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Your Job
Koch Capabilities Company (KCC) is seeking a motivated and self-driven Accounting Manager to join our Payroll and Benefits team.
This role creates value through excellence in business partnering, financial stewardship and reporting.
This role will be responsible for components of accounting and reporting of US payroll and benefits.
What You Will Do
* Lead, develop and supervise a team and implement integrated service delivery to business partners
* Coordinate payroll and benefits funding through effective partnership with operating businesses, HR Solutions and treasury
* Ensure accurate accounting of payroll and benefits activities within the general ledger
* Partner with the Global Mobility team to support accurate accounting, reporting and billing of relocation expenses across the enterprise
* Maintain complete and timely balance sheet reconciliations and stewardship of effective internal financial controls
* Own financial statements and related audits of US 401k plans, including coordination with external record keepers
Who You Are (Basic Qualifications)
* Experience summarizing and explaining complex accounting/finance topics to team members and leadership
* Experience collaborating with others while building and maintain trusted partnerships
* Experience innovating and transforming processes
* Experience with coaching and team development, including the ability to manage team priorities and expectations
* Experience with Microsoft Office Suite or Office 365, including advanced Excel skills (spreadsheet creation/editing, pivot tables, graphs, data manipulation/analysis and formula creation)
What Will Put You Ahead
* Experience in the monthly close and/or year-end audit processes
* Experience with Defined Contribution Plan or Health & Welfare audits
* Experience using FSM or other ERP systems
* Experience using OneStream or other consolidation systems
* Process improvement / process transformation / process implementation experience
At Koch companies, we are entrepreneurs.
This means we openly challenge the status quo, find new ways to create value and get rewarded for our individual contributions.
Any compensation range provided for a role is an estimate determined by available market data.
The actual amount may be higher or lower than the range provided considering each candidate's knowledge, skills, abilities, and geographic location.
If you have questions, please speak to your recruiter about the flexibility and detail of our compensation philosophy.
Hiring Philosophy
All Koch companies value diversity of thought, perspectives, aptitudes, experiences, and backgrounds.
We are Military Ready and Second Chance employers.
Learn more about our hiring philosophy here .
Who We Are
Koch creates and innovates a wide spectrum of products and services that make life better.
Our work spans a vast number of industries across the world, including engine...
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Type: Permanent Location: Wichita, US-KS
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:24
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Your Job
Flint Hills Resources, LP has a lot of exciting energy around our growth and new initiatives.
We are pleased to be adding a Project Controls Senior Estimator to the Project Controls Team located in Corpus Christi, TX at the Corpus Christi Refinery.
The estimating role will partner with Team Based Projects and Construction Management in the development and delivery of Capital Projects and Turnarounds estimates from conceptual phase through construction execution budget reconciliation, and in the benchmarking analysis of project competitiveness.
Our Team
We believe in being the most competitive projects delivery system in the industry.
We do this by leveraging industry benchmarking and internal performance analysis to create stretch goals via realistic target setting.
The FHR Estimator will bring data driven analytics based on Project Design and Execution deliverables with line of sight to project risks, and opportunities that influence improved outcomes.
We value data transparency and mobility to deliver a competitive advantage and have deployed a tailored Aspentech CCE and associated internally developed platforms to support these objectives:
What You Will Do
* Develop complete project estimates with multiple disciplines in accordance with phased project delivery guidelines and procedures from conceptual phase (+/-50%), Funding (+/- 10%) and through to detail construction budget reconciliation (+/-3%).
* Develop accurate, realistic, and competitive estimates based on competitive scope and execution that support industry leading results using
* Process Flow Diagrams
* Piping and Instrument Diagrams
* Piping routing plans, Isometrics
* General Arrangements
* Electrical single lines and routing plans
* Instrument index and loop diagrams
* Civil and Structural layouts, elevations and sections
* Identify, mitigate, and eliminate risks or gaps and influence competitive project outcomes through estimate reviews, field walk downs, constructability, interactive planning sessions and benchmarking analytics
* Work direction with the Cost Engineering and Construction Management teams to:
* Validate that estimates are developed within competitive budgets and coded correctly according to WBS.
* Ensure projects adhere to published change management procedures and analyze submitted change requests.
Who You Are (Basic Qualifications)
* 5+ years' experience in Project Cost Estimating on industrial projects.
(Refining, oil & gas, power, energy etc.)
* Experience estimating multiple disciplines to include piping, electrical, instrumentation, structural steel, civil and all related crafts required to perform project execution.
* Experience using Microsoft Office Suite with proficient skills in Excel (creating charts, formatting cells, pivot tables, etc.) and PowerPoint.
* Experience in project cost estimating and creating an estimate using material take-offs...
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Type: Permanent Location: Corpus Christi, US-TX
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:23
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Home Infusion RN:
Take your nursing expertise and passion to the next level by helping to improve the lives of those we serve.
Accredo is the specialty pharmacy division of Evernorth Health Services.
We are hiringregistered nurses like you to administer intravenous medications to our patients in their homes.
For more than 30 years, Accredo by Evernorth® has delivered dedicated, first-class care and services for patients.
We partner closely with prescribers, payers, and specialty manufacturers.
Bring your drive and passion for purpose.
You'll get the opportunity to make a lasting impact on patients' lives.
Get ready for a nursing career experience unlike any other.
Accredo Infusion Nurses travel to patient homes and deliver critical infusion drugs, but that's only half of our story.
The other half? It's being able to develop meaningful relationships with patients - without feeling rushed or pressure to move on to the next.
In this role, you'll work independently to make decisions and execute them for the best possible outcome for your patients, while feeling the impact you're making every single day.
How you'll make a difference and improve the lives of your patients:
* Be a coach to empower your patients to be at their best.
Focus on the overall well-being of your patients and work with Pharmacists and Therapeutic Resource Centers (TRC) to ensure your patients' needs are met.
* Take full ownership of the patient experience when you travel to patient homes and administer IV infusion medications autonomously along with providing response management and follow-up care.
* Be the single point of contact for regular updates on patient status.
You'll document all interactions and communication with patients including assessments, treatments, responses, disease progression, etc.
* Challenge yourself to be a better nurse every day.
Use your commitment to your craft, confidence in your abilities, positive attitude, and adaptability to handle even the most difficult situations with the support of your leader and team.
