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Your Job
KBX Logistics is looking for an Accounts Receivable Specialist whose core responsibility will be to ensure freight invoicing and payment processes are completed in an accurate and efficient manner.
The successful candidate will have a high level of attention to detail, the ability to think economically and be able to work in a fast-paced environment.
Our Team
Join our dynamic accounting team, where we're all about growth, development, collaboration, and adaptability.
The division you'll support thrives in a fast-paced environment and embraces a passionate approach.
We're excited to partner with you to ensure processes and procedures are followed diligently.
Your role in maintaining standards and fostering efficiency will be key as we journey together towards excellence.
What You Will Do
* Create customer invoices in an accurate, timely manner
* Provide customers with supporting documentation required for customer payment
* Provide payment instructions to the cash application team
* Resolving rate, fuel, and additional charge issues, etc.
* Manage customer aging's - research, review, and resolve open invoices and submit balance dues
* Ensure customer invoicing is compliant with KBX Logistics contracts
* Monitor customer accounts to ensure they are within payment terms
* Assist with month-end accruals and reporting
* Support management goals and operations to create real long-term value
* Critique processes for better and more efficient way of doing things
* Promote and maintain continuous, positive communication with customers regarding correct billing procedures to minimize receivable discrepancies
* Collaborate with internal teams to resolve disputes, payments, and miscellaneous issues that arise
Who You Are (Basic Qualifications)
* High school diploma or GED
* Experience using Outlook, Word, and Excel
What Will Put You Ahead
* Degree in accounting or mathematics
* Experience in an Accounts Receivable or Accounts Payable role
* Experience in a Supply Chain or Logistics or Operations related role
* Experience managing Invoices
* Experience building relationships with customers
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
As a ...
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Type: Permanent Location: Green Bay, US-WI
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:50
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The HRS Scheduler will place outbound and take inbound calls from members to schedule a home visit for our providers.
The HRS Scheduler should be comfortable making 200+ outbound calls a day and working in an independent environment.
You will also work with insurance portals and verify eligibility of members before scheduling.
Candidates for this role must be either a current employee or contractor with The Cigna Group, Evernorth Health Services or one of their subsidiaries.
Ideal candidate will have a combination of:
* High School Diploma or equivalent
* 2+ years of inbound and/or outbound call center/customer service experience
* Scheduling experience highly preferred
* Ability to demonstrate positive customer service behaviors
* Ability to convey information to customers in a warm, clear, concise manner
* 1+ year direct sales experience, over the phone, preferred
* 1+ year of experience in health care related work, sales preferred
* Experience with insurance verification portals and electronic medical records, preferred
* Ability to type 50 WPM, preferred
* Ability to multi-task, prioritize, and manage time effectively
* Excellent verbal and written communication skills
* "Self-starter" attitude
* Bilingual (Spanish), preferred
Duties and Responsibilities:
* Place 200+ outbound calls to potential patients daily
* Take inbound calls daily from members returning the original call
* "Sell" the assessment to members, entice the member to agree to a free benefit provided by their insurance and secure the scheduled visit
* Communicate effectively with the department through email about provider's schedule status, leads to call, and any daily assignments
* Act as the primary point of contact with assigned providers; updating with scheduled patients.
* Develop a map to track location of potential patients and scheduled appointments.
Schedulers must use maps and the list of leads to decide where their provider will travel
* Access various insurance portals to verify members before outreach.
Learn about each insurance portal and find eligible members
* Respond to emails from providers, schedulers, and upper management in a timely manner
* Become familiar with the scheduling software and effectively schedule appointments for appointed providers, update patient demographics, and document calls made to members
* Meet departmental goals and achieve compliance targets
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 hourly rate of 17 - 24 USD / hourly, 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 y...
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Type: Permanent Location: Plano, US-TX
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:36
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The Cigna Group is a global Health Service company dedicated to helping people improve their health and vitality.
Our Pharmacy Benefit Management (PBM) team seek dedicated, compassionate, and empathetic Customer Service Representatives to join our team who are genuinely interested in helping people at some critical points of their lives.
The Call Center Customer Service Representative represents the company, and our people make all the difference in our success.
RESPONSIBILITIES
• Answer inbound calls from members, providers, and pharmacies with questions about Pharmacy Benefit Management (PBM) benefits and mail-order pharmacies.
• An average of 70-80 calls are expected daily.
• Take calls back-to-back while toggling through several applications on multiple screens.
• Attend 100% of trainings, and the first 90 days of employment.
• Resolve customer complaints through independent problem-solving skills and one-call resolution.
• Understand and strive to meet or exceed call center metrics while providing excellent consistent customer service.
QUALIFICATIONS
• High School diploma or equivalent
• 1 year of customer service experience is required
• A dedicated workspace with no distractions is required
• Intermediate proficiency in Microsoft Outlook
• Strong organization skills, written, and verbal communication skills
• Ability to remain calm and helpful even when dealing with difficult situations
• Foster teamwork and partnership with cross-functional departments to resolve issues and improve customer experience
• Computer literacy and ability to manage multiple applications simultaneously.
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 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 applicatio...
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Type: Permanent Location: Tampa, US-FL
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:35
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Under the general direction of the Supervisor, the Benefit Specialist will support Transplant Case Managers and Medical Directors with insurance knowledge and application as related to the delivery of the Case Management Product.
Additional responsibilities include but are not limited to completing benefit reviews for currently enrolled members and also for members looking to enroll into our Transplant Case Management Program.
As a Benefit Specialist, you will review eligibility; liability, primacy, claim payment direction and benefit coverage information.
Provide on-going follow-up through periodic case file review.
Responsibilities:
Review eligibility, liability, and coverage information on new cases and on regularly scheduled follow-up; provide communication of benefit plans for cases on an as-needed basis; periodically update this information
Review and direct claim payment for cases that have a treatment plan in place, and that are being managed by the coordinators.
Consult on cases moving into management regarding treatment plan funding based on case management philosophy.
Periodically review cases during management according to guidelines.
Research and analyze insurance, claim payment and nonpayment issues and problems.
Provide insurance training for new personnel and conduct insurance in-service programs as needed.
