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Remote Provider Network Management Jobs in Virginia

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Remote Provider Network Management information

What are the key skills and qualifications needed to thrive as a Remote Provider Network Management professional, and why are they important?

To thrive in Remote Provider Network Management, you need expertise in healthcare provider relations, contract negotiation, and a solid understanding of health plan regulations, often supported by a degree in healthcare administration or a related field. Familiarity with provider network management software, data analytics tools, and knowledge of regulations like HIPAA are typically required. Excellent communication, problem-solving abilities, and attention to detail are essential soft skills for building strong partnerships and managing network performance. These skills and qualifications ensure efficient network operations, regulatory compliance, and high-quality service for both providers and members.

What is the difference between Remote Provider Network Management vs Remote Provider Relations Specialist?

AspectRemote Provider Network ManagementRemote Provider Relations Specialist
CredentialsHealthcare administration, network management certificationsCustomer service, healthcare communication certifications
Work EnvironmentHealthcare organizations, insurance companies, remote office settingsHealthcare providers, insurance companies, remote customer support
Industry UsageManaging provider networks, credentialing, contractingBuilding provider relationships, resolving provider issues

Remote Provider Network Management focuses on overseeing healthcare provider networks, including credentialing and contracting. In contrast, Remote Provider Relations Specialists primarily handle communication and relationship-building with providers. Both roles require healthcare knowledge but differ in their core responsibilities and focus areas.

How does a Remote Provider Network Management professional typically collaborate with healthcare providers and internal teams?

Remote Provider Network Management professionals frequently coordinate with healthcare providers via virtual meetings, emails, and secure online portals to address contract negotiations, credentialing, and performance issues. They also work closely with internal departments such as claims, quality assurance, and customer service to ensure seamless provider onboarding and ongoing support. Effective communication and strong relationship-building skills are essential, as much of the collaboration happens through digital channels. This setup allows for flexibility but requires self-motivation and proactive engagement to maintain strong provider networks.

What is a Remote Provider Network Management role?

A Remote Provider Network Management role involves overseeing relationships and contracts with healthcare providers, such as doctors, hospitals, and clinics, while working remotely. Professionals in this field are responsible for recruiting new providers, maintaining communication, ensuring compliance with regulations, and addressing network issues. They play a key part in expanding and maintaining a healthcare organization's provider network to ensure members have access to quality care. This job typically requires strong organizational, negotiation, and communication skills, as well as familiarity with healthcare regulations and provider credentialing processes.
What are the most commonly searched types of Provider Network Management jobs in Virginia? The most popular types of Provider Network Management jobs in Virginia are:
What are popular job titles related to Remote Provider Network Management jobs in Virginia? For Remote Provider Network Management jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Remote Provider Network Management jobs in Virginia look for? The top searched job categories for Remote Provider Network Management jobs in Virginia are:
What cities in Virginia are hiring for Remote Provider Network Management jobs? Cities in Virginia with the most Remote Provider Network Management job openings:
Remote Provider Network Management jobs near you
Manager, Network Management - Cigna Healthcare - Hybird (VA, MD)

Manager, Network Management - Cigna Healthcare - Hybird (VA, MD)

Cigna

Richmond, VA • Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago

Cigna Healthcare rating

8.3

Company rating: 8.3 out of 10

Based on 215 frontline employees who took The Breakroom Quiz

33rd of 869 rated healthcare providers

Job description

Join Cigna Healthcare, a division of The Cigna Group, and help shape our provider network. As a Network Contracting Manager, you will report to the AVP, Provider Network Management. In this individual contributor role, you will support the strategic direction of the provider network while managing daytoday contracting and network management activities.

Responsibilities
  • Manage complex feeforservice and valuebased contracting and negotiations with large physician groups, ancillary providers, and hospital systems.
  • Lead key market contracting strategy projects, with responsibility for managing direct reports as assigned.
  • Build and maintain strong provider relationships to support network growth and valuebased business opportunities.
  • Partner closely with matrix teams (e.g., Claims, Medical Management, Credentialing) to ensure aligned execution.
  • Develop strategic network positions, identify valueoriented and riskbased opportunities, and contribute to alternative network initiatives and analytics.
  • Meet unit cost targets while maintaining an adequate and competitive provider network.
  • Design and manage initiatives to improve medical cost and quality, providing consultative guidance informed by clinical informatics.
  • Prepare, review, and project the financial impact of large or complex provider contracts and alternative contract terms.
  • Create, implement, and ensure operational accuracy of healthcare provider (HCP) agreements through effective crossfunctional collaboration.
  • Lead the resolution of escalated provider issues and manage key provider relationships, demonstrating deep knowledge of the local market landscape, including contract loading and maintenance.
Required Qualifications
  • 3+ years of healthcare provider contracting and negotiation experience involving complex physician groups and ancillary providers
  • Experience in managed care, healthcare, or health insurance, including commercial contracting
  • Proven leadership experience, including mentoring and guiding others
  • Strong provider relationship management skills, with demonstrated success building longterm partnerships
  • Knowledge of complex reimbursement methodologies, including incentivebased models (strongly preferred)
  • Deep understanding of hospital, managed care, and provider business models, with the ability to influence sales and provider audiences
  • Strong presentation and communication skills, including the ability to build internal relationships in a fastpaced, matrixed organization
  • Customercentric approach with strong interpersonal skills and comfort navigating change
  • Strong problemsolving, decisionmaking, negotiation, contract interpretation, and financial analysis skills
  • Proficiency in Microsoft Office
Preferred Qualifications
  • Bachelor's degree in a related field (relevant industry experience may be substituted)
  • MBA or MHA 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 92,000 - 153,300 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 and paid holidays. 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 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.

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