Scott Durrant Email & Phone Number

Responsible for managing all aspects of the hospital, physician and ancillary provider networks for the Utah market, ensuring access to care for all Cigna members, while providing contracting support/guidance to the Colorado, New Mexico and Wyoming network management teams. Ensures the approaches, processes and practices for delivering through all major healthcare service models are consistent with company strategies, and are compliant with standard operating procedures designed for managing a variety of contractual agreements. In addition to contract negotiation and network management, responsibilities include accurate analyses and recommended strategies relative to contracting, reimbursement and other healthcare provider initiatives. Responsible for effective administration, quality of service, and cost effectiveness of contracts in meeting Cigna’s fiduciary responsibilities to its customers and clients.

Managed contracting staff and cultivated relationships with hospital, institution and other medical facility representatives along with professional, dental and ancillary health care providers to successfully service Regence products. Negotiated contracts, prepared analysis, recommended strategies, researched problem issues and implemented contracting and reimbursement initiatives.

Directed analytical staff and established processes to ensure department provided timely customer-focused business information that was accurate, accessible and consistent. Provided independent and objective analytical review of medical cost components to assist with understanding cost and utilization of service trends and identification of medical cost drivers. Designed reporting tools for use by internal customers to help with business-critical decisions relative to claims expense, case and disease management programs and provider contracting efforts.

Developed reports and tools utilized throughout the organization to efficiently monitor service center results and effectively provide consistent, clear and accurate statistics to senior management. Involved in the budgeting process, assisting with development and re-forecasting to help the management team make decisions in support of financial targets.

Motivated team members to provide improved customer satisfaction while lowering administrative costs to ensure increased profitability for the company. Assisted with development and implementation of human resource policies designed to identify abilities, competencies and knowledge needed for an employee’s career growth and development. Administered all training and quality assurance programs for national account, redesigning quality initiatives to ensure compliance with corporate and client objectives.

Managed technical and clinical staff of 80-100 individuals, including mailroom, clerical, data entry, membership, claims processing, customer service, training, quality assurance and medical review associates and nurses. Coordinated recruiting and hiring activities for self-directed teams and management. Provided quality service to internal and external customers while managing costs below operating budget.

Facilitated all customer presentations, resolved presidential and department of insurance inquiries and handled all litigation for national account. Oversaw daily activities of customer service unit of 30-40 employees. Assisted with successful implementation of Managed Care product for national account, facilitating enrollment meetings throughout the western region.

Supervised data entry personnel and processing staff of 15-20 individuals. Conducted training classes for new associates for claims processing, keying (data entry) and customer service positions. Researched and replied to all insurance department and presidential complaints for major national group. Interpreted employee benefits and applied/enforced contract guidelines while successfully resolving and responding to member calls and correspondence.