Adheres to quality assurance standards and all case management policies and procedures, especially those related to confidentiality
Adheres to productivity and workload management goals and accurately reports
Accurately and timely assessment of provider's contract to determine coverage and benefit availability
Communicates professionally with all internal and external customers, peers, matrix partners.
Qualifications:
High School diploma or GED required.
5+ years of progressive movement within group health insurance positions preferred.
2+ years of customer service experience required.
Excellent knowledge of group health benefit plans preferred.
Good analytical, evaluation, organizational and communication skills.
Ability to clearly communicate information to case managers using case management applications.
Working knowledge of medical terminology.
Ability to work independently and make independent decisions and ability to work unsupervised on special projects.
Ability to adapt to a high volume environment and work within a fast-paced dynamic environment.
Ability to function as part of a team.
Solid time management skills
Demonstrated ability to participate on/lead projects and workflow improvement initiatives.
Ability to act as change agent to support organization's objectives.
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 hourly rate of 23 - 34 USD / hourly, depending on relevant...
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Type: Permanent Location: Philadelphia, US-PA
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:35
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MUST live in MISSOURI within commute to 70 & N.
Hanley, St.
Louis, MO.
Must be able to work 11:30 am - 8 pm (Mon - Fri)
Do you want to Drive Growth and Improve Lives? Accredo, a division of The Cigna Group is looking for several Customer Service Representatives who will be responsible for handling a high volume of inbound calls assisting patients with their prescription medications.
How you'll make a difference:
* Manage all inbound/outbound patient, physician, and physician advocate communications in a professional manner and within program guidelines
* Accurately enter eligibility paperwork, prescriptions, refills, and/or other information into system
* Maintain accurate and complete documentation and system records of all inquiries to continuously improve the customer service experience and mitigate potential legal issues
* Enter and interpret program materials to determine enrollment criteria; explain to the caller or other employees the necessary requirements to be on the program
* Report to the proper group any allergy, adverse events, or duplicate therapy warnings that appear
* Place outbound phone calls for clarification on any issues involving program or pharmacy guidelines.
employees, answering questions, etc
What you'll need to succeed:
* High school degree or GED required.
* REQUIRED to work 11:30 am - 8 pm Mon - Fri) REQUIRED
* Ability to obtain and retain Missouri state Pharmacy Technician License per state guidelines required
* 1+ years of experience in the medical field preferred
* 6+ months of experience as a pharmacy technician or pharmacy knowledge preferred
* Proficiency with Microsoft office (Excel, Outlook & Word) and navigating various applications required
* Ability and willingness to work a flexible schedule to cover peak times (within operational hours: 7am-8pm) required
* Excellent written and verbal communication skills
* Ability to learn quickly, maintain accurate information, adapt in a fast -paced changing environment and make decisions with minimal supervision
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, ance...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:34
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Health Educator / Health Coach - Evernorth -
Our Custom Coaching program connects employees with a highly skilled wellness coach for face-to-face sessions.
Coaches take a holistic approach to help employees set and accomplish goals, manage chronic conditions and encourage healthy behaviors.
Our experienced Health Coach will:
• Provide onsite face-to-face customer coaching and support
• Identify customer health education needs through targeted health assessment activities.
• Collaborate with customers to establish health improvement plans, set personalized evidence-based goals, and support customers in achieving those goals.
• Empower customers to become an active participant in their own health outcomes.
• Assist Customer in overcoming barriers to better health
• Lead and support a variety of Health and wellness promotional activities, such as group coaching, wellness challenges and Health related seminars.
• May perform biometric screenings, including finger sticks, blood pressure, body composition, etc.
• Utilize biometric values and motivational interviewing techniques to collaborate with customer to drive to improve clinical outcomes.
• Provide support for health-related site events, which include open enrollment, wellness committee facilitation, flu shot events, health fairs, etc.
The Successful Coach Will Possess:
• Strong Clinical skills with at least 3 or more years of experience health coaching, health education and health promotion
• Bachelor's degree in a health-related field.
Master's degree preferred.
• Current ACLS/BLS/CPR/AED Certification
• High energy level, with dynamic presentation skills is required.
• Positive role model in demonstrating healthy behaviors
• Passion for health improvement
• Ability to work independently
• Customer-centric focus
• Ability to proactively collaborate professionally with the client and other matrix partners.
• Understand and own a variety of clinical targets and outcome measurements.
Develop action plans that drive clinical value for the customers and clients.
• Proven administrative abilities, with strong computer and software application skills.
Bonus points for :
• CHES (Certified Health Education Specialist)
• Registered Dietitian (preferred) licensed in respective state
• Motivational interviewing training/experience.
• Smoking cessation and diabetes 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.
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 ...
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Type: Permanent Location: Kingsport, US-TN
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:33
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Coding Education Specialist (AHIMA or AAPC certified) -
Philadelphia, PA or Nashville TN
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!
Our people make all the difference in our success.
What you must have in order to do the job:
* Remote, Work from Home - must be located in Philadelphia, PA or Nashville TN - required to work in the field/visit multiple provider offices each week
* Coding certification required (at least one of the below):
Certified Professional Coder (CPC)
Certified Risk Adjustment Coder (CRC)
Certified Coding Specialist for Providers (CCS-P)
Certified Coding Specialist for Hospitals (CCS-H)
Registered Health Information Technician (RHIT)
Registered Health Information Administrator (RHIA)
* OR - RN/LVN/LPN licensure (must obtain one of the above coding certifications within one year of hire)
* At least two years of hospital inpatient / outpatient or medical office coding experience, preferably two years risk adjustment coding experience.
* Extensive knowledge and adherence to ICD-10-CM/outpatient and CPT coding principles and guidelines.
* Excellent understanding of medical terminology, disease process and anatomy and physiology.
* Working knowledge of CPT/Evaluation and Management guidelines
* Working Knowledge of CMS Risk Adjustment and HCC Coding Process
* Strong computer skills (i.e.
MS Office)
* Prior audit/quality experience.
* Prior experiences teaching/training others on correct coding guidelines and/or have the ability to present to large groups of Physicians/Providers.
