-
The Account Management Senior Associate will provide support to the Account team of their assigned Clients/Coalition(s).
The Senior Associate will provide analytics, standard and non-standard reporting, and project support as requested.
The primary focus for the position is executing on client-specific operational and administrative deliverables.
To function effectively in the model, the Senior Associate must collaborate with the Account Manager, Account Executive, and Clinical Account Executive to successfully service the entire Book of Business.
The primary measure of the Senior Associate's performance is by way of both the Account Team and client satisfaction.
ESSENTIAL FUNCTIONS
* Manages day-to-day client reporting/administrative requests submitted by the account team.
* Maintains ownership for assigned service/operational deliverables and ensures operational excellence and set-up quality.
* Assist with both standard and non-standard reporting/analytics as needed.
* Handle Billing and Rebates research.
* Work on Ad-hoc Projects as needed.
* Ensures that a shared global email box stays organized and work is accurate and timely
* Serve as a voice of the client within Express Scripts to drive continuous service improvement and accountability with enterprise partners
* Coordinates deliverables with internal operational departments to ensure client satisfaction and retention
* Attend client support meetings as needed
* Can sometimes assist the Account Management team by providing client facing support.
QUALIFICATIONS
* Bachelor's degree in related field or 2+ years relevant experience
* Ability to adapt in a dynamic work environment, learn quickly, solve problems, and make decisions with minimal supervision.
* Strong Microsoft Excel skills preferred
* Excellent verbal, written communication and presentation skills.
* Strong analytical and problem-solving skills.
* Responsiveness, relationship building and Accountability
* 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.
* Knowledge of the healthcare and PBM industry preferred.
ABOUT THE DEPARTMENT
As a member of the Sales and Account Management team in the Commercial Division, you will be providing service to both the account team and clients.
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 62,700 - 104,500 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...
....Read more...
Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:17
-
EXPECTATIONS: This role partners with the sales team and requires travel to client offices based on location.
This role is aligned to South Texas.
GENERAL PURPOSE:
* Cigna's mission is to improve the health, well-being and sense of security for those we serve.
The Clinical Sales and Network Organization, as Champions for affordable, predictable and simple health care, is dedicated to achievement of our Enterprise goals improving affordability and customer health outcomes, client growth and retention, and network performance.
OVERVIEW:
* The Nurse Executive Sales Specialist, trusted Clinical Leader, Educator and Advocate, is closely aligned with Clients, Brokers, and other Key Stakeholders to promote improved healthcare quality and affordability for clients, members and communities we serve.
This role executes on strategic priorities to meet enterprise targets related to Cigna Healthcare U.S.
Sales Growth, Persistency and Total Medical Cost.
RESPONSIBILITIES:
* Stays current with healthcare industry trends and maintains a working knowledge of Cigna business segment strategies, clinical programs, services and operational processes necessary to educate and provide consultative clinical insights to Sales, Clients, Brokers and other key stakeholders.
* Fosters deep collaborative relationships with Sales, Sales Operations, Clients and Brokers, championing Cigna's differentiated clinical value proposition.
* Supports achievement of business growth targets including prospective review, request for proposal, finalist meeting and new client onboarding.
* Supports achievement of business persistence targets including medical cost driver analysis and action, complex case review, referral and engagement, account renewal consultation and recommendations to positively impact medical cost trend, healthcare quality and outcomes.
* Collaborates and aligns across business units, working closely with sales, clinical product and program teams, marketing, data and analytics, clinical operations, health engagement, Evernorth Workplace Care and others, to design and deliver innovative client and market specific solutions.
* Participates in cross-functional projects at the local or national level, implementing actions that improve organizational or enterprise effectiveness and affordability.
* In conjunction with Sales, Health Engagement and others, facilitates Client and/or Broker external engagements (health forums, community and worksite events, educational presentations, corporate tours, other) promoting Cigna's integrated value proposition.
* Responds to and facilitates resolution to escalated case inquiries, benefit and coverage explanations and non-standard client benefit requests.
* Ideal candidate must reside in the state of Texas, preferably Austin or Houston area.
QUALIFICATIONS:
* Active and unrestricted nursing license in Texas
* Bachelor's degree is required.
* Advanced Degree is p...
....Read more...
Type: Permanent Location: Houston, US-TX
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:17
-
Home Infusion Registered Nurse - Accredo Specialty Pharmacy
Take your nursing skills to the next level by helping to improve lives with Accredo Specialty Pharmacy, a division of Evernorth Health Services.
We are looking for dedicated registered nurses like you to administer intravenous medications to patients in their homes.
As a Home Infusion Registered Nurse at Accredo, you'll travel to patients' homes to provide critical infusion medications.
However, this job is about more than just administering meds; it's about building relationships with patients and seeing the positive impact of your care.
You'll work independently, making decisions that lead to the best outcomes for your patients.
You'll drive growth in your career by challenging yourself to use your nursing skills, confidence, and positive attitude to handle even the toughest situations, with the support from your team.