Requirements:
* Active, unencumbered Registered Nurse (RN) license in the state in which the position is located, and in which you reside
* Minimum 2 years of RN experience
* Minimum 1 year of RN experience in critical care, acute care, or home healthcare
* Strong IV insertion skills
* Valid driver's license
* Willingness to travel within an assigned geographic area
* Ability to work at least 2 weekdays each week (M-F, day shift), as well as the ability to do occasional evening or weekend patient visits as needed.
* Flexibility to work alternate shifts on short notice and be on call for field visits as determined by business need
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.
About Evernorth Health Ser...
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Type: Permanent Location: Kalamazoo, US-MI
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:19
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WORK LOCATION: Hybrid - if live close to a Cigna Office [potential for Remote if do not live near a Cigna Office]
We have an immediate need to strengthen our Risk Adjustment and Stars Enablement team.
The Risk Adjustment and Stars Enablement team is responsible for developing solution changes for the ongoing needs of CMS Medicare Risk Adjustment processes and systems.
The Medicare Risk Adjustment Analytics Advisor would be a member of the Risk Adjustment and Enablement team that provides support by leveraging multiple data domains to answer important business questions.
This position is connected with multiple teams to ensure that data is reviewed, explained and reported to measure success for Risk Adjustment Enablement projects.
This position will have a primary focus on supporting Risk Adjustment compliance and audit projects.
Principal Duties:
* Perform required tracking and reporting for all Risk Adjustment overpayments including: identification, actuarial valuation, submission to CMS, processing by CMS, and reconciliation.
* Answering questions for external counsel and compliance partners to support overpayment reporting and managing reconciliation reporting of all requested risk adjustment deletes.
* Assists in the analysis and reporting solutions which address Risk Adjustment compliance and audit business needs.
* Identify and analyze user requirements, procedures and prepares detailed specifications from which analysis and reports will be written.
* Analyzes and revises existing reporting logic difficulties and documentation as necessary.
* Competent to work on any phase of the team Risk Adjustment analysis project activities.
* Leverage data and predictive analysis to clearly articulate problems and influence decisions that support the strategic direction.
* Communicate key information to Compliance and Audit partners for awareness of trends, processes, and Risk Adjustment issues.
* Working closely with Compliance, Audit, Actuary and other data domain leaders that share Risk Adjustment responsibilities.
* Reviewing, researching, investigating and correcting issues through data and process analysis.
* Develop collaborative relationships with internal partners to ensure Risk Adjustment goals are met.
* Analyze the integrity of data, diagnose issues and test changes.
* Participates in change management procedures to support accurate Risk Adjustment team documentation and process flows supporting processes and requirements.
* Maintain reporting describing results against internal goals; presenting results and updates to leadership.
* Resolve issues and problems by conferring with both internal and external partners as necessary.
* Other duties as assigned by supervisor/organizational leadership.
* Maintain professional contact with other departments as needed; attend interdepartmental meetings.
Qualifications Required:
* Bachelor's Degree require...
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Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:18
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*
*
*Mon-Thurs 7pm-5:30am shift differential 15% per hour worked
*
*
*
Are you passionate about working for a company on a mission to make medicine safer, more affordable, and accessible for millions of Americans? Cigna is looking for high-energy, positive individuals to join our pharmacy technician team at Accredo Specialty Pharmacy.
Members of this team are tasked with ensuring prescriptions are processed and shipped appropriately so they can arrive in the hands of the 100 million patients whose health depends on their delivery.
Join us in our mission to change lives!
Onsite Pharmacy Technician Shift
Sunday-Wednesday 7:00 pm-5:30 am
What you'll do:
* Fill new and refill prescriptions
* Select and retrieve appropriate medications
* Verify quantities and prepare labels for bottles
* Send orders to pharmacy staff for completion and verification of prescription based programs
* Select appropriate packing materials and prepare packages for shipment
* Enclose client specified materials to orders
* Affix shipping labels on packages and sort by carrier
* Clean equipment and replenish workstation supplies like pill bottles, caps, safety seals, and paper
* Other duties as assigned
* Restock inventory through out the day
What you need to do the job:
* High School diploma or GED required
* A pharmacy technician license/certification/registration is required based on your state's laws.
* Basic math skills and general PC knowledge (i.e.
Microsoft Office, Internet, and Email)
* Strong verbal and written communication skills
* Strong attention to detail, accuracy, and quality
* Ability to work in a fast-paced production environment
* Willingness to work a flexible schedule to accommodate peak volume times
* Willingness and ability to learn internal systems/processes as needed
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.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality.
We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people.
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 reaso...
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Type: Permanent Location: Orlando, US-FL
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:18
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Help us program our future.
Get ready for a job that encourages you to think strategically yet stay connected with your teams.
Do you have IBM Mainframe Engineering experience? If so, prepare to innovate, create, and inspire.
The CICS Systems Senior Advisor (Infrastructure Engineering Senior Advisor) Provides counsel and advice to top management on significant Infrastructure matters, often requiring coordination between organizations.
Serves as the lead technical consultant responsible for the design, engineering, and development of information technology solutions.
Leads the design, analysis, development, and implementation of engineering infrastructure solutions of projects and/or work requests for complex business solutions .
Responsibilities
* Technical leadership of large-scale mainframe infrastructure projects.
* Hands-on technical expertise building and supporting complex CICS environments leveraging:
+ DB2 Data sharing
+ MQ Shared Queue Managers
+ Rexx
+ z/OS
* 10 or more years of CICS Systems Programming and Internals including a "Master-level" knowledge/understanding of CICSPlex and OEM products preferred.
* Self-motivated professional capable of working independently or part of a large team
* Strategic thinker and results-orientated.
* Ability to coordinate projects with end-users and technical teams in a high-paced service-oriented environment.
* Strong overall problem-solving skills with excellent verbal and written communication skills.
Qualifications
* High School diploma or equivalent; Bachelor's degree preferred.
* Evaluate and recommend innovative solutions to meet new or existing business requirements
* Demonstrated timely diagnosis of application or system issues, identify root cause, and recommend appropriate solutions
* Demonstrated consulting and support to the large and diverse application development organization
* Installation, configuration, and maintenance of CICS and associated program products
* Provide 7x24 support as scheduled or as needed.
Capable of handling high-risk and high-visibility tasks with ease.
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.
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives.
At The Cigna Group, we're dedicated to improving the health and vitality of those we serve.
Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients.
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 lact...
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Type: Permanent Location: Morris Plains, US-NJ
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:17
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Role Summary
Responsible for growing membership within existing accounts and for directly managing business relationships with client accounts.