* Minimal travel may be required for this position and person needs to be available for day, evening and weekend training sessions and meetings.
Core Responsibilities:
* Develop relationships with clinical providers and staff
* Ability to communicate coding and documentation guidelines and education
* Conduct provider training on health plan coding initiatives guidelines and requirements of the Risk Adjustment program to ensure correct coding and documentation
* Customize presentations to educate providers and staff.
* Understands, develops, tracks, monitors and reports on key program performance metrics for coding initiative
* Conduct chart reviews for providers and review provider performance.T his is accomplished by doing virtual training sessions or traveling to the individual practices and performing side-by-side education.
* Work closely with internal representative for needs and support
* Evaluate documentation to ensure that diagnosis coding is supported and meets specificity requirement to support clinical indicators, HEDIS and STARS quality measures
* Query providers regarding missing, unclear or conflicting health record docume...
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Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:32
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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 throughout 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 requi...
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Type: Permanent Location: Orlando, US-FL
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:31
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Job Purpose
The Centene PMO team is a group of program management support professionals responsible for successfully managing and delivering strategic projects while driving client/customer focused problem resolution and influencing/leading process improvement.
As a Program Management Advisor on Centene PMO Team, you are responsible for end-to-end management of project delivery with strong emphasis on project management, process and product knowledge and internal and external communications.
This role is involved in all aspects of program management on a day-to-day basis including all client meetings and discussions, leading topics and guiding decision making with the client.
The role exists within a fast-paced and dynamic team of highly supportive program management and operations specialists and leaders whose focus is to collaborate and empower each other to deliver complex projects on time and support Centene without issue in order to best position our clients, their members and those who support them for success.
Essential Responsibilities
• Lead or co-lead implementation of new Centene Initiatives, including project plan management and status reporting, intent gathering, and overall client relationship management.
The role is client facing.
• Support Centene with day-to-day initiatives, escalations, issue resolution and program management, and development and maintenance of weekly program status reports.
• Work directly with clients, Account Team, Sales, Client Service Teams, Operations and Product partners to ensure delivery of client contractual requirements and to manage expectations driving overall client satisfaction.
• Communicate status and risk to appropriate client and Express Scripts leadership.
• Support team development and effectiveness by engaging with peers and leadership in knowledge sharing, training and special projects.
• Demonstrate Cigna values - including teamwork and enterprise mindset - to support a high-performance culture.
• Work with team leadership to identify opportunities for process improvement within the tools and the processes we use, including those coordinated with our internal partners.
Skills and Attributes for Success
• Critical thinker with project management experience and proven ability to lead and manage multiple projects simultaneously
• Demonstrated ability to coordinate resources cross-functionally to resolve complex issues and deliver results on behalf of our partners and clients
• Ability to work effectively in a dynamic team-based environment, learn quickly, solve problems and make decisions with minimal supervision
• Willingness to work a flexible schedule during high-volume periods to accommodate business requirements
• Strong organization and communication skills to meet timelines for initiatives involving multiple teams.
Qualifications
• High School Diploma required
• Bachelor's degree preferred
• 3 plus years of experience required
•...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:31
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Job Description for a Pharmacy Technician that has PTCB Certification.
Are you ready to step into a position that combines your communication skills, attention to detail, ability to multitask, and unrelenting drive to patients? We're looking for Pharmacy Techniciansto join our Pharmacy team.
If you've worked in Pharmacy Operations before, this role is different - you'll take your knowledge and expand it beyond your belief.Take a break from a retail environment, enjoy a set schedule, and come enjoy the satisfaction of helping others! Prepare prescriptions on a large scale while working closely with our team of Pharmacists.We're pretty sure you'll love this position.
This role is Worksite dependent and can only be performed onsite.
You must be fully vaccinated if you're to come onsite OR undergo testing twice a week.
How you'll make a difference:
* Be a superstar in the eyes of your team and the patient.Select and retrieve appropriate quantities of medication and prepare the labels that correspond.
* Use your expert problem-solving skills to help our patients be at their best every day.Work with a skilled team to ensure patients get the medication they need in a timely manner.
* Gain new knowledge with our systems and new relationships with your peers.You'll start with training, but you're not doing it alone.
You'll enjoy a supportive environment with your peers and other teams who want you to succeed.
Why join us?
* Health coverage effective day 1 (including medical, dental, vision)
* Holiday, PTO and OT pay
* 401K with company match
* Tuition reimbursement
* Fun, friendly and unique culture - bring your whole self to work every day!
* $1,600 sign-on bonus paid in three installments:
+ $300 at 30 days post hire
+ $300 at 90 days post hire
+ $1,000 at 1 year post hire
What you should have:
* High School Diploma / GED required.
* Valid Pharmacy technicianlicense/certification/registrationas required by state laws.
* Basic math skills and General PC knowledge including Microsoft Office, use of the internet and email
* Excellent verbal and written communication skills.
Let us tell you a little more.
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.
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...
....Read more...
Type: Permanent Location: Orlando, US-FL
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:30
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Summary
This position is best suited for an experienced SIEM engineer with a proven understanding of enterprise security.
The successful candidate will possess deep technical knowledge on a number of security technologies; have a solid understanding of information security and networking, and extensive experience interacting with customers.
The SIEM Engineer is responsible for delivery of client specific SIEM management solutions.
The SIEM Engineer serves as an escalation point for critical and complex client issues, performs configuration and testing of products, assists with developing and documenting work processes and trains other members of the team.The primary focus for this role is to act as a Subject Matter Expert for SIEM and CRIBL technology and be able to configure, manage, operate and administrate the platforms.