For more than 30 years, Accredo 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 the lives of others.
How you'll make a difference and improve lives:
* Empower Patients:Focus on the overall well-being of your patients.
Work with pharmacists and therapeutic resource centers to ensure that patients' needs are met and to help them achieve their best health.
* Administer Medications:Take full responsibility for administering IV infusion medications in patients' homes.
* Provide follow-up care and manage responses to ensure their well-being.
* Stay Connected:Be the main point of contact for updates on patient status.
Document all interactions, including assessments, treatments, and progress, to keep track of their journey.
Requirements:
* Active RN license in the state where you'll be working and living
* 2+ years of RN experience
* 1+ year of experience in critical care, acute care, or home healthcare
* Strong skills in IV insertion
* Valid driver's license
* Willingness to travel to patients' homes within a large geographic region
* Ability to work 40 hours a week (can include days, evenings, and weekends, per business need)
* Flexibility to work different shifts on short notice and be available for on-call visits 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...
....Read more...
Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:15
-
New Production Site opening in Mendota Heights, MN!
As a Maintenance Supervisor , you will manage and assist in the completion of the day-to-day activities, involving the maintenance of the building/facility, equipment and machinery including HVAC, building lighting systems, CNC machines, ovens, grounds keeping, security and overall facility appearance.
You will be responsible for Supervising and coordinating the work of employees who repair and maintain building/facility, equipment and machinery.
What will you do?
* Manage, supervise and execute maintenance as well as support activities.
* Assist with site environmental conformance as well as hazardous material programs.
* Maintain adequate inventories of tools, supplies and parts to accurately repair all equipment.
* Maintain systems to supervise service requests promptly complying with safety requirements.
* Conduct preventive maintenance work.
* Maintain cleanliness at shop and storage areas as well as well-stocked and organized.
* Inspect regularly machinery with respect to safety issues inclusive but not restricted to ground and trip hazards, non-functioning lights, broken pieces along with exposed wiring.
* Conduct proper follow-through on all maintenance issues.
* Address maintenance issues in timely way working with maintenance staff.
* Plan maintenance employees' schedules as per forecasted workloads.
* Perform with maintenance employees along with other technical personnel to develop proactive and effective team working together to attain set objectives.
* Ensure compliance to company safety and security standards, procedures and policies.
* Ensure maintenance personnel wears and utilizes all safety equipment correctly as needed.
* Conduct safety inspections as scheduled and complete accurately as required.
* Establish priorities, goals and expectations to prepare action strategies and plans to accomplish same working with team.
* Utilizes LEAN management within your business unit
* Responsible for 5/6S within your area / business unit
* Be able to operate and succeed in a metrics driven environment
* Positive attitude towards employees and peers to aid in forging a metric driven culture
* Attends and participates in training opportunities and seminars relevant to this position.
* Acquire additional certifications and credentials as required for work or career development
What can you bring to the table?
* Bachelor's or equivalent combination of education in a comparable field.
* 5+ years of Maintenance experience
* 5+ years of Supervisory experience.
* Certified in OSHA programs and practices, AB programmer/Maintainer Certification
* PC Skills, ability to multi-task and prioritize
* Demonstrates mechanical and electrical knowledge and repair abilities
* PLC-Allen Bradley-PCN network(s)
* Strong electrical/mechanical background
* Ex...
....Read more...
Type: Permanent Location: Bloomington, US-MN
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:13
-
Evernorth Workplace Careoffers health care delivery services along with population health and health coaching solutions, conducted in person.Our mission is to deliver proactive, personalized, and holistic patient care and coaching by acting on health data and insights to improve the overall health and wellness of our clients' employees, and those they care about most, by providing access to high quality, affordable services where they work and live.
Our Evernorth Workplace Care solution isn't a one-size-fits-all model.
Using data-driven insights, we'll customize a solution that addresses your organization's most pressing needs-creating a more affordable, predictable, and simple health care experience.
Evernorth Workplace Care - Personalized Care Where You Are
Summary
The Clinical Program Advisor will be a critical team member in transforming Evernorth Workplace Care (EWC) into an innovative health care provider promoting quality care and accessible services in an efficient and customer centric manner.
Reporting directly to the Director of Population Health and working in collaboration with the Medical, Operations and Shared Services Leaders to establish ongoing assessment, analysis, metric development and organizational structure to ensure the effective implementation of clinical practice to support organizational long-term and short-term strategic objectives, cost-effective care and services, and optimal quality patient outcomes.
The successful candidate will be responsible and accountable for collaborating with the Director of Population Health to develop the design of patient care delivery; manage training and development of initiatives that advance clinical and leadership competencies; building strong relationships and collaboration among staff and colleagues; and development and implementation of on-going programs to strengthen the skill sets, diversity, and sense of community relationships across EWC.
The Clinical Program Advisor informs and trains staff to function consistently within licensed and / or certified scopes of practice and regulatory requirements.