Ensures that systems and processes are in place to meet the needs of internal and external clients.
Develops and implements strategies and policies relating to account management.
Responsibilities
* Overall account management responsibility for CIGNA HealthCare assigned customers including responsibility for persistency results, membership and revenue growth, and the cultivation of customer and producer/broker relationships.
* Provides input that positively impacts financial results.
* Ensures exceptional service and growth through the development of client and broker relationships
Qualifications
* College Degree or equivalent related experience
* Minimum 3 years' experience in health benefits
* Excellent communication/customer service skills/sales negotiation skills
* Sales/marketing/underwriting or operations
* Financial Savvy; ability to grow book of business
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.
This role is also anticipated to be eligible to participate in an incentive compensation 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 fo...
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Type: Permanent Location: Walnut Creek, US-CA
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:17
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The Pharmacy Production Clerk is responsible for ensuring that all medication meets quality control standards; medications are properly labeled, stored, and stocked; visually inspect patient-bound medications for any defects, spills or quality concerns and report any concerns or issues promptly.
Areas they can be assigned to include, but are not limited to, Bulk and Prep, Packing, Mail Manifest, or any other Pharmacy Support function.
This role is Worksite dependent and can only be performed onsite.
How you'll make a difference:
* Juggle multiple tasks without sacrificing deadlines or attention to detail.
Sort, package, seal, and inspect packages.
* Use your expert problem solving skills to help our patients receive their product on time .
Package and label for safe delivery, then work with technology to efficiently get it out the door.
* Create new knowledge with our systems and new relationships with your peers.
You'll start with training and you're not doing it alone.
You'll have the opportunity to cross-train and support overall pharmacy health in other areas like technicians, bulk & prep, and the packing manifest area.
You'll enjoy a supportive environment with your peers and other teams who want you to succeed.
ESSENTIAL FUNCTIONS
* Ensure each package receives the correct paperwork, envelopes, medications, packing and / or shipping labels before sealing and sending packages to patients.
* Consistently work on only one order at a time at their workstation at all times.
* Ensure that the address prints correctly on each package.
* All bags are correctly sealed; Printers are accurately loaded with the correct paper.
* Accurately package prescriptions requiring special handling according to specific process and policy requirements.
* Work collaboratively with all coworkers to ensure that best-practices are shared while maintaining productivity and quality standards.
* Capability to accurately escalate issues to leadership for action; provide input regarding solutions.
* Bulk up of medications from manufacturer bottles, including visual inspection and labeling of large containers.
* Visual inspection of patient bound medications.
* Orientation of packages for sortation system.
* Preparation of mail sacks or bulk containers for shipment.
* Manual material handling, storage, and stocking of shelves, workstations, and/or channels.
* Sorting and distribution of literature packs to CADS / Averts stations.
* Keep workstation clean at all times.
* Other duties assigned as needed.
QUALIFICATIONS
* 0-1 years of relevant experience.
* General PC knowledge is required.
* Excellent verbal and written communication skills.
* Good visual acuity.
* Ability to read and compare and differentiate data.
* Ability to stare/review small medications or bottles for extended periods of time.
If you will be working at home occasionally or perm...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:16
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As a Federal Government Contractor, it is integral to the overall success of our performance to remain in compliance with various Government contracts and regulations.
In order to assist the Organization in maintaining compliance with these contracts, we are looking for an energetic and self-motivated Compliance professional with experience in Federal Government Contracting.
The right candidate will serve as a subject matter expert who coordinates and facilitates compliance activities across a number of contracts while working with a cross functional team including Account Management, Legal and Operations.
RESPONSIBILITIES:
* Ensure the division has robust processes and procedures in place to ensure compliance with all contractual elements, including ensuring accurate reporting to the client.
* Collaborate with other functional areas, such as Legal or Contracts Administration, while supporting Federal Contracts to determine compliance status and assisting with process improvements when needed.
* When compliance concerns arise, coordinate with business partners to resolve the open issue and ensure it does not reoccur.
* Support Compliance Governance activities including facilitating Governance Committee meetings and completing contract mappings and related documents
* Perform annual updates to trainings specific to Federal Contracting and verify assignment lists
* Serve as the Service Contract Act (SCA) Administrator, coordinating with other areas for scoping and reporting requirements
* Support proposal and implementation activities for prospective and new contracts
* Manage ongoing listing of team Standard Operating Procedures (SOPs) inlcluding assisting business owners as they write new SOPs and regularly valiadating existing SOPs to keep them current
* Understand Government Regulations such as:
+ Federal Acquisition Regulations (FAR)
+ DoD Federal Acquisition Regulations (DFARS) and
+ eCost Accounting Standards (CAS)
* Perform additional duties as Compliance needs and responsibilities change
IDEAL CANDIDATES WILL HAVE A COMBINATION OF THE FOLLOWING:
* Bachelor's degree preferred.
Related degree or experience required.
* Accounting experience preferred.
* Experience with Federal Government Contracting including knowledge of the Federal Acquisition Regulation and Defense Supplement.
* Highly proficient in Microsoft Office including Excel or other PC based database tools.
* Exceptional executive presence in written and verbal communications.
* Strong organizational skills necessary to prioritize and accomplish a large number of tasks within a specified timeframe.
* Solid judgment and analytical skills to analyze, recommend, and improve processes.
* Self-motivated, detail-oriented, and willing to adapt to tactical needs in a fast-paced, changing environment .
If you will be working at home occasionally or permanently, the i...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:16
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Summary
The Risk Adjustment Reporting & Analytics Manager is an opportunity to lead complex analytics projects and initiatives for Cigna's Medicare Advantage Risk Adjustment business.
The Manager will work collaboratively with business analytics work groups, such as STARs, Clinical, and analytics engineering, to transform ideas into concept through a team of business analytics professionals.
Reporting to the Senior Manager of Risk Adjustment Analytics, this position will manage the prioritization, intake, and deliverables for core Risk Adjustment Analytics programs in support of the broader RA Business Strategy.
Responsibilities
* Lead a team of analytics professionals to develop and apply fast-paced, scalable analytical/reporting solutions for Risk Adjustment programs
* Exercise considerable creativity, foresight, and judgment in planning and delivering initiatives
* Provide expert content/professional leadership, understanding business strategy, to best deploy analytics solutions that help them achieve business goals in conjunction with the senior manager
* Provide individual and team leadership for the team as they grow their capabilities, achieve their career goals, and meet team objectives
* Ensure project status, analytic approach, and results are clearly understood and communicated to business partners
* Assist in presenting results and recommendations to Risk Adjustment leaders, including executive leaders
* Translate business need into specifications for Analytics teams to execute on requests
* Partner with others on the Analytics lead team to prioritize work across multiple project types for optimal outcomes.