Essential Duties and Responsibilities
* Administration, CIM mapping and platform management of a Splunk / Splunk SaaS Platform
* Enrolling log sources, administration, content development and working with SIEM customers/stakeholders across the globe
* Build new capabilities and installation of new applications from the app exchange to extend functionality
* Monitor the impact of deploying new content to the health and performance of the SIEM
* Creation and improvement of security policies, processes and procedures and other SIEM related documentation
* Lead logging enrollments from multi-tier applications into the enterprise logging platforms
* Modify existing parsers, as well as implement and test custom parsers and log source extensions in order to capture and correlate events from non-standard log sources
* Evaluate deployment to identify flaws and key areas for improvement in effort to maintain an optimal SIEM operating environment
* Comprehend error logs and act as escalation point for underlying event collection and correlation components
* Experience with Linux or CentOS
* Understanding of regular expressions (Regex) and Python scripting
* Knowledge in the following areas is a plus: Perl and shell scripting, Docker, ELK, Hadoop
* Ability to isolate problems between hardware and software and provide information to appropriate development team(s)
* Highly developed, process-oriented skills for troubleshooting, problem solving, and problem resolution
* Superior written and verbal communication skills are a must
* Must be able to work in a fast-paced technical environment and sophisticated cyber-security products with frequent product releases and updates
Core Competencies Desired
* Expert level administrative and engineering experience with Splunk and Splunk SaaS
* 5+ years security engineering experience in mid-sized to large organizations, with emphasis on security operations, incident management, intrusion detection, firewall deployment and security event analysis.
* 3+ years with SIEM and UEBA technologies
* Inves...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:29
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eviCore is currently seeking a Communications Coordinator.
A communication coordinator has to identify root causes of notifications not sending out by looking at case data and comparing against our rules, and request the appropriate updates from the appropriate teams so they match the rules.
If those updates cannot be completed, the coordinator will use tools to manually send the notifications with as much automation as possible.
They will also intake requests for sending new notifications, often requiring deciphering the requestor's terminology and determining how to solve the request appropriately.
Although it can be fast-paced, it is important to solve the request correctly on the first attempt.
RESPONSIBILITIES:
* Runs daily missing letter reports, reviews the results, and sends the cases requiring letters to IT for generation.
* Reviews daily support requests and researches issues to determine the root cause (no rule match, ineligible member, missing plan code, etc.) and then recommends and/or makes corrections.
* Works directly with client services and the client service managers to remedy case data so letters can transmit timely.
* Reports unresolved formatting, system or logic issues as identified.
* Writes and sends required manual letters through the appropriate transmission methods.
QUALIFICATIONS:
* HS Diploma or GED required.
* A minimum of 12 months experience at eviCore.
* PeopleSoft configuration or support experience.
* Advanced Microsoft Office skills
* Strong written and verbal communication.
* SQL experience.
Run SQL queries.
* Understanding of complex data structures.
* Logical problem solving.
* IT savvy.
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 hourly rate of 17 - 23 USD / hourly, 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 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 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, pre...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:28
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The Account Manager is responsible for ensuring clients and patients receive superior service.
Key member of the core client account team is responsible for overall satisfaction and retention of assigned book of business.
Manages the day-to-day client relationship.
Accountable for core service delivery for clients working cross-functionally with all operational.
The Account Manager proactively reviews performance metrics to promote client satisfaction, profitability, and retention.
Utilizes technology, tools, processes and resources to anticipate and exceed client needs and expectations.
Collaborates with Account Directors on client activity, expectations, and service needs.
Essential Functions
Manages day to day client relationships through comprehensive knowledge of client's benefit plan and product offerings.
Daily interaction with clients, consultants and producers providing preventative consultation, analysis and issue resolution associated with core services.
Responsible for timely and accurate management and execution of all client benefit requests, including benefit changes, product upsells, new groups, terminations and escalated issues.
Accountable for new group and specific product implementations; including establishing and leading internal meetings to ensure collaboration and attention to detail throughout the process in order to meet expected timelines and quality standards.
Lead client centric team meetings to review operational performance against client's expectations and needs.
Presentation of operational performance metrics to clients on a monthly and/or quarterly basis to show specific performance measures in comparison with the book of business to promote client satisfaction, client retention and upsell opportunities.
Qualifications
Bachelor's degree in related field or 5 to 6 years of experience.
Excellent PC skills including Microsoft Office and Internet experience.
Excellent verbal and written communication and presentation skills.
Strong analytical and problem solving skills.
Strong focus on book of business client satisfaction and client retention results.
Demonstrated ability managing projects, utilizing proven project management processes.
Ability to work cross-functionally to proactively communicate and to resolve issues with the highest sense of urgency.
Ability to travel overnight up to 10%
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...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:27
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Job Summary
The Program Management Senior Advisor role will be responsible for the overall project management of key client initiatives.
The role involves analyzing discrepancies, resolving issues and ensuring accurate and timely adjustments to the pharmacy benefit claims.
This role will also work closely with internal partners and the client to resolve adjustments in a regulated market environment.
The role supports the delivery of a strategic projects by providing expertise, governance and overall project management.
Solves complex problems; takes a broad perspective to identify solutions.
May lead functional teams or projects.
Essential Responsibilities
• Excellent PC skills including Microsoft Office tools and Internet experience; excellent verbal and written communication and presentation skills; Strong analytical and problem-solving skills.
• Review adjustment data and assist with resolution of discrepancies
• Collaborate with client and internal partners to resolve issues related to adjustments, address and resolve disputes and inquires
• Prepare and submit reporting on adjustment activities and outcomes, requests and decisions
• Knowledge of Express Scripts proprietary systems, products and processes a plus.
• Engages all necessary ESI areas working cross functionally to ensure projects are effectively implemented to meet business need and minimize operational risk & disruption
• Conducts presentations when needed on project background, project status and current issues
• Proactively collaborates with other PM's when project deliverables overlap, or dependencies exist
• Documents, tracks and manages project risks, mitigation strategies and contingency plans
• Serves as a point of escalation for critical project issues requiring a high degree of expertise and/or discretion to ensure timely resolution
• Identifies common issues, constraints and risks across the project
• Effectively escalates project risks and areas requiring Senior Leadership intervention
Skills and Attributes for Success
• Critical thinker with project management experience and proven ability to lead and manage multiple projects simultaneously
• Demonstrated ability to coordinate resources cross-functionally to resolve complex issues and deliver results on behalf of our partners and clients
• Ability to work effectively in a dynamic team-based environment, learn quickly, solve problems and make decisions with minimal supervision
• Willingness to work a flexible schedule during high-volume periods to accommodate business requirements
• Strong organization and communication skills to meet timelines for initiatives involving multiple teams.