Responsibilities and Essential Functions
Clinical Program Development, Support & Education
* Creates training and educational curriculum to establish and maintain standards of practice to drive positive patient engagement and improve health outcomes through a multidisciplinary innovative approach in the delivery of care and services.
* Assess educational needs cross clinical and administrative roles to inform curriculum development and career-stage learning opportunities
* Facilitate onboarding and orientation for new staff, ensuring alignment with organizational values and clinical expectations
* Curate and maintain instructional materials across various platforms, including EWC web pages
* Evaluate the effectiveness of educational programs using defined metrics and feedback loops
* In a coordinated approach with clinical leadership, develops ...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:12
-
Darkroom Attendant - Titanium Aerospace Parts Production - Weekend Day Shift
If you would love to be part of a company that is poised for substantial growth with opportunities for advancement, then working for CPP and its subsidiaries may be the right fit for you! We have multiple facilities in Albany, OR and are a world class supplier of titanium castings for the aerospace industry.
If you are selected to join our team you will enjoy benefits such as quarterly bonus, medical, dental, vision, 401(k), company paid life insurance, and other great benefits!
Primary Purpose:
Darkroom attendants will process radiographs, order film supplies, perform testing, and provide assistance to X-ray Shooters and Readers.
Duties and Responsibilities:
* Properly handle unexposed X-ray film.
* Load X-ray film into cassettes for radiographers.
* Process exposed X-ray film for viewing by readers.
* Monitor automatic film processing equipment.
* Sort and file processed X-ray film by control number.
* Maintain a proper film inventory.
* Cut and tape day pack film for special shots.
* Clean and repair screens in film cassettes to maintain film quality.
Minimum Qualifications and Experience:
* Able to understand, comprehend, and follow all verbal and written instructions.
* Individual must be organized and efficient with tasks and duties.
* Requires attention to detail and ability to work as a team member.
* Prior experience in file processing is beneficial.
* Ability to file data in alpha/numerical order.
* Compliance with general company attendance standard is required.
* Must be able to withstand long periods of standing and walking.
* HS diploma or equivalent GED required, but candidates not meeting this requirement who possesses relevant experience will be considered.
* Must be at least 18 years of age.
* Solid job history including more than 1 year at previous or recent employer.
* Must be willing to undergo a pre-employment background check.
* Must be willing to participate in pre-employment and periodic drug screening.
Working Conditions:
* Position requires individual to work in a Darkroom for extended periods of time.
* Exposure to dust, dirt, and fumes.
Work is typically performed under reasonably good working conditions; while exposure to any or all of the mentioned elements may occur, such exposure is generally not present to the extent of being disagreeable.
Schedule:
* Weekend day shift (Fri/Sat/Sun 3x12) $1.25/hour shift differential
Consolidated Precision Products (CPP) is an industry-leading manufacturer of highly-engineered
components and sub-assemblies, supplying the commercial aerospace, military and industrial markets with small-to-large "function critical" products.
CPP provides its customers with a "total solution" source, taking them from concept to finished product with one of the broadest and most diverse product offering...
....Read more...
Type: Permanent Location: Albany, US-OR
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:12
-
Job Summary
The Information Protection Senior Advisor is responsible for designing, implementing, and maintaining robust security protocols across SAP and other IT systems to ensure compliance with internal policies and external regulations.
This role requires deep expertise in SAP security, GRC, and cloud-based solutions, along with strong analytical and communication skills to collaborate effectively with cross-functional teams.
The advisor will play a key role in safeguarding enterprise applications, managing access controls, and supporting audit and compliance efforts.
Key Responsibilities
* Research, analyze, and implement end-user and IT security solutions within SAP and broader IT landscape.
* Collaborate with business and IT teams to gather requirements for roles, interfaces, batch jobs, and troubleshoot security requests.
* Apply IT security and compliance policies to ensure adherence to established standards.
* Manage integrations with Active Directory, SSO, and other identity/access management tools.
* Provide security support for key applications including BTP, SAC, IBP, S4 HANA, HANA DB, and other cloud platforms.
* Develop custom security solutions to meet business needs using approved tools and utilities.
* Secure custom transactions, tables, and programs; promote security development standards and procedures.
* Periodically review and revise application security roles to align with business changes and audit requirements.
* Design and implement user administration solutions for new applications and transition processes to appropriate teams.
* Maintain GRC Segregation of Duties (SoD) and provide analytical support for SoD conflicts.
* Monitor SOX compliance related to security and access management.
* Review SAP security notes for risk assessment and coordinate implementation with Basis and functional teams.
* Support internal, external, and SOX audits; collaborate with compliance teams.
* Participate in SAP security patch reviews and provide on-call support as part of a team rotation.
Qualifications
* Bachelor's degree in Information Technology, Computer Science, or related field.
* Minimum of 10+ of professional experience, including 6+ years in SAP security.
* Experience with at least 1-2 SAP implementations.
* 2+ years of hands-on experience with SAP GRC 12.
* Proficiency in SAP applications including GRC 12, S4 HANA, Solution Manager, BI, ECC, and Fiori.
