The Provider Relations Lead Analyst is a key member of the Provider Relations Team within the national Dental Service Organization (DSO) service model. This role involves direct interaction with senior-level DSO leadership and internal stakeholders to ensure effective provider relations and contract management. This team member reports to the Manager of the DSO team.
Key Responsibilities:
Engage and present to senior DSO leadership, including at times CEOs and CFOs.
Build and maintain strong relationships with day-to-day contacts within assigned DSO groups.
Demonstrate knowledge of DPPO and DHMO products, including compensation structures and administrative processes.
Respond to provider inquiries, concerns, complaints, appeals, and grievances within designated timeframes.
Collaborate with internal and external partners to resolve complex, escalated, or sensitive issues.
Provide ongoing education on dental products to assigned groups.
Promote and support enrollment in delegated credentialing, Electronic Data Interchange (EDI), and Electronic Funds Transfer (EFT) programs.
Analyze financial data and communicate practice needs to internal finance teams to develop mutually acceptable compensation arrangements.
Develop and evaluate financial proposals using strong analytical skills.
Manage budgets and monitor financial performance of contracts to ensure compliance with contracting guidelines.
Perform other duties and projects as assigned.
Preferred Qualifications:
Bachelor’s degree or equivalent experience.
3+ years of dental industry experience required.
Background in dental insurance, with knowledge of PPO and DHMO products.
Experience in customer service or provider relations.
Self-starter with strong organizational skills.
Clinical or dental office experience is a plus.
Ability to manage multiple priorities independently.
Proficiency in Microsoft Excel and ability to learn specialized systems quickly.
Strong skills in analytics, negotiation, financial analysis, reporting, presentations, and both written and verbal communication.
Detail-oriented with a high level of accuracy.
Willingness and ability to travel is needed.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure. That’s why 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) with company match, 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, visit Life at Cigna Group.
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.