Qualifications
• High School Diploma required
• Bachelor's or Master's degree preferred
• 5 plus years Pharmacy Benefits Management/healthcare experience preferred
• Knowledge of and experience in Pharmacy Benefits Management and Healthcare industries preferred
• Pr...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:26
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Job Purpose
The Centene PMO team is a group of program management support professionals responsible for successfully managing and delivering strategic projects while driving client/customer focused problem resolution and influencing/leading process improvement.
As a Program Management Advisor on Centene PMO Team, you are responsible for end-to-end management of project delivery with strong emphasis on project management, process and product knowledge and internal and external communications.
This role is involved in all aspects of program management on a day-to-day basis including all client meetings and discussions, leading topics and guiding decision making with the client.
The role is tasked with achieving business results through consistent customer-centric service delivery, operational excellence, and effective partnership with cross-functional colleagues and external consultants, coalition partners and clients.
The role exists within a fast-paced and dynamic team of highly supportive program management and operations specialists and leaders whose focus is to collaborate and empower each other to deliver complex projects on time and support Centene without issue in order to best position our clients, their members and those who support them for success.
Essential Responsibilities
• Lead or co-lead implementation of new Centene Initiatives, including project plan management and status reporting, intent gathering, and overall client relationship management.
The role is client facing.
• Review of Benefit Master Grids to coordinate benefit updates across multiple teams for timely delivery
• Track Performance Guarantees around timely set up of benefits
• Support Centene with day-to-day initiatives, escalations, issue resolution and program management, and development and maintenance of weekly program status reports.
• Work directly with clients, Account Team, Sales, Client Service Teams, Operations and Product partners to ensure delivery of client contractual requirements and to manage expectations driving overall client satisfaction.
• Communicate status and risk to appropriate client and Express Scripts leadership.
• Support team development and effectiveness by engaging with peers and leadership in knowledge sharing, training and special projects.
• Demonstrate Cigna values - including teamwork and enterprise mindset - to support a high-performance culture.
• Work with team leadership to identify opportunities for process improvement within the tools and the processes we use, including those coordinated with our internal partners.
Skills and Attributes For Success
• Critical thinker with project management experience and proven ability to lead and manage multiple projects simultaneously
• Demonstrated ability to coordinate resources cross-functionally to resolve complex issues and deliver results on behalf of our partners and clients
• Ability to work effectively in a dynamic team-based environment,...
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Type: Permanent Location: Bloomington, US-MN
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:25
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Summary
The inQbator AI team has a mature ecosystem of solutions currently deployed to production that use state of the art natural language processing and machine learning techniques to bring tangible improvements to healthcare processes.
Our near-term focus is on building solutions to address problems within the domain of prior-authorization, and our long-term problem space is incredibly broad and open-ended.
As such, to identify the next generation of problems that we will tackle, we interact regularly with a diverse and highly matrixed group of stakeholders that includes teams from multiple divisions across the enterprise, as well as clinicians and hospital networks with whom we have partnerships and ultimately the patients we seek to help.
Responsibilities
* Work closely and interactively with our data science and product teams to build data pipelines which support the inQbator
* Migrate legacy data ETL pipelines to cloud-based data platforms (Databricks, Snowfake)
* Develop new data resources which can be used for ML/NLP or product innovation
* Collaborate with various data stakeholders to identify internal and external healthcare data resources which can be used by the inQbator
* Establish data engineering best practices for junior data engineers and data analysts
* Establish quality metrics which can be used for identifying value of inQbator projects
* Provide BI support for new inQbator innovations
* Keep current with industry advances in data engineering
* Solve problems that will have a positive impact on the health and well-being of many people
Qualifications
* 5+ years' of relevant experience building and managing sophisticated ETL pipelines
* High degree of proficiency with SQL
* Experience with cloud-based data platforms (Databricks, Azure)
* Familiar with git source control
* Experience with Python and Tableau is preferred
* Experience building and managing data model architecture is highly desirable
* Experience working with ML or NLP teams is highly desirable
* Experience with healthcare data (claims, EMR) and/or Healthcare Utilization Management is highly desirable
* Degree in Computer Science, Engineering, Information Systems, Math or related technical field highly desired; Master's degree preferred
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 121,400 - 202,400 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 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.
Star...
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Type: Permanent Location: Boston, US-MA
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:25
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Job Profile Summary
The Managing Director, Supply Chain Business Development is a dynamic role within Evernorth's Pharmacy Benefit Management (PBM) division that provides primary direction, leadership, and strategy around changes within Medicare prescription legislation within the supply chain organization.
This role will work with cross functional teams to enhance contracting strategy within the supply chain as well we help plans determine plan liability and appropriate management strategies to ensure an affordable and predictable benefit for Medicare beneficiaries.
Leads the PBM through changes to Medicare benefits to ensure competitiveness and appropriate investment in external and internal opportunities.
Develops, executes and enables strategic projects and integrates policy across several departments.
Possesses significant freedom to act in the medium term and contributes to strategic policy decisions and long-term margin growth.
Role & Responsibilities
* Represent Evernorth Business Development, serving as a subject-matter expert (SME) internally and externally, as needed, for large margin-driving projects, implementations and external contract negotiations.
* Collaborate with external business development contacts and other internal departments, such as all areas of Evernorth and broader PBS including Sales and Account Management, Legal, Product Accounting, Technology, Human Resources and Finance to facilitate cross-functional initiatives key to margin growth.
* Lead role in presenting internally and externally about Business Development and new Product Development initiatives and broader strategic projects, as well as broader healthcare market landscape dynamics within regulated market.
Presentations will be to the executive level both internally and externally.
* Manage tight deadlines for multiple competing priorities, scope, and converging opinions to solution in a timely manner.
Responsible for medium-large sized projects / implementations from original concept through system implementation and maintenance, as required.
* Strong financial acumen with the ability to seamlessly gather and analyze data and using data to develop insights, and drive to appropriate conclusions about the strategic and financial attractiveness of concepts/initiatives.