Help remove roadblocks
* Contribute to executing reporting and analytics roadmap and strategy
Qualifications
* 5+ years' industry experience solving business problems through the application of analytics approaches
* Experience with risk adjustment, healthcare analytics, clinical data, and/or financial data
* Experience managing a team, ideally in a virtual environment or across multiple locations
* Proven ability to work collaboratively in complex matrix organizations, driving outstanding results
* Strong verbal/written communication skills to work with various matrix partners, such as finance, business leaders, and IT
* Bachelor's degree required in preferred fields of Statistics, Biostatistics, Econometrics, Economics, Actuarial Science, or Data Science or equivalent work experience
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 102,800 - 171,400 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...
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Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:15
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LOCATION: Can be based in Houston, Austin or San Antonio, TX
PROVIDER CONTRACTING ADVISOR
This position serves as an integral member of the Provider Contracting Team and reports to the Provider Contracting Senior Manager.
This role assists in developing the strategic direction and management of the day to day contracting and network management activities for a local given territory.
DUTIES AND RESPONSIBILITIES
* Manages complex contracting and negotiations for fee for service and value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups).
* Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
* Initiates and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management.
Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service.
* Manages strategic positioning for provider contracting, develops networks and identifies opportunities for greater value-orientation and risk arrangements.
* Contributes to the development of alternative network initiatives.
Supports and provides direction to develop network analytics required for the network solution.
* Works to meet unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position.
* Creates and manages initiatives that improve total medical cost and quality.
* Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist with total medical cost initiatives.
* Prepares, analyzes, reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms.
* Creates "HCP" agreements that meet internal operational standards and external provider expectations.
Ensures the accurate implementation, and administration through matrix partners.
* Assists in resolving elevated and complex provider service complaints.
Researches problems and negotiates with internal/external partners/customers to resolve highly complex and/or escalated issues.
* Manages key provider relationships and is accountable for critical interface with providers and business staff.
* Demonstrates knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape.
* Responsible for accurate and timely contract loading and submissions and interface with matrix partners for network implementation and maintenance.
* May provide guidance or expertise to less experienced specialists.
POSITION REQUIREMENTS
* Should possess a bachelor degree; preferably in the areas of Finance, Economics, Healthcare or Business related.
Significant industry experience will be considered in lieu of a Bachelor degree...
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Type: Permanent Location: Houston, US-TX
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:15
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The Financial Analysis and Modeling Advisor position within the Medicare Advantage Revenue Finance Team is an opportunity to support our quarterly financial forecasts and provide consultative advice to leadership on tracking the company's Medicare Revenue.
This role will work with a series of stakeholders on setting our risk adjustment strategy.
Reporting to the Medicare Advantage Revenue Finance lead, this position will work within both the larger Medicare finance and operation teams to ensure appropriate risk adjustment goals are developed, set, and measured on a routine basis.
This role requires independence, analytics, critical thinking, creativity, business acumen, and relentless problem solving to successfully support business partners in achieving our goals.
Responsibilities
* Analyzes drivers of the company's historic Medicare Advantage revenue trends and summarizes key drivers for segment leadership on an annual basis.
* Forecasts Medicare Advantage revenue trends for the company up to five years in the future.
* Collaborates with risk adjustment and market facing business partners to ensure appropriate risk adjustment goals are set and incorporated into reporting and forecasts.
* Leads monthly discussions with leadership on risk adjustment progress, priorities, and key risks and opportunities.
* Supports analytics partners in evaluating risk adjustment programs, inclusive of prospective and retrospective coding initiatives.
* Owns and develops tools to measure and report progress on prospective coding initiatives.
* Exercises significant independence, foresight, and judgement when completing deliverables.
* Develops and maintains an advanced knowledge of Medicare Advantage risk adjustment and can articulate emerging developments to peers.
* Leverages existing toolsets while continually working towards improved data assets and processes.
Qualifications
* Bachelors Degree in Finance, Actuarial Science or related field strongly preferred
* 4+ years of experience developing financial models and leveraging SQL to manipulate large datasets.
* Experience working and coordinating across teams to achieve goals.
* Proven track record communicating complex topics to a non-technical audience.
* Prefer candidates with some familiarity of Medicare Advantage and risk adjustment.
* Actuarial experience is preferred, but not required.
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 104,300 - 173,800 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.
We want you to be healthy, balanced, and feel secure.
That's why yo...
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Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:14
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Work Location - Remote, United States
60% travel required, including some overnights
Valid insurance license required
Summary:
The Regional Vice President for Cigna Supplemental Benefits (CSB) will be a critical team member responsible for making CSB a market leader in the Medicare Supplement and individual ancillary products space.
This individual will be part of a rapidly growing business unit that will execute on CSB's national broker distribution strategy with National Marketing Organizations (NMO's) and other topline distributors.
You will recruit, train, and motivate a group of external distributors/wholesalers that will deliver industry leading results via business development activities.
Responsibilities:
* Prospects, appoints and manages agency relationships to achieve sales and profitability objectives.
* Develop and execute a market level distribution strategy that drives significant sales growth of Medicare Supplement and ancillary products with their accounts.
* Build and maintain strong, focused relationships with distributors at all levels.
* Train current and new National Marketing Organizations along with their downline agencies on our processes and procedures.
* Participate in planning and execution with internal business units in order to drive sales and profit growth.
* Develop and execute sales plan with each NMO partner to help contribute to our corporate objectives of doubling revenue over a 5 year period.
* Maintain up-to-date knowledge of local market trends, competitive intelligence, core product strategies, and other indicators ensuring a competitive edge.
* Represent our organization at trade shows and industry events.
Qualifications:
* High School Diploma, required.
Bachelor's degree or equivalent relevant work experience; advanced degree, highly preferred.
* 10 or more years' experience securing and retaining National Marketing Organizations to market Medicare Supplement and all supplemental health insurance products.
* Must be able to demonstrate critical, strategic thinking skills to drive positive outcomes with key NMO partners.
* Build strong working relationships with internal and external partners, driving positive energy through influential leadership.
