Development jobs in Virginia are:

What are popular job titles related to From Home Provider Network Development jobs in Virginia?

For From Home Provider Network Development jobs in Virginia, the most frequently searched job titles are:

What job categories do people searching From Home Provider Network Development jobs in Virginia look for?

The top searched job categories for From Home Provider Network Development jobs in Virginia are:

What cities in Virginia are hiring for From Home Provider Network Development jobs?

Cities in Virginia with the most From Home Provider Network Development job openings:

From Home Provider Network Development jobs near you

Provider Network Operations Advisor - Cigna Healthcare - Hybrid

Cigna

Richmond, VA • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 19 hours ago

Cigna Healthcare rating

8.4

Company rating: 8.4 out of 10

Based on 238 frontline employees who took The Breakroom Quiz

23rd of 887 rated healthcare providers

Job description

Join our team as a Provider Network Operations Advisor, playing a key role in creating and maintaining provider networks that deliver quality, affordability, and access to care. This role shapes provider network strategy across a matrixed group of partners, using data to driveinitiatives that support Cigna Enterprise goals and directly impact our clients and customers.

Key Responsibilities

Provider Data Resolution

  • Support the management and implementation of provider, hospital, and ancillary networks by researching and resolving provider data issues, including demographic, claims, and system loading errors.
  • Troubleshoot issues escalated by Market Network Advisors using Cigna systems such as HCPM, Cognos, and the Developer Database.
  • Respond to questions from the Contracting team and matrix partners related to provider locations, policies, and data accuracy.
  • Perform rate and fee schedule audits upon request.
  • Support accurate loading of provider contracts and reimbursement methodologies.

Market Guidebooks

  • Create, manage, and maintain Market Guidebooks, including rate updates, provider inclusion/exclusion, and audit documentation.
  • Advise Market leadership and the National Alternative Access Network Manager on market-specific network dynamics.
  • Participate in quarterly reviews, identify corrections, and assist with provider terminations, additions, and updates.

Alternative Access Network (AAN)

  • Serve as the market subject matter expert for Alternative Access Networks, including inclusion/exclusion criteria and anchor providers.
  • Develop and maintain the AAN field guide for Contracting teams.
  • Coordinate, edit, and approve AAN communications, such as provider notices and Sales materials.
  • Conduct provider research and approve mailing lists for new or expanded product offerings.
  • Perform ongoing network maintenance, answer questions, and resolve issues.
  • Partner with the Network Manager on Split TIN handling and loading for IFP.

Affordability

  • Facilitate monthly affordability calls and agendas.
  • Monitor opportunity detection tools and support total medical cost savings through provider research, claims analysis, action planning, and outcome monitoring.
  • Partner with Market Medical Directors and Data Analytics on savings opportunities.
  • Perform medical benchmarking and network modeling using HPN tools.

Compliance - Network Adequacy & State Filings

  • Partner with matrix teams to ensure accurate provider data for filings, including hospital listings and state-specific requirements for the Mid-Atlantic market.
  • Support recruitment efforts to address network adequacy gaps by validating provider locations, specialties, and viability.

HSCRC - State of Maryland

  • Represent the market on monthly state-facilitated calls.
  • Provide regulatory updates to Contracting leadership and the Market Medical Director.
  • Participate in AHEAD learning activities and support related initiatives.

Regulatory Compliance - Mid-Atlantic

  • Support subject matter expertise related to the No Surprises Act, CMS guidance, and federal and state regulations.
  • Partner with business owners to ensure workflows and policies are implemented in a timely manner.
  • Identify operational gaps and recommend process improvements.

Qualifications

  • Bachelor's degree or equivalent experience required.
  • 5+ years of experience in provider network management or healthcare insurance.
  • Project management experience preferred.
  • Strong analytical, problem-solving, and critical-thinking skills.
  • Excellent communication, stakeholder management, and organizational skills.
  • Healthcare compliance and regulatory experience preferred.
  • Knowledge of CMS regulations, NSA, and reimbursement structures preferred.
  • Ability to work independently and manage multiple priorities.
  • Proficiency in Microsoft Office; Cigna systems experience preferred.
  • Local market knowledge preferred.

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.For this position, we anticipate offering an annual salary of 79,700 - 132,800 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.


At The Cigna Group, 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), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.


About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need 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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

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.

What Cigna Healthcare employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About Cigna

Sourced by ZipRecruiter

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Bloomfield, CT, US

Social media

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