Qualifications & Experience
* Master's degree in finance with 8-10 years of experience
* Actuary experience within the Medicare and/or Medicaid market
* Experience with new product development a plus.
* Experience in directing or working with multi-disciplinary teams.
* Ability to work independently with minimal guidance.
* Proven track record for success in leading high-performing teams in a matrixed environment.
* Develop high performing team to meet margin annual margin goals.
This includes managing, motivating, and mentoring potential direct reports over time.
* Demonstrated thought leadership on challenging problems with...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:24
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Position Summary
The role is responsible for providing operational management of work requests to drive satisfactory results for the Centene internal team, leadership, and for Centene.
Role requires strong client account and PBM operational knowledge.
Position is accountable for assigned work with a focus on client satisfaction, quality, timeliness, performance guarantees and the effective use of cross-functional partnerships.
Position requires strong analytical skills to drive resolution of complex issues.
Role is empowered to identify and drive solutions and improvements for client and ESI processes.
Role will take on any special projects as assigned.
Position requires proactive approach to ensure workload remains at full capacity based on accomplished cross-training.
Role requires navigation across numerous operational areas within our organization.
Essential Responsibilities
* Manages assigned service and operational deliverables, including but not limited to: analysis, capture of client intent, cross-functional project management, management of complex and escalated assignments, and handling of member service and client operational initiatives.
Meets all defined service standards to ensure CST and client satisfaction.
* Independently determines direction for resolution of any service or escalated issue.
Appropriately escalates as needed.
* Participates on cross-functional teams to identify opportunities to address global client issues, presenting recommendations to leadership.
* Leads special projects as assigned.
Shares best practices and knowledge of the business with peers to improve service levels.
Assists with peer training and support.
* Participate in client discussions regarding issues/resolutions, and other initiatives.
* Provide clear and timely client facing updates.
* Lead meetings and work across numerous operational areas to bring complex issues to resolution.
* Manage work to performance guarantees.
Qualifications
* High School Diploma or GED required.
Bachelor's degree preferred.
* 3+ years of professional experience required.
* Experience in healthcare or PBM industry preferred.
* Excellent verbal and written communication and presentation skills.
* Strong leadership skills and the ability to effectively influence others.
* Strong focus on quality, effective communication, critical thinking, problem solving and customer service required.
* Demonstrated ability managing projects utilizing proven project management processes.
* Ability to work and build partnerships cross- functionally to proactively communicate and to resolve issues with the highest sense of urgency.
* Ability to handle analysis from issue identification to solution delivery.
* Demonstrated initiative with commitment and ability to work under pressure and meet tight deadlines.
* Client facing experience preferred.
* Proven experience using Microsoft Word, ...
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Type: Permanent Location: Bloomington, US-MN
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:23
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Description of the Business Unit:
Verity Solutions, a Cigna Company, is an award-winning leader in software and services developed for the pharmaceutical supply chain.
Our mission is to simplify the complex process of managing the pharmaceutical supply chain processes for healthcare systems in the US.
Our solutions span the breadth of the pharmaceutical supply chain.
We were pioneers in simplifying the complex process of maintaining 340B program compliance resulting in critical 340B cost savings for our customers.
We value fresh thinking, drive, transparency, and provide agile and proactive solutions to those who serve the most vulnerable in our communities.
At Verity Solutions, we foster a collaborative, casual, and technology-driven environment and want to evolve and grow with diverse people who are inspired by progress and delighted by partnering with others.
Job Summary:
The Senior Product Manager will play a crucial role in defining the product vision, strategy, roadmap and backlog for one or more products.
An ideal candidate would have successfully led a product from concept to launch and managed the product for continued success.
Working closely with cross-functional teams to grow existing products and bring new innovative products to market is an important part of this role.
The ideal candidate will have a strong passion for technology, an exceptional ability to understand and articulate the problem space, conceptualize frameworks and develop strategies.
Job Duties:
* Define and communicate a vision, strategy, roadmap and backlog for new and existing products.
* Deliver detailed product documentation with prioritized features and justification based upon business value, product strategy and roadmap.
* Communicate with customers (internal & external) to gain feedback on user product experiences and opportunities.
Ensure correct features are identified, considering customers, operations, sales, finance, related lines of business and others.
Prioritize and negotiate to build best possible set of features to be included and developed in the new products.
* Assist/develop/coordinate new idea reviews and recommendations, concept and design development, project management, and market introduction.
* Assist/develop product profiles, competitive analysis, presentations, demos, white papers, and product updates for organizational marketing materials.
* Able to synthesize relevant data to generate insights that inform understanding of problems, product performance, strategy and KPIs.
* Partner with Marketing to coordinate external messaging and expression of product/feature value propositions.
* Partner with Finance on estimating product demand, profitability and establishing pricing.
* Present to the Senior Leadership team as necessary
* Represent Verity Solutions at industry trade group meetings and presentations as requested.
* Support and promote the Verity Solutions values through p...
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Type: Permanent Location: Kirkland, US-WA
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:22
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The job profile for this position is Infrastructure Engineering Senior Advisor, which is a Band 4 Senior Contributor Career Track Role with Cigna-Evernorth Services, Inc.
Job Description:
* Provide F5 operations support;
* Plan and perform changes on F5 application switches;
* Run application check-out meetings for F5 change validations;
* Analyze F5 requirements for application migrations to new infrastructure;
* Manage changes through ServiceNow ITSM application;
* Remove old F5 configurations no longer required;
* Attend project meetings to report statuses, timelines, and any F5 issues;
* Participate in trouble-shooting application issues that may involve F5 configurations;
* Ensure F5 infrastructure can support the application migrations; and
* Manage multiple complex F5 configurations and deployments at once.
* Partial work from home benefit available.
Qualifications:
* Master's degree or foreign equivalent in Information Technology Management or a related field
* 3 years of experience as a Network Engineer, Network & Computer Systems Administrator, or a related occupationOR a Bachelor's degree or foreign equivalent in Information Technology Management or a related field and 5 years of experience as a Network Engineer, Network & Computer Systems Administrator, or a related occupation.
