[Hiring] Government Program Network Engagement Specialist @Cigna Healthcare

Role Description

The Government Program Network Engagement Specialist is a highly specialized role responsible for owning MDLIVE’s Medicaid provider enrollment and regulatory relationships across an assigned cohort of states. This role serves as the primary liaison to state Medicaid agencies and managed care organizations (MCOs), ensuring providers are fully enrolled, linked, and remain continuously compliant with state-specific Medicaid requirements.

This individual partners closely with Network Recruiting and Credentialing to operationalize enrollment strategy, minimize risk of enrollment lapses, and ensure provider availability aligns with business growth goals.

Success in this role requires the ability to gain/maintain deep Medicaid regulatory knowledge, strong provider-facing communication skills, comfort engaging with regulators, and advanced analytical capabilities to track, report, and improve performance.

What you’ll do to make a difference:

• Serve as primary point of contact for assigned state Medicaid agencies, Medicaid MCOs, and providers.
• Maintain expert‑level knowledge of state‑specific Medicaid enrollment, revalidation, linking, and termination requirements.
• Own end‑to‑end Medicaid enrollment and linking outcomes for an assigned group of states.
• Proactively manage regulatory changes, renewals, audits, and revalidations to ensure uninterrupted provider participation.
• Ensure providers are enrolled, linked, billable, and compliant within required state timelines.
• Actively prevent enrollment lapses and terminations through tracking, outreach, and proactive revalidation management.
• Build and maintain trusted relationships with state regulators and payer partners to resolve enrollment issues and escalations.
• Engage directly with providers to explain Medicaid requirements, enrollment status, timelines, and next steps.
• Translate regulatory requirements into clear, actionable guidance for providers and internal stakeholders.
• Represent the voice of the provider in Medicaid workflows, process improvements, and issue resolution.
• Partner closely with Network Recruiters to support hiring priorities aligned to state Medicaid needs.
• Collaborate with Credentialing on applications, verifications, renewals, linking, and data accuracy.
• Work cross‑functionally with Operations, Finance, and Leadership to resolve enrollment blockers impacting access or revenue.
• Support development and refinement of standard operating procedures across government programs.
• Track, analyze, and report Medicaid enrollment metrics by state, provider, and timeline.
• Develop executive‑ready reporting on performance, risks, trends, compliance, and continuity of enrollment.
• Use data and analysis to identify gaps, improve enrollment speed, inform strategy, and support leadership decision‑making.
• Measure success by number of enrolled and linked providers, timeliness and accuracy, reduced lapses, provider satisfaction, reporting quality, and strength of state and MCO relationships.

Qualifications

• High school diploma or GED required, Bachelor’s degree in Healthcare Administration, Public Policy or Business preferred.
• 4+ years of direct experience with Medicaid provider enrollment, government programs, or payer operations preferred.
• Demonstrated deep knowledge of state Medicaid regulatory and enrollment processes preferred.
• Proven experience working directly with state agencies, Medicaid MCOs, or government payers preferred.
• Strong provider-facing communication skills with the ability to explain complex regulations clearly.
• High confidence interacting with regulators, providers, and executive stakeholders.
• Advanced analytical skills with experience tracking metrics, building reports, and identifying trends.
• Strong Excel skills (pivot tables, formulas, data analysis); experience with dashboards and reporting tools preferred.
• Exceptional organizational skills with the ability to manage multiple states, timelines, and priorities.
• Familiarity with credentialing systems, payer enrollment platforms, and provider data management.
• Experience presenting data and progress updates to senior leadership.
• Background in process improvement, compliance, or risk mitigation within healthcare operations.

Requirements

• 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 66,600 - 111,000 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.

Benefits

• Comprehensive range of benefits, with a focus on supporting your whole health.
• Health-related benefits including medical, vision, dental, and well-being and behavioral health programs starting on day one of employment.
• 401(k), company paid life insurance, tuition reimbursement.
• A minimum of 18 days of paid time off per year and paid holidays.