* Strong presentation and public speaking skills.
* Strategic thinker capable of developing long term and best in class distribution relationships.
* 60% overnight travel required
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.
This role is also anticipated to be eligible to participate in an incentive compensation 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 em...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:14
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The Medicare Advantage (MA) Finance Enablement VBA Modeling Advisor will manage FP&A models for provider groups engaged via a professional capitation, risk/surplus sharing, or other value-based arrangement (VBA).
This includes development and coding of enhancements to current models (whether added functionality/complexity or greater efficiency).
The Advisor will need to understand existing models, help maintain and provide education to users on current models, understand national and market level needs regarding reporting and analysis for these arrangements, and consider implications to a variety of stakeholders for proposed updates (such as Accounting, Network Operations, Analytics, Medical Economics, etc.).
Responsibilities
* Act as model steward for segment-wide value-based arrangement accrual and settlement models (manage maintenance and updates; add to documentation and user education).
* Consider and implement ways to improve accuracy, completeness, granularity, or efficiency in calculating liabilities or settlement expectations in accordance with a variety of contract types and stipulations.
* Help ensure that all reporting and results are provided in a timely and well-structured manner to stakeholders including the Enterprise FP&A team and Accounting team.
* Advise and collaborate with Contracting/Operations/Strategy teams on the financial implications of new proposed arrangements or modifications to existing programs.
Qualifications and Competencies
* Bachelor's degree in Analytics, Health Information Management, Management Information Systems, Finance, Economics or related field.
* 3+ years of experience with complex model / data governance (primarily in Excel / SQL).
Familiarity with R / Python a plus.
* Experience with financial analysis and/or financial processes
* Experience with various standard methodologies for calculating accruals, short duration financial reserves, and financial projections as well as experience with claims analytics, clinical data, and financial data.
* Experience organizing best practices for automated workflow development, ensuring consistency in documentation and coding styles across a team to help enable portability of models among analysts.
* Proven ability to work collaboratively in complex matrix organizations, driving outstanding results.
* Strong verbal/written communication skills to work with various matrix partners such as Actuaries, Data Scientists, Clinical Leaders, and Information Technology teams.
* Willingness to learn and apply new skills to improve processes.
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 104,300 - 173,800 USD / yearly, depending on relevant factors, including experience and g...
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Type: Permanent Location: Philadelphia, US-PA
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:13
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Job Description Summary
Provides administrative support, with the majority of duties being high level administrative tasks, which may include planning/coordinating large events, meetings or conferences, screening inquiries or complaints as well as projects, and space planning.
Performs budget preparation, scheduling, reporting and tracking information, a wide variety of complex meeting prep/presentations, as well as editing and composing correspondence.
Work requires initiative and judgment in making decisions and knowledge of department and company policies and procedures.
This role is "flex" with 3 days per week required in a nearby Cigna office, and the remaining time work from home.
Responsibilities
* Provides executive administrative services for Market Growth Leader and local market leadership team, including calendar management, expense reporting, and other support.
* Produces and updates presentations and other materials, including editing in PowerPoint, Excel, and Word
* Performs meeting and event support, such as preparing meeting materials and notes, ensuring appropriate space set up and clean up, catering management, and any other projects as needed.
May include large meetings or events with senior leaders, brokers, and clients
* Supports local community and civic affairs events, assisting with event planning, management, and break down
* Assists with various projects within a high traffic sales office, including office initiatives, mail and office supply management, and facility oversight
* Order all office supplies and promotional items and maintain the budget for management monthly and year-end
* Assists with printing requests, including printing, binding, and shipping materials
* May support segment-level administrative services projects in partnership with other local offices
* Communicates professionally and collaborates with internal matrix partners, brokers, and clients
* Backup other administrative professionals when needed
* Performs additional responsibilities as assigned
Qualifications
* Previous experience as an Administrative Assistant, with demonstrated ability to support senior leaders, preferred
* Previous experience with office or facility management preferred
* Strong computer based technical skills including Outlook, Word and internet/web navigation, strong knowledge base of Microsoft Excel, preferred
* Health insurance background with general understanding of the overall sales process and knowledge of Salesforce.com
* Strong written & verbal communication skills
* Strong problem-solving and analytical skills
* Detail oriented with exceptional follow-up skills
* Ability to work in a production-like, fast paced environment and adapt quickly to change, with the ability to manage, prioritize and work on numerous projects at one time.
* Strong organizational skills with the ability to work both independently and ...
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Type: Permanent Location: Irvine, US-CA
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:13
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Primary Care Physician - Outpatient Practice - Internal or Family Medicine
Positions available, onsite:
Phoenix, AZ 3003 N.
3rd St.
Phoenix , AZ 85012
Mesa, AZ 1840 S.
Stapley Dr.
Mesa , AZ 85204
Scottsdale, AZ 1355 N Scottsdale Rd.
Scottsdale, AZ 85257
Who We Are:
Evernorth Care Group continues to build on its foundation as a trusted leader in integrated primary care.
For more than 50 years, we've been delivering high-quality, affordable, and accessible care for our patients and the community.
The physician will provide primary care for Evernorth Care Group patients deemed to fall within the scope of practice of Internal Medicine or Family Medicine.
Diagnoses and treats patients for disorders on a general level, without restriction to special systems or regions of the body; serves as the general practitioner to patients for general diagnostic and therapeutic medical care.
Our Patient-First Care Model:
* Team Approach - Quality-driven patient care model
* Low daily patient census - to allow our physicians to provide the "gold standard" in patient care
* Dedicated clinical staff to help alleviate the administrative requirements
What you'll enjoy about working here:
* Compensation package includes competitive base salary and bonuses
* Benefits start on day one
* Predictable work schedules, no nights, weekends or holidays
* 8 Paid Holidays + 23 PTO Days
* 401(K) with company match
* Reimbursement for continuing medical education
* Career growth opportunities across the enterprise
* Networking with peers across multiple medical specialties
Qualifications:
* MD or DO Degree
* Board Certification in Family Medicine or Internal Medicine (new grads who are board eligible are welcome to apply)
* Active and unrestricted AZ medical license, or ability to obtain
* Outpatient practice experience, preferred
* Proficient computer skills - MS Office Products (Word/Excel) and Electronic Health Records systems
* Demonstrates flexibility
* Displays excellent/compassionate communication skills with staff and patients
* Epic experience, a plus - not required
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.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality.
We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people.
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 o...