* Strong understanding of SSO integrations, Active Directory, and OKTA identity/security management.
* Excellent analytical, organizational, and problem-solving skills.
* Strong interpersonal and communication skills with the ability to manage cross-functional relationships.
* Experience in object-oriented design and implementation.
* Ability to work independently, manage multiple priorities, and meet deadlines in a dynamic environment.
* Willingnes...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:11
-
This position serves as an integral member of the Provider Contracting Team and reports to the AVP of Contracting.
This role assists in developing the strategic direction and managing day-to-day contracting and network management activities for a specific territory within New Jersey.
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 and 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 the 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's degree; preferably in the areas of Finance, Economics, Healthcare, or Business-related.
Significant industry experience will be considered in lieu of a Bachelor's degree.
MBA or MHA preferred.
* 3+ years of contracting and negotiating experience involvi...
....Read more...
Type: Permanent Location: Morristown, US-NJ
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:11
-
CMM Operator - Titanium Aerospace Parts Production - Day Shift
If you would love to be part of a company that is poised for substantial growth with opportunities for advancement then working for CPP and it's subsidiaries may be the right fit for you! We have multiple facilities in Albany, OR and are a world class supplier of titanium castings and components for the aerospace industry.
If you are selected to join our team you will enjoy benefits such as quarterly bonus, medical, dental, vision, 401(k), company paid life insurance, and other great benefits!
Primary Purpose:
A CMM Operator will inspect machined and un-machined castings, wax patterns, and fixtures using manual CMM and Automated CMM devices.
Essential Duties and Responsibilities:
* Inspect machined and un-machined castings, wax patterns and fixtures using Manual CMM and Automated CMM.
* Use of hand-held MTE will also be required (calipers, micrometers, bore gages, etc.).
* Complete detailed inspection reports, as well as review/interrogate the dimensional data generated by the CMM inspection.
* Communicate closely with engineering.
Minimum Qualifications and Experience:
* Self-motivated individual with good math skills.
* Able to perform inspections on raw and machined castings and first articles.
* Able to read blueprints and interpret customer specifications.
* Able to use Microsoft programs, i.e.
Excel, Word, Outlook, Visio, etc.; CAD experience helpful.
* Able to read and follow both verbal and written instructions, as well as excellent communication skills both written and oral.
* Capable of performing precise setups on machine.
* Possess a positive attitude and attention to detail.
* Able to push/pull/lift up to 50 lbs with or without reasonable accommodations.
* Must be at least 18 years of age.
* HS diploma or equivalent GED required, but candidates not meeting this requirement who possesses relevant experience will be considered.
* Solid job history including more than 1 year at previous or recent employer.
* Must be willing to undergo a pre-employment background check.
Preferred:
* 2 recent years of dimensional experience working on aerospace castings as well as on-the-job experience as a layout inspector, including ability to use inspection equipment including calipers, micrometers, bore gauges and height gages.
* Experience operating manual CMM, automated CMM or CNC machining center.
* Experience with OpenDmis and Calypso.
* CMM and CNC programming.
* CAD experience.
Working Conditions:
* Frequently working near moving mechanical parts.
Schedule:
* Day shift - Monday-Thursday (4x10)
Consolidated Precision Products (CPP) is an industry-leading manufacturer of highly-engineered
components and sub-assemblies, supplying the commercial aerospace, military and industrial markets with small-to-large "function critical" products.
CPP provides its customers ...
....Read more...
Type: Permanent Location: Albany, US-OR
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:10
-
Take your nursing skills to the next level by helping to improve lives with Accredo, the specialty pharmacy division of Evernorth Health Services.
We are looking for dedicated registered nurses like you to administer intravenous medications to patients in their homes.
As a Home Infusion Registered Nurse at Accredo, you'll travel to patients' homes to provide critical infusion medications.
However, this job is about more than just administering meds; it's about building relationships with patients and seeing the positive impact of your care.
You'll work independently, making decisions that lead to the best outcomes for your patients.
You'll drive growth in your career by challenging yourself to use your nursing skills, confidence, and positive attitude to handle even the toughest situations, with the support from your team.
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 the lives of others.
How you'll make a difference and improve lives:
* Empower Patients:Focus on the overall well-being of your patients.
Work with pharmacists and therapeutic resource centers to ensure that patients' needs are met and to help them achieve their best health.
* Administer Medications:Take full responsibility for administering IV infusion medications in patients' homes.
* Provide follow-up care and manage responses to ensure their well-being.
* Stay Connected:Be the main point of contact for updates on patient status.
Document all interactions, including assessments, treatments, and progress, to keep track of their journey.
Requirements:
* Active RN license in the state where you'll be working and living
* 2+ years of RN experience
* 1+ year of experience in critical care, acute care, or home healthcare
* Strong skills in IV insertion
* Valid driver's license
* Willingness to travel to patients' homes within a large geographic region
* Ability to work 40 hours a week (can include days, evenings, and weekends, per business need)
* Flexibility to work different shifts on short notice and be available for on-call visits 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.