* Experience performing maintenance and system upgrades including patches, hot fixes and security configurations;
* Experience creating and renewing SSL certificates to ensure data is encrypted between client and server;
* Experience working with F5 VIP, Pool, SSL, or iRules software deployment methodologies;
* Experience creating application-specific monitors, configuring the most appropriate load balancing (LB) method, and determining when to use source network address translation;
* Experience collaborating with Information Protection and Vulnerability Management teams in reviewing Vulnerabilities published for Network Devices;
* Experience performing Vulnerability remediation as per SOP laid by Architecture Team;
* Experience working within established configuration and changing management policies to ensure awareness, approval and success of changes made to the infrastructure;
* Experience participating in on call rotation and assist with troubleshooting variety of Network related issues;
* Experience coaching and Cross-training other staff on new and existing technologies;
* Experience performing incident management and root cause analysis;
* Experience using: ServiceNow ITSM application;
* Experience using: HTTP, ClientSSL, ServerSSL, TCP, UDP, SyslogNG, SevOne, Spectrum, Splunk, tcpdump, and Qradar;
* Experience configuring, implementing and troubleshooting of F5 VIPRION based solution; and
* Experience working with F5's next generation chassis-based VELOS solution.
If you will be working at home occasionally or pe...
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Type: Permanent Location: Plano, US-TX
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:21
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Location: Remote Opportunity - Must live in Arizona, Florida, Indiana, Georgia, Pennsylvania, Texas, or Utah.
Summary: Are you passionate about assisting others and thrive in a dynamic virtual environment? Join our team at Accredo by Evernorth, a leading specialty pharmacy serving patients with complex health conditions.
As a Customer Service Associate Representative, you'll play a crucial role in delivering exceptional patient care and support while representing Accredo with professionalism and empathy.
Key Responsibilities:
* Assist patients and prescribers through inbound/outbound phone calls or web support.
* Handle various inquiries including scheduling medication orders, order status updates, explaining patient benefits, resolving account issues, and billing inquiries.
* Serve as a liaison between patients and internal expert teams.
* Participate in extensive paid training to ensure proficiency in Accredo/Cigna systems and procedures.
* Maintain high call volume productivity, handling an average of 30-50 calls daily.
* Adhere to scheduled work hours and meet performance metrics.
Role Summary: Our Customer Service Associate Representatives are integral to our mission of elevating patient care.
With a focus on empathy and attention to detail, you'll anticipate patient needs and provide solutions proactively.
This role requires a commitment to excellence in customer service and the ability to thrive in a fast-paced virtual environment.
Qualifications:
* High School Diploma or equivalent required.
* 1+ years of customer service experience.
* Proficient in Microsoft Office Suite and navigating multiple systems simultaneously.
* Ability to excel in a high-volume call center environment.
* Strong communication skills, both written and verbal.
* Organized with excellent time-management abilities.
* Customer-oriented with the capacity to adapt to various patient perspectives.
* Must be available to work within Contact Center hours: Monday through Friday, 8:00 am to 11:00 pm EST, and Saturday, 8:00 am - 5:00 pm EST.
* Reliable internet connectivity and a dedicated workspace free of distractions required.
* Must attend 100% of training within the first 90 days of employment.
Join Our Team: Embark on a rewarding career with Accredo by Evernorth, where your dedication to exceptional customer service will make a difference in the lives of patients.
We offer comprehensive training, career development opportunities, and a supportive virtual environment.
Apply now to be part of a team committed to transforming healthcare and improving patient outcomes.
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 p...
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Type: Permanent Location: Tampa, US-FL
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:20
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Pharmacy Technician
This role is Worksite dependent and can only be performed onsite.
Are you ready to step into a position that combines your organizational skills, ability to multitask, and unrelenting drive to help others? We're looking for certified pharmacy technicians to join our fast-paced, customer-focused pharmacy teams at EVERNORTH Care Group locations across the Phoenix Valley.
If you've always wanted to work in pharmacy operations and enjoy a friendly work environment...
well, we're pretty sure you'll love this position.
Work hours: Typically Monday-Friday 9 a.m.-5 p.m.
Before we move on, let us tell you a little more about us.
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, have the opportunity to train, grow, and develop a career you will be proud of.
What you'll do:
* Ensure day-to-day operations run like a well-oiled machine: Use your organizational skills to help manage pharmaceutical stock, ensure a safe and clean pharmacy by following policies and procedures, prepare reports, and maintain records of physician orders and prescriptions.
* Get hands-on: Calculate needed quantities; prepare labels; and organize and assemble medications for the lead pharmacist to dispense...and check, double check, and then check again for accuracy.
* Be a superstar in the eyes of providers and patients alike: Help answer questions and requests, both in person and by phone, and handle all the transaction-related steps of any purchases made.
This job is for you if you:
* Have PTCB Certification, or willing to obtain within 1 year of start date.
* Have excellent customer skills, and care deeply about providing empathetic, quality care to customers
* Have spent time in a retail environment
* Know your way around a computer
Bonus points for:
* 2+ years of retail pharmacy experience
* CPhT credential
* Bilingual (English/Spanish) skills
Why you should join our team:
* Benefits that start on day 1
+ 18 PTO days + 8 holidays off/year
+ Tuition reimbursement
+ 401K match
* Consistent 40 hour work week, Monday - Friday
* Voluntary overtime opportunities
* Real clinical focus on pharmacy skills
* Career progression opportunities
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.
J...
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Type: Permanent Location: Tempe, US-AZ
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:19
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Clinical Care Management - Operations Senior Advisor
The job profile for this position is Operations Senior Advisor, which is a Band 4 Senior Contributor Career Track Role.
Role Description:
This position reports into the Cigna Clinical Care Management organization.
Incumbent will be responsible for the department's management process, producing Operational Dashboards, and partnering with clinical leaders to improve processes to meet metric targets.
In addition, the incumbent will provide leadership visibility into the health of the department's project portfolio, along with highlighting and mitigating risks.
This role requires program management expertise, both to lead projects individually, as well as guide junior team members.
Projects often involve developing new clinical solutions to improve the affordability and quality of care.
The incumbent should have health care industry experience, although a clinical background is not needed.