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Type: Permanent Location: Scottsdale, US-AZ
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:12
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Work Location - West/ Northwest Arkansas (must be located in/or near area)
Valid local state Agent Health and Life Insurance license is required
Excited to grow your career?
We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions.
If you think the open position, you see is right for you, we encourage you to apply today!
Our people make all the difference in our success.
First things first.
We're a global health service company dedicated to helping people improve their health, well-being and sense of security.
But we don't just care about your well-being, we care about your career health too.
That's why when you work with us, you can count on a different kind of career - you'll make a difference, learn a ton, and share in changing the way people think about healthcare.
Ideal locations: West/ Northwest Arkansas
Travel - Locally 75%
Reliable transportation, valid driver's license, and insurance required - mileage reimbursement provided
Bilingual preferred, but is not required
Valid local state Agent Health and Life Insurance license is required
Now let's talk about the role:
SUMMARY:
Responsible for the execution of the Cigna Medicare strategy for local topline sales agencies, directly contracted agents, and broker down-line sales within the market for the book of business they manage through training, relationship management, member retention and sales growth.
RESPONSIBILITIES:
• Execute multi-year local broker strategy for book of business
• Influence brokers to sell more by positioning our product and promoting our brand
• Execute on national topline strategies with downline sales agencies & local direct agencies to drive profitable growth through down-line sales (e.g.
educate and expand on MA products)
• Develop & execute direct agent strategies to drive profitable growth and member retention
• Search for new local/regional agencies & agents to cultivate and grow
• Responsible for a territory, manage contacts and exercise long-term vision approach
• Executes on strategy to expand sales efforts across multiple products as appropriate (e.g.
synergies with MA, PDP, CHS)
• Execute on market / region sales goals and objectives (sales events, training, branding, etc.)
• Communicate and monitor downline agency sales goals against production within their book of business, assist in recruiting, business plan development and new agent training
• Meet or exceed sales objectives through broker channel
• Conduct advertised sales presentations for prospects and leverage community partnerships to host events
• Meet with brokers and agencies to build relationships and promote our brand
• Produce campaign and event tracking reports showing return on investments and key initiatives using data and excel.
• Carry out appropriate sales activity standards as directed by their manager
• Responsible for reporting their dail...
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Type: Permanent Location: Bentonville, US-AR
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:12
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Key Responsibilities
1.
Proposal Management:
1.
Collaborate with stakeholders to understand customer needs and the scope of projects.
2.
Lead the creation and development of persuasive and compelling technical proposals that clearly convey the company's value proposition.
3.
Lead the end-to-end proposal development process both technical and price, from initial request to submission
4.
Ensure all proposals are prepared accurately and delivered on time in accordance with customer specifications.
5.
Create and maintain a proposal library with templates, tables, workbooks, case studies, and other reusable content.
6.
Work with cross functional teams to develop, implement and manage contract budgets based on price proposals.
2.
Contract Management:
1.
Collaborate with the management team to support the organizations goals in achieving revenue targets by providing accurate and well-structured proposals.
2.
Manage the contract lifecycle, from drafting and negotiations to execution and renewal.
3.
Draft, review, and negotiate contracts, agreements, and amendments with customers, suppliers, subcontractors, and other partners.
4.
Ensure contracts are aligned with company policies, legal requirements, and industry standards.
5.
Monitor contract performance to ensure compliance with PWS/SOW, contract deliverables, terms and conditions and resolve issues that may arise.
6.
Interface with project managers to facilitate a seamless transition from contract award to project initiation.
3.
Record Keeping and Documentation:
1.
Maintain accurate and up-to-date records of all proposals and contracts, including amendments, task orders, and change orders.
2.
Ensure all proposals and contracts are properly documented, organized, and accessible for future reference.
3.
Create and maintain a comprehensive database of proposals, contracts, and related documents for easy access.
4.
Risk Management:
1.
Identify potential risks associated with contracts and develop strategies to mitigate them.
2.
Implement risk assessment and management techniques to protect the company's interests.
3.
Monitor key performance indicators (KPIs) to track the success of the contract.
5.
Continuous Improvement:
1.
Keep abreast of industry best practices, emerging trends, industry standards, and changes in regulations.
2.
Recommend and implement process improvements to enhance efficiency and effectiveness in the proposal and contract management process.
3.
Implement improvements and best practices to enhance the efficiency of the proposal and contract management processes.
6.
Stakeholder Collaboration:
1.
Collaborate effectively with senior management and cross functional teams to gather necessary information and insights for proposals and contracts.
2.
Communicate...
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Type: Permanent Location: San Antonio, US-TX
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:11
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The Engagement Consultant is responsible for driving consistent wellness program development, guidelines, and delivery to the Select & Middle Market Buyer Group Clients.
In working with Clients with diverse employee populations, this role identifies the right wellness program mix and the program setting to educate, engage and activate employees to achieve health improvement goals.
In partnership with the account management team, Engagement Consultant recommends the appropriate delivery and coordination of wellness programs, customer education initiatives, and monitors effectiveness of the programs.
A core objective of this position is to facilitate wellness initiatives that educate and influence employees at the worksite to lead healthy lifestyles.
This role strives to enhance employee consumerism and achieve customer-centric, utilization goals.
Responsible for consulting with employers and brokers in the development of strategic health engagement plans, spearheading customer engagement initiatives, coordinating awareness and education activities and educating customers on being a better consumers of healthcare.
Engagement Consultant also presents benefit plan design to our customers at annual open enrollment meetings.
This position is responsible for supporting client wellness objectives and managing the communication and execution of these initiatives/tactics to ensure successful implementation and desired results.
Engagement Consultant will research and respond to health information and wellness plan inquiries and proactively communication of all changes, problems, and issues that may occur.
May act as a liaison between wellness team and billing department, marketing department, outside customers, and vendors.
Will apply standard techniques and procedures to routine instructions that require professional knowledge in specialist areas and provide standard professional advice and creation of initial reports/analysis for review.
* Assess client's employee health challenges and objectives, helping to design a strategic multi-year wellness program that is customized to their workforce, goals and budget.
The assessment will utilize health assessment data, organizational assessment data and in addition to factor in claim/utilization data, employee survey data, or other data as appropriate.
* Consult with client to convey the importance of the right framework for an effective wellness program, i.e., leadership support, a wellness committee, appropriate incentive structure, and supporting organizational policies related to wellness
* Coordinate with sales partners to identify opportunities for product penetration of existing accounts, potential sales of ancillary products and strategies to maximize membership
* Provide ongoing analysis and evaluation of client communication/health/wellness strategies to determine effectiveness, penetration, and impact to client's total claims and utilization, biometric data, and employee enga...
