
Provider Contract & Network Underwriting Specialist
Conducts hospital provider contract underwriting/analysis, partnering with Contracting to deliver unit cost results in line with trend/cost expectations to ensure competitive positioning within the marketplace. Analyze impact to trends for facility contract negotiations. Effectively influence contracting in a strategic fashion and offer meaningful options during negotiations with a provider. Provide ad hoc analysis and deep dives into data as appropriate to support negotiation and provide value to our contracting partners. Summarize and explain findings and recommendations. Independently and effectively manage the planning process for assigned markets and drive the plan to meet overall corporate planning objectives. Proactively identify opportunities for trend reduction and engage contracting to build these into plan where appropriate.
5 plus years of experience in health care/managed care work experience
Experience in TMC and/or Contract Underwriting preferred
Understanding of managed care business processes, data, systems, and applications for claims payment, enrollment
Familiarity various data mining and reporting tools
Experience working with claim data and familiarity with standard medical coding: CPT, ICD9, HCPC.
Sql
Time Management
Analytical skills
MS Excel
SAS
MS Access
Utilization management
Adaptable
Process Improvement
Verbal communication
written communication
Detail Oriented and Organized
According to JobzMall, the average salary range for a Provider Contract & Network Underwriting Specialist in One Front Street, 1 Front St, San Francisco, CA 94111, USA is $50,000 to $75,000 per year.
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Cigna Corp. provides medical, dental, disability, life and accident insurance and related products and services to businesses, governmental and non-governmental organizations and individuals. It operates through following segments: Global Health Care; Global Supplemental Benefits; Group Disability and Life; Other Operations; and Corporate.

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