For this position, we anticipate offering an annual salary of 76,900 - 128,100 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.
Starting on...
....Read more...
Type: Permanent Location: Albany, US-NY
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:09
-
The Dental Consultant (DC) is responsible for reviewing dental claims and predetermination treatment plans involving dental services to determine reasonableness of treatment as it relates to plan contract provisions, dental plan benefits and claims administration policies, and dental standards of practice.
* The Consultant may review radiographic images, chart notes, narratives, periodontal charting, and other diagnostic tools to determine if there is sufficient clinical documentation to warrant treatment.
* The consultant will be responsible to review appeal requests.
* The consultant will help to identify trends, educational needs and corrective actions related to the structure and delivery of care by health care professionals.
* The consultant is responsible to provide timely responses, and effectively communicate clinical opinion of reviews.
* The consultant must be able to work directly with Dental Claim Review staff, Medical Directors, Dental Directors, Client Service, and Health Care Professionals.
Hours: M-F 8am-5pm local time
Qualifications:
* Must maintain an active dental license (DDS or DMD) to practice dentistry in the state of residence, CA preferred.
* The individual must have experience in private practice outside of academia for minimum of five (5) years.
* Experience with professional claim (utilization) review is strongly preferred.
Knowledge of the community standards of oral health care delivery and dental care benefit administration is essential.
* Requires a thorough knowledge of oral health care and experience in the practice of Dentistry.
* Command of dental terminology, clinical procedures, and benefit language.
Excellent oral and written communication skills are required.
* Skilled in the use of Microsoft Word, Excel, PowerPoint, and Outlook.
* Capable of quickly learning and mastering the intricacies of a variety of IT systems.
* Excellent analytical, quantitative, and problem solving skills.
* Works well independently and as a contributing member of a team.
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 79,700 - 132,800 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 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,...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:08
-
Summary
The Drugfile Analyst plays a crucial role in the healthcare industries, focusing on the collection, management, analysis, and interpretation of drug-related data.
The primary objective of a Drugfile Analyst is to ensure the accuracy, integrity, and utility of drug data to support pharmacy claims processing, drug dispensing, regulatory compliance, patient safety, and evidence-based decision-making.
Responsibilities
* Data Collection and Management: Collect drug data from various sources including data vendors and internal sources.
Maintain, update, and validate databases to ensure completeness and accuracy
* Data Cleaning and Quality Assurance: Identify inconsistencies, missing values, and errors in datasets.
Apply standard operating procedures and quality checks to ensure high data quality
* Data Analysis and Interpretation: Analyze the data, evaluate, make updates to the database as required on a daily basis
* Reporting and Documentation: Review comprehensive reports, and summaries.
Make necessary updates to drug and drug pricing data upon review
* Cross-functional Collaboration: Work closely with pharmacy personel, internal drugfile analyst, IT specialists, and quality assurance personnel to coordinate data flow and resolve discrepancies
* Risk Assessment and Signal Detection: Identify trends or patterns that may indicate potential financial concerns
* Database and System Maintenance: Oversee the integrity and security of drugfile databases.
Manage user access, conduct periodic system audits, and implement updates or migrations as needed
* Training and Support: Provide guidance and training to staff regarding data entry protocols, system use, and best practices in drug data management
Qualifications
* 2+ years' of experience in working with pharmacy and/or drug related data management
* Familairy with industry standard pharmacy pricing and drug data
* Analytical Thinking: Ability to scrutinize large datasets, draw meaningful conclusions, and present findings in a clear, concise manner
* Attention to Detail: Strong focus on data accuracy, documentation, and regulatory compliance
* Communication: Effective written and verbal communication skills to interact with various teams
* Problem-Solving: Capability to identify issues, propose solutions, and implement corrective actions efficiently
* Time Management: Skill in managing multiple updates, meeting deadlines, and prioritizing tasks in a fast-paced environment
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 100,100 - 166,900 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate i...
....Read more...
Type: Permanent Location: Morris Plains, US-NJ
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:07
-
Role Summary
Develops and implements sales strategies for targeted key accounts in a plan, a territory, or a specified geographic area.
Very knowledgeable of complete line of products/services and clients' issues and needs.
Primarily focuses on seeking out new clients.
Typically has at least three years of related sales experience.
Responsibilities
* Obtain new accounts through direct or brokerage channels for sales.
* Meet or exceed annual business plan as measured by new firms, revenue, membership and profitability objectives.
* Maintain prescribed weekly activity levels.
* Manage the sales process for Medical, Dental, Pharmacy, Behavioral products.
* Review and respond to RFP's, manage internal strategy and present quotations.
* Manage database of prospects and assigned producers.