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Type: Permanent Location: Overland Park, US-KS
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:11
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Work Location: Hybrid.
3 days (Tues, Wed, + 1 Flex Day) in Pittsburgh office.
Assistant Vice President, Network Management, Western PA and West Virginia markets
This position serves as an integral member of the Provider Contracting Team and reports to the Vice President, Network Management, Liberty Valley.
This role is a key contributor to the development of the strategic direction and is accountable for the management of contracting and network management activities for multiple local geographies.
DUTIES AND RESPONSIBILITIES
* Directly manages a contracting team or geography, providing leadership, mentoring, and development opportunities to their direct reports.
* Accountability for managing contracting and network management activity supporting Commercial, Medicare Advantage, and other products/initiatives (i.e.
Exchange products) as applicable to market.
* Manages increasingly complex contracts and negotiations for fee for service and sophisticated value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups) across Western PA and West Virginia.
* Leads cross market and cross functional initiatives as needed.
* Proactively builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
* Initiates, nurtures, and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management.
Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service.
* Manages strategic positioning for provider contracting, develops networks and identifies and acts upon opportunities for greater value-orientation and risk arrangements.
* Responsible for meeting unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position.
* Identify and manages initiatives that improve total medical cost and quality.
* Prepares, analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms.
* Manages key provider relationships and is accountable for interface with providers and business staff.
* Demonstrates comprehensive knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape.
* Responsible for accurate and timely contract loading and submissions and interface with matrix partners for network implementation and maintenance.
POSITION REQUIREMENTS
* Bachelor's degree strongly preferred; preferably in the areas of Finance, Economics, Healthcare or Business related.
Significant industry experience will be considered in lieu of a Bachelor degree.
MBA or MHA preferred.
* Minimum of 5 years Provider Contracting and Negotiating experience involving complex delivery systems and or...
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Type: Permanent Location: Pittsburgh, US-PA
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:10
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This is a hybrid role and requires the ability to work in person.
This position is a high functioning role with account management and strategic planning responsibilities for a specific provider book of business.
They are responsible for engaging with providers as collaborative partners to drive strategic planning activities to improve experience outcomes while encouraging and influencing the provider/customer relationship in support of the connected care strategy.
This role is external facing and supports the provider in delivering education on Cigna products, policies, procedures, collaborative programs and more.
They work in partnership with matrix partners; (Contracting, Market Medical Executives, Sales, Accounts Receivable Support and more) to support provider specific and local market initiatives.
This individual is empowered to make decisions as it pertains to the provider experience, is required to have local market knowledge and will contribute to building a culture of service excellence while continuously improving the relationship between Cigna, providers, and customers.
DUTIES AND RESPONSIBILITIES
* Accountable for the end-to-end provider experience for assigned Book of Business (BOB) (based on Cigna's local market strategy; CAC's, Integrated Delivery Systems, Independent Physician Groups, etc)
* Supports local market total medical cost strategies for assigned BOB
* Owns end-to-end management and execution of corrective and strategic action plans
* Leads, collaborates, and provides direction to improving the provider experience in accordance with action plans activities
* Proactively identify new opportunities and risks for providers through SWOT or competitive analysis actions
* Responsible for coordinating, directing, and implementing Service Experience Review (SER) as defined by the SER strategy
* Manage joint operating committees (JOC), including agenda development, facilitating appropriate meeting participation and follow up activities
* Facilitates education and discussion on products, quality initiatives, disease management programs, joint ventures, etc.
* Monitors internal metrics and service performance in accordance of organizational and provider specific goals.
* Proactively educate and influence policies on CIGNA's business objectives, standard operating procedures, policies and programs
* Participate in local professional associations/organizations
* Responsible for capturing, documenting, and sharing market intelligence; use market intelligence to develop and drive strategic improvements
* Collect, analyze, interpret, translate and distribute provider informatics with Account Management team
* Review provider reports/dashboard with individual HCPs
* Understands and applies service culture principles and methodology
* Serve in a consultative role or subject matter expert to key matrix partners
* Participates in presentations to exi...
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Type: Permanent Location: Morristown, US-NJ
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:10
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Do you crave an intellectually stimulating job that allows you to leverage your clinical expertise while developing new skills and improving the lives of others? Then look no further! As a Dermatology Medical Director at eviCore, part of Evernorth Health Services, a division of The Cigna Group, you'll use your clinical know-how to provide evidence-based medical reviews for patient care.
Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases.
This role offers you the opportunity to build new skills while enhancing the health and vitality of others.
We're seeking a detail-oriented individual with good communication, technology, and typing skills, as well as strong clinical judgment.
Drive growth in your career with our innovative team.
How you'll make a difference:
* You'll start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success.
* Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on eviCore's case management software.
* Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence-based medical necessity and appropriateness of the requested service or treatment.
* Leverage your clinical expertise to recommend alternative services or treatments as necessary.
* Work collaboratively with over 500 eviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making.
What you'll enjoy about working here:
* Benefits start on day one
* Predictable work schedules
* 100% work from home
* 8 Paid Holidays + 23 PTO Days
* 401(K) with company match
* Reimbursement for continuing medical education
* Career growth opportunities across the enterprise
* Networking with peers across multiple medical specialties
Requirements:
* M.D.
or D.O.
with a current, active, U.S.
state medical license and board certified in Dermatology recognized by the American Board of Medical Specialties, or American Osteopathic Association
* Eligible to acquire additional state licensureas required
* Prefer one of the following state medical licenses but is not required: DC, MD or VA
* 5 years of relevant clinical experience post residency/fellowship
* Knowledge of applicable state federal laws
* Utilization Review Accreditation Commission and National Committee for Quality Assurance standards is a plus
* Ability to commit to a set, weekly work schedule (Monday through Friday)
* Strong computer skills: ability to work autonomouslywith automated processes, computer applications, and systems
* Meet physical demands of the role including, but not limited to, typing, speaking, and listening 100% of time
* In accordance with our HITECH Security Accreditation, company provided encrypted-workstation is...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:09
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RN Clinical Wellness Nurse - Orlando, FL
Role Summary
The primary focus of the Clinical Wellness Nurse focuses on individual coaching, site health promotion, and Clinic Functions.
