|Category||Operations||Job type||Full Time|
General Summary: This individual reports directly to the Network Operations Manager and will develop and maintain positive relationships with physicians and other provider types within the provider network. Will also support the activities of the Network Operations Department, including: negotiating contracts and single case agreements, assisting and supporting the contractual and operational relationship with providers, coordinating provider databases, credentialing, resolution of claims and appeals; assisting with the analysis of financial, medical cost trends for providers.
Coverage Area: Texas/Oklahoma; Medicare licensed service areas
Candidate must be located in Texas, preferably Houston, TX area
Essential Duties and Responsibilities
Contracting and Credentialing Support
Coordinate Load Forms and Maintain Provider Data Bases
Provider Orientations and Operational Meetings
Resolution of Claims and Operational issues with Providers
Analyze Outpatient Cost Reporting for Providers
Other Duties and Responsibilities
While this job description is intended to be an accurate reflection of the duties involved in this position, the company reserves the right to add, remove or alter duties when business need dictates.
1-2 year's experience in a healthcare environment preferred
Bachelor's Degree preferred; High School Diploma required
Additional Skills: Excellent presentation, communication and customer service skills required. Excellent time management and relational skills. Demonstrated analytical skills. Strong organizational abilities with attention to detail.
Computer Skills: MS Office- Microsoft Word, Excel, PowerPoint
Travel up to 25%
This role is Flex which allows most work to be performed at home. Employees must be fully vaccinated if they choose to come onsite.
This position is not eligible to be performed in Colorado.
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. What difference will you make?
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.
|Employer||829 GulfQuest, LP|