The incumbent should be comfortable tackling ambiguous challenges, developing solutions from concept to implementation, and working effectively with matrixed partners.
Responsibilities:
* Strategic Planning:
+ Develop subject matter expertise related to aligned program(s) and understanding of internal/external landscape, strategy and business objectives
+ Gather, analyze and synthesize key insights/research (e.g., data, industry, market, key stakeholder, operational)
+ Provide counsel and advice to top management on strategy and multi-year roadmap development
+ Support the enterprise portfolio submission processes
* Management Process:
+ Utilize established program and project management methodologies and best practices for effective governance, meeting preparation and management, execution, and monitoring results
+ Establish, support and iterate on governance structure, meeting cadences, and communication strategy to align with and inform key stakeholders on assigned programs and initiatives
+ Manage intake and prioritization of actions to support program goals
+ Ensure that program-level success metrics/KPIs/scorecards are established and measured
+ Create, enhance and maintain playbooks and repeatable framework(s)
+ Ensure creation of and maintenance of sharepoint(s) /information management
* Execution:
+ Collaborate with enterprise partners in the design and development of new solutions, enhancements and process improvements; go-to person for the most complex program management assignments
+ Ensure appropriate actions are taken to effectively implement initiatives; may serve as project manager to lead initiatives and/or provide project management oversight and partnership as business/program lead
+ Effectively prepare for and facilitate various governance meetings, project status/communication meetings and work sessions.
+ Develop/utilize best prac...
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Type: Permanent Location: Morris Plains, US-NJ
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:19
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Responsible for Part C audit activities for the Cigna Compliance Department, with particular emphasis on Coding, Risk Adjustment and Coding Decisions.
Collaborates with Cigna Compliance colleagues and business partners to drive process improvements, monitor and audit ICD-10 codes submitted to Cigna by providers, identify codes that may be submitted inappropriately and where identified ensure effective corrective action.
S/he forges and maintains positive working relationships with business owners, management, regulators and compliance colleagues and demonstrates the ability to influence business partner and/or staff behavior at whatever level and to whatever extent is needed.
To be successful, this candidate must exhibit superior analytical, coding skills (including ICD-9 and ICD-10), strong knowledge of HCC's and risk scores, communication and collaborative skills, as well as the ability to excel in a dynamic, fast-paced environment.
The candidate must demonstrate solid command of risk adjustment.
This compliance team member must be adept at working with a variety of internal and external stakeholders.
S/he will promote an enterprise-wide culture of compliance and provide first-rate support within the Compliance Department and across the business units.
* Reports to the Part C Legal Compliance Manager;
•Monitors transactions and business processes associated with reconciling ICD-9/ICD-10 codes received from providers with the provider's medical records as well as establishing the appropriate use of codes received;
•Provides subject matter expertise in response to day-to-day business issues related to coding and risk adjustment;
•Manage a specific caseload of risk adjustment projects as assigned, from start to finish, in a timely manner;
•Monitor transactions related to the risk adjustment process and coding (ICD-9/ICD-10) either onsite, via webinar or by means of a desk review.
Monitoring risk adjustment transactions include, amongst others, validating universes, preparing and/or executing programs to monitor and monitoring targeted transactions by way of walk-throughs, conducting interviews, and performing tests/reviews;
•Stay abreast of industry changes and/or trends including but not limited to Federal Risk Adjustment cases;
•Researches guidelines to ensure Cigna coding best practices remain consistent with CMS RADV Coding Guidance and ICD-10 coding guidelines;
•Collaborates with all areas of compliance, the special investigations unit, and business owners to drive process improvements and ensure that corrective action plans are tailored and appropriate for the deficiencies identified; and
•Provide meaningful and appropriate reporting to support compliance audit.
Qualifications:
Bachelor's degree or equivalent.
5+ years of experience with Medicare Risk Adjustment-is required.
5+ years of experience working with Medicare Advantage, Medicare-Medicaid.
Plan (Dual-...
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Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:18
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INTRODUCTION:
Help us to change the status quo with your data analysis skills! The Network Data Analytics Senior Analyst is responsible for maintaining and analyzing the Provider and Network data as well as developing automation processes and tools for the Retail Compliance team in the Supply Chain Department.
SUMMARY:
Routinely complete large data analysis in Excel/SQL/R/Python to validate, update, analyze the pharmacy information, and regularly assist in improving and refining the analysis using various tools.
The Network Data Analytics Senior Analyst will assist in solving complex problems with cross-functional business partners to assist in ongoing workflow enhancements for various projects.
This position is expected to have a thorough understanding of business processes and to be able to work independently with minimal guidance once trained.
RESPONSIBILITIES:
* Responsible for accurate, timely maintenance of complex provider information and synchronization of data on all claims and provider databases including expertise on business requirements for multiple business regions.
* Participate in system testing and analysis in support of new functionality, new system processes, and business rules changes.
* Use analytical skills to identify opportunities for improvement.
* Develop automation tools to reduce manual efforts and increase working efficiency.
* Design and implement various algorithms and processes to support our data analysis initiatives in the Network Operation Department.
* Manage and maintain the provider and network information; ensure data integrity and data interoperability.
* Perform data analysis to provide insights about providers and network using analytical tools such as Excel, R or Python.
* Responsible for projects from original concept through system implementation & maintenance
* May provide guidance, coaching, and direction to more junior members of the team in Provider Validation.
IDEAL CANDIDATES WILL HAVE A COMBINATION OF THE FOLLOWING:
* Bachelor's degree or higher required in Data Analysis or related field, or equivalent work experience.
* Expert data analysis or programming skills with all MS Office applications, SQL, R or Python.
* Excellent quantitative skills and ability to perform complex data analysis and advanced problem solving.
* Demonstrated experience in challenging problems and driving outstanding results
* Knowledge of PBM business model
* Analytical, highly organized, able to work and lead projects with little supervision, motivated to successfully meet deadlines.
* Strong verbal/written communication skills to work with various matrix partners, including but not limited to Supply Chain, Compliance, Legal and IT.
* Capability to prepare and present concepts and proposals to all levels of management.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-09-20 09:09:17