Qualifications
* 5+ years sales experience strongly preferred
* Prior Insurance experience in Underwriting, Operations or Proven sales track record
* 1-2+ years' experience in managed care sales
* Highly motivated with excellent organizational skills
* Self-starter with ability to work independently or as a team to achieve goals and objectives
* Excellent presentation skills, verbal and written communication skills
* Ability to work strategically with matrix partners to design presale strategies and proposals
* Ability to obtain necessary licenses
* Acceptable driving record
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, nat...
....Read more...
Type: Permanent Location: Baltimore, US-MD
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:06
-
Home Infusion Registered Nurse - Accredo Specialty Pharmacy
Take your nursing skills to the next level by helping to improve lives with Accredo Specialty Pharmacy, a division of Evernorth Health Services.
We are looking for dedicated registered nurses like you to administer intravenous medications to patients in their homes.
As a Home Infusion Registered Nurse at Accredo, you'll travel to patients' homes to provide critical infusion medications.
However, this job is about more than just administering meds; it's about building relationships with patients and seeing the positive impact of your care.
You'll work independently, making decisions that lead to the best outcomes for your patients.
You'll drive growth in your career by challenging yourself to use your nursing skills, confidence, and positive attitude to handle even the toughest situations, with the support from your team.
For more than 30 years, Accredo 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 the lives of others.
How you'll make a difference and improve lives:
* Empower Patients:Focus on the overall well-being of your patients.
Work with pharmacists and therapeutic resource centers to ensure that patients' needs are met and to help them achieve their best health.
* Administer Medications:Take full responsibility for administering IV infusion medications in patients' homes.
* Provide follow-up care and manage responses to ensure their well-being.
* Stay Connected:Be the main point of contact for updates on patient status.
Document all interactions, including assessments, treatments, and progress, to keep track of their journey.
Requirements:
* Active RN license in the state where you'll be working and living
* 2+ years of RN experience
* 1+ year of experience in critical care, acute care, or home healthcare
* Strong skills in IV insertion
* Valid driver's license
* Willingness to travel to patients' homes within a large geographic region
* Ability to work 32 hours a week (can include days, evenings, and weekends, per business need)
* Flexibility to work different shifts on short notice and be available for on-call visits 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...
....Read more...
Type: Permanent Location: Albuquerque, US-NM
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:06
-
Role and Responsibilities:
The Data Governance & Validation Senior Advisor will be responsible for Data Governance and Validation by ensuring the accuracy, quality, and integrity of data within the Forsyth organization.
The Senior Manager will provide guidance based on experience and knowledge and will play a key role in decision making, problem solving and strategic planning.
* Define guidelines for data accuracy, completeness, consistency and format across all data sources.
* Implement procedures to actively detect and clean inconsistencies, duplicates, missing values and other data quality problems.
* Develop and enforce policies related to data access, usage and retention.
* Continuously monitor data quality metrics.
Generate reports and visualizations to identify issues and track improvements.
* Document data lineage, tracking the origin and movement of data throughout the organization to understand its provenance and potential downstream impact.
* Educate Forsyth data users on data governance policies, data quality expectations and best practices for handling data.
Qualifications:
* 8+ years of healthcare experience in data governance, data validation or similar role.
Bachelor's degree in a related field preferred
* Strong proficiency in data management tools and platforms, including SQL, Python and/or Databricks
* Prior people leadership experience strongly preferred (role will have direct reports)
* Adapt to a dynamic work environment, learn quickly, solve problems, and make decisions with minimal oversight.
* Ability to identify and prioritize opportunities for impact, develop analytic solutions and leverage technology.
* Excellent verbal and written communication skills, including the ability to clearly and openly communicate status, issues/risks, and challenges presented to a project.
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 111,800 - 186,400 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.
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 Servi...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:05
-
Are you ready to Drive Growth and Improve Lives? The Cigna Group is hiring a Manager of Client Account Implementation, to lead a team and ensure positive client experience across one to two sales markets for the under 500 segment.
The role includes managing day-to-day implementation operations for new and renewed commercial clients, building strong partnerships with sales and matrix teams, and driving timely, high-quality outcomes.
Responsibilities also include developing and executing market strategies, resolving escalated client issues, and leading executive-level communications and reporting.
WHAT YOU'LL DO:
* Foster a culture of inclusion and accountability, while developing a resilient, high-performing team through strategic coaching and continuous growth
* Manage team capacity, pipeline, and staffing to ensure timely service delivery and client commitments are met while addressing business needs such as backfills, upskilling, and time-off coverage
* Drive service excellence across the market's book of business through data-driven decisions and proactive risk management
* Transform broad strategies into clear, actionable goals and execute them within the market
* Ensure client satisfaction and support sales by collaborating with partners and communicating key updates through dashboards and reports
* Serve as primary escalation contact for operational issues, partnering with internal teams to drive swift, effective resolutions and ensure service excellence
* Partner with sales for strategic planning for client renewals and retention, using market and competitive insights to strengthen team positioning and drive growth across key markets
* Proactively identify, champion, and execute process improvement initiatives to support client growth and retention
WHAT YOU NEED TO DO THIS JOB:
* High School Diploma or GED required, bachelor's degree preferred
* 3+ years of experience and industry insight in the healthcare sector, bringing a strong understanding of its complexities, challenges, and evolving landscape, required
* 3+ years of experience driving high-quality client implementations and cultivating strategic partnerships through direct engagement with clients and brokers, consistently leveraging persuasive communication, business acumen, and polished interpersonal skills to influence outcomes and build trust, required
* 3+ years of experience using data to uncover trends, inefficiencies, and opportunities, delivering strategic insights to diverse audiences, and managing a dynamic book of business , required
* Proven ability to inspire high-performing teams and consistently elevate results year over year through strategic leadership coaching and a focus on continuous growth, preferred
* Skilled in applying an enterprise-wide mindset to challenge conventional practices, influence change, and drive continuous improvement, preferred
* Proficient PC skills i...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:04
-
POSITION SUMMARY
Is service your passion? Do you enjoy problem solving and helping others achieve the best outcome?
