Medicare Issue Management Senior Advisor - Cigna Healthcare - Remote

The Medicare Issue Manager is responsible for leading and managing cross-functional issue resolution through the issue management process for all operational related matters including those with compliance implications.

This role is expected to understand the needs of various business functions, coordinate highly matrixed challenges, and influence solutions.

This individual must be an accomplished communicator leading cross-functional meetings which drive root cause identification and timely remediation that includes management controls to limit recurrence.

Provide strategic partnership in analytics, to identify and prioritize opportunities for improvement, and to support decision making and execution based on data and analytical findings across the segment.

ESSENTIAL DUTIES AND RESPONSIBILITIES


* Own the end-to-end cross-functional issue management and resolution process and be accountable for timely issue remediation and/or challenge and risk escalations to Senior Leadership.


* Collaborate with upstream and downstream business partners to identify the key stakeholders within the process necessary to drive remediation.


* Collaborate with cross-functional business partners to identify the problem, outline the root cause, and develop plans for action to eliminate and remediate issue.


* Coordinate high priority P2 communications regarding issues among cross-functional teams ensuring that all communications are consistent with content and distributions.


* Utilize system platform to manage issues and accurately capture/categorize all necessary trend information.


* Review submitted data for quality and accuracy.


* Champion and implement process improvements to improve turn-around time on issue identification and resolution.


* Assist in training, documentation, and other duties required to sustain and improve process performance.


* Facilitate escalated and complex issues.


* Ensure all necessary parties are informed of issue status.


* Develop collaborative partnerships with business operations and leadership, providing value-added perspective, insights, guidance, and tools.


* Apply an agile approach to all engagements, constantly assessing and refining efforts as new information and/or requirements come to light.


* Support weekend coverage for Managed Incidents on rotating basis.

QUALIFICATIONS, EDUCATION and/or EXPERIENCE


* Is certified in and/or has at least 5 years of experience with concepts and tools associated with Incident Management, Project Management, Change Management, and Process Engineering/ Process Improvement /Lean Six Sigma


* High School Diploma required, higher level education preferred


* 5+ years of experience in Medicare/Medicaid experience strongly preferred, including a strong comprehension of basic regulatory requirements.


* Strongly prefer a candidate with experience with FACETS and/or Symplr


* Strongly prefer a candidate with experience...