In collaboration, with the Cigna benefits and account teams, this Nurse balances individual coaching sessions with appropriate delivery and coordination of wellness programs including event scheduling and appointment coordination and monitors effectiveness of the programs.A core objective of this position is to facilitate wellness programs that educate and influence employees at the worksite to lead healthy lifestyles.
Coach Responsibilities
•Individual coaching sessions
•Assist in the identification of members' health advocacy needs.
•Utilize motivational interviewing and engagement strategies to support overall
health and wellness of employees.
•Provide onsite support to members in order to help them identify a need for behavior change to improve health status, reduce health risks and improve quality of life.
•Provide health and wellness education utilizing a multitude of media including group presentations, support group facilitation, creative use of modalities (i.e.
games, quizzes, etc.), newsletter contributions, etc.
•Follow up with employees to ensure that wellness program engagement has been achieved and assess future educational and/or program referral needs.
Health Promotion
•Educate about wellness programs, tools and services
•Raise awareness and create visibility for wellness
•Wellness Events and Campaigns
•Travel to scheduled school locations for program and wellness program delivery
Mobile Van Based Clinical Functions/Telemedicine
•Prepare and manage Van for clinical use by stocking with supplies as needed
•Travel with van to designated scheduled locations for in scope clinical service delivery
•Prepping patient for virtual provider
•CLIA waived testing
•Draw Labs and prepare for pick up (or drop off)
•Input HPI info into the system
•Biometric Testing
•Vaccine administration
What we expect from you:
•Active and unrestricted RN license in respective state, with ability to maintain active licensure is required.
•Minimum of 3 or more years of clinical experience as an RN or LPN in a physician's office or hospital setting
•Experience in health education and wellness coaching preferred.
•Demonstrated experience and ability in providing superior Client service to organizations and individuals.
•Positive role model in demonstrating healthy behaviors.
•Proven administrative abilities with strong computer and software application skills.
•Excellent interpersonal skills and the ability to work in a team environment.
•A high energy level and excellent written and oral communication skills are essential.
•Self-directness and the ability succeed in an independent role.
Bonus points for:
•1:1 coaching experience
Virtual/telemedicine experience
•Positive role model in demo...
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Type: Permanent Location: Orlando, US-FL
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:09
-
RN Clinical Wellness Nurse - Nashville, TN
Role Summary
The primary focus of the Clinical Wellness Nurse focuses on individual coaching, site health promotion, and Clinic Functions.
In collaboration, with the Cigna benefits and account teams, this Nurse balances individual coaching sessions with appropriate delivery and coordination of wellness programs including event scheduling and appointment coordination and monitors effectiveness of the programs.A core objective of this position is to facilitate wellness programs that educate and influence employees at the worksite to lead healthy lifestyles.
Coach Responsibilities
•Individual coaching sessions
•Assist in the identification of members' health advocacy needs.
•Utilize motivational interviewing and engagement strategies to support overall
health and wellness of employees.
•Provide onsite support to members in order to help them identify a need for behavior change to improve health status, reduce health risks and improve quality of life.
•Provide health and wellness education utilizing a multitude of media including group presentations, support group facilitation, creative use of modalities (i.e.
games, quizzes, etc.), newsletter contributions, etc.
•Follow up with employees to ensure that wellness program engagement has been achieved and assess future educational and/or program referral needs.
Health Promotion
•Educate about wellness programs, tools and services
•Raise awareness and create visibility for wellness
•Wellness Events and Campaigns
•Travel to scheduled school locations for program and wellness program delivery
Mobile Van Based Clinical Functions/Telemedicine
•Prepare and manage Van for clinical use by stocking with supplies as needed
•Travel with van to designated scheduled locations for in scope clinical service delivery
•Prepping patient for virtual provider
•CLIA waived testing
•Draw Labs and prepare for pick up (or drop off)
•Input HPI info into the system
•Biometric Testing
•Vaccine administration
What we expect from you:
•Active and unrestricted RN license in respective state, with ability to maintain active licensure is required.
•Minimum of 3 or more years of clinical experience as an RN or LPN in a physician's office or hospital setting
•Experience in health education and wellness coaching preferred.
•Demonstrated experience and ability in providing superior Client service to organizations and individuals.
•Positive role model in demonstrating healthy behaviors.
•Proven administrative abilities with strong computer and software application skills.
•Excellent interpersonal skills and the ability to work in a team environment.
•A high energy level and excellent written and oral communication skills are essential.
•Self-directness and the ability succeed in an independent role.
Bonus points for:
•1:1 coaching experience
Virtual/telemedicine experience
•Positive role model in de...
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Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:08
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Role Summary
The Privacy Compliance Senior Supervisor will ensure enterprise compliance with HIPAA and other federal and state privacy laws; develop, implement, and maintain privacy policies and procedures; conduct privacy risk assessments; lead privacy education and awareness campaigns; and promote a culture of compliance throughout The Cigna Group.
The successful candidate will thrive in a fast-paced environment; work effectively in a matrixed organization across all levels of leadership; have excellent interpersonal, communication, and presentation skills.
Responsibilities
* Help drive Cigna's compliance with federal and state privacy regulatory requirements, Cigna privacy policies, and supporting our client and customer expectations for privacy
* Serve as point of contact for business colleagues for privacy compliance
* Execute and deliver on the Privacy Program Elements
* Balance priorities to achieve departmental objectives
* Coordinate with internal departments on training, privacy by design, privacy education, guidance, and corrective action plan implementation and other remediation
* Monitor developments in privacy legislation, regulations, and industry best practices to ensure that enterprise privacy compliance practices remain current and effective
* Conduct privacy risk assessments to identify and mitigate potential compliance risks
* Manage and lead individuals team members on the privacy compliance team
Qualifications
* Minimum of 3-5 years of related privacy and data protection compliance experience, preferably in the health care industry
* Knowledge of and experience with Privacy regulations such as HIPAA privacy and security rules; state privacy and data breach Laws; GLBA; TCPA, consumer state privacy laws required
* Organizational skills
* Ability to prioritize and manage multiple assignments to completion and meet deadlines
* Strong willingness to learn about the team's workflows and businesses we support
* Ability to work collaboratively with others and ability to professionally interface with others at all levels
* Bachelor's degree preferred
* Privacy Certification, a plus
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.
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives.
At The Cigna Group, we're dedicated to improving the health and vitality of those we serve.
Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients.
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...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-16 08:07:08