We are looking for a dedicated onsite specialist to provide exemplary customer and client service of our Cigna products, benefits, and claim processes.
As the Dedicated Client Service Partner you can take your career to the next leveland have regular opportunities to present your big ideas.
Want to make a difference?
How you'll make a difference:
As the Dedicated Client Service Partneryou're an extension of the Cigna Account Management team.
You have a critical role applying your relationship management skills to develop a partnership with a key client as our onsite liaison, and bringing key insights and program delivery opportunities to the Account Management Team's strategy discussions to ensure we continue to provide solutions that exceed service expectations to access care.
Requires onsite presence at least 1 - 2 days per week at 1201 Wilson Blvd, Arlington, VA 22209.
Responsibilities:
* Deliver hands-on, dedicated, personalized support to the Client, their employees, and the HR Team
* Respond to, own and assist with escalated, complex issues and inquiries from the Client's benefits delivery team and/or the employees.
Including but not limited to complex claims, authorizations, denials, appeals, incentive issues, etc.
* You will provide education and guidance around plan offerings, benefit optimization, steerage, as well as tool and resource navigation.
This may include lunch and learn sessions, presentations, or general communication development in alignment with client's programs and services (mycigna.com, incentives, discount programs, health savings account, etc.) offered
* Manage new hire onboarding and open enrollment/health fair support
* Assist with client wellness activities
Qualifications:
* High School Diploma or GED required, advanced degree preferred
* 3+ years of experience in the Healthcare Industry, Pharmacy, or PBM highly preferred
* Client facing experience preferred
* Ability to manage multiple priorities and deadlines independently and pro-actively
* Ability to negotiate, manage expectations and creatively problem-solve effective client solutions
* Ability to pivot seamlessly from customer interaction to client level updates, communication, and coordination
* Excellent presentation skills
* Previous success in delivering Customer and Client communications highly preferred
* Candidate must meet travel requirements for this role
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 o...
....Read more...
Type: Permanent Location: Arlington, US-VA
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:04
-
As a Chief of Staff, Sr.
Advisor you would provide direct support to the Provider Operations (PO) Vice President, while coordinating across the leadership team not only for PO but across Provider Experience and Operations - interfacing with other Chief of Staff Sr.
Advisors in support of our comprehensive team.
The Chief of Staff will play a critical role driving efficiency and effectiveness, in close partnership with the broader PX&O Team, across the larger enterprise eco-system.
Responsibilities:
* Supporting the PO Vice President to drive critical initiatives - ensuring on-time delivery.
* Accountable to own and deliver key requests and initiatives in support of the PO and broader PX&O organization.
Acts as a connector within PO and across the enterprise to ensure an enterprise approach to solving our most critical business challenges and identifying opportunities for leverage and value creation.
* Leading/coordinating across the OE organization to connect management processes, key initiatives, and other endeavors.
* Serve as a "force multiplier" by increasing the effectiveness and success of the our Senior Leadership Team across the organization and Cigna's enterprise.
* Work collaboratively with the senior leadership team and with leaders across the enterprise on all aspects of day to day execution to ensure alignment against the most critical initiatives across our team and the enterprise supporting the alignment of measures of success and tracking across the goals and metrics.
* Monitors information flow; sometimes acting as a gatekeeper ensuring the involvement of the VP in a project or decision-making process at the right moment.
* Supports our management process; responsible for ongoing implementation, adherence, revisions, etc.Prepares agendas for team meetings / off-sites and facilitates governance for PO.
Partners closely with our Administrative Assistant to understand upcoming meetings and helps to pull together materials in advance of sessions.
* Strong analytical skills, project management skills and innovative thinking; problem solver; self-starter and self-manager.
This is both a highly matrixed and highly self-managed role.
* Much of the work generated by this individual will ultimately be shared with members of the SLT.
The incumbent will need to drive task completion with the highest degree of accuracy to minimize rework and chance of error.
* Will help to coordinate, schedule and facilitate team meetings (both virtual and in-person).
Will make sure an agenda is set and adhered to, and that takeaways are clearly documented with an action plan to address.
* Will maintain all SharePoint pages in support of ensuring materials are updates and available to all team members.
Supports distribution list maintenance and ensuring accuracy of lists in support of our communication strategy.
* Host Townhalls and Open Forums, completing all tasks in support of delivering succe...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:03
-
Home Infusion Registered Nurse - Accredo Specialty Pharmacy
Take your nursing skills to the next level by helping to improve lives with Accredo Specialty Pharmacy, a division of Evernorth Health Services.
We are looking for dedicated registered nurses like you to administer intravenous medications to patients in their homes.
As a Home Infusion Registered Nurse at Accredo, you'll travel to patients' homes to provide critical infusion medications.
However, this job is about more than just administering meds; it's about building relationships with patients and seeing the positive impact of your care.
You'll work independently, making decisions that lead to the best outcomes for your patients.
You'll drive growth in your career by challenging yourself to use your nursing skills, confidence, and positive attitude to handle even the toughest situations, with the support from your team.
For more than 30 years, Accredo 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 the lives of others.
How you'll make a difference and improve lives:
* Empower Patients:Focus on the overall well-being of your patients.
Work with pharmacists and therapeutic resource centers to ensure that patients' needs are met and to help them achieve their best health.
* Administer Medications:Take full responsibility for administering IV infusion medications in patients' homes.
* Provide follow-up care and manage responses to ensure their well-being.
* Stay Connected:Be the main point of contact for updates on patient status.
Document all interactions, including assessments, treatments, and progress, to keep track of their journey.
Requirements:
* Active RN license in the state where you'll be working and living
* 2+ years of RN experience
* 1+ year of experience in critical care, acute care, or home healthcare
* Strong skills in IV insertion
* Valid driver's license
* Willingness to travel to patients' homes within a large geographic region
* Ability to do multiple patient visits per week (can include days, evenings, and weekends, per business need)
* Flexibility to work different shifts on short notice and be available for on-call visits 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.
Quali...
....Read more...
Type: Permanent Location: Des Moines, US-IA
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:03
-
Job Summary
Responsible for owning the ongoing account relationship and regular communications with a group of Verity Solutions accounts.
Educates, guides and set appropriate expectations with customers on maximizing Verity Solutions products for cost savings and compliance with 340B program guidelines.
Duties and Responsibilities
* Develop ongoing account relationships and serve as the key contact with assigned customers to understand their 340B program, compliance obligations, concerns and other pertinent data to develop clear service solutions.
* Consistently apply the client business review standards and expectations for consistent communication with assigned accounts, including frequency of scheduled contact and topics for review.
* Establish routines to review and analyze key savings metrics and account elements to maintain compliance and visibility to account performance including, but not limited to multipliers, ignores, unknowns, and savings reports.
* Educate and train customers on platform interaction specifics and new features/functions of all Verity products.
* Proactively report on findings for data anomalies to the appropriate team members and advise on next steps for resolution when possible.
* Use primary client management toolset (Salesforce) to manage and document all client interactions and projects as assigned.
* Respond timely and completely to customer cases as assigned, ensuring our service level standards are achieved.
* Support and promote the Verity Solutions performance standards and values through positive interactions with both internal and external stakeholders on a regular basis.
* Support occasional after-hours/weekend on-call support expectations
* Attend to other initiatives and goals as assigned
Experience, Skills and Qualifications
* BA or BS in Business or related field or equivalent work experience.
* 3+ years in a customer support, technical support or SaaS account management position.
* Strong written business communication skills, including proven ability to deal with competing goals, ability to lead difficult conversations, and the ability to achieve compromise outcomes.
* Aptitude to analyze data issues and troubleshoot problems with customer data.
* Strong experience and comfort level with MS office products, especially Excel.
* Experience using a CRM toolset, preferably SalesForce.com
* Ability to professionally and calmly communicate in both written and verbal forms with all levels of customer staff and management.
* Ability to be a self-starter, including strong multi-tasking capability, track record of managing multiple client accounts with shifting priorities and details in a fast-paced environment.
* Passion for working with customers, proactive problem-solving, and embodying a culture to exceed expectations.
* Experience working in a goal oriented, delivery focused, and dynamic environment.
...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:02
-
Summary
We are seeking self-motivated and inquisitive data analytics professional with a strong desire to learn and join our team.
This individual should be a team player who enjoys working with data in a dynamic and fast-paced environment.
As part of Actuarial Data Strategy & Solutions, the Disruption Analytics team supports presale and renewal process and is responsible for providing provider network reporting which assists potential customers in the decision-making process of the proposal process which drives new sales and client retention.
This role will work collaboratively to support our Stakeholders (Sales and Repricing) with business-critical contract reporting and analysis.
The Senior Analyst will be expected to complete day-to-day assigned business requests without immediate supervision.
The responsibilities include providing custom and complex reporting needs and discretionary recommendations based on analytical trends and reporting methodologies to deliver accurate results and value-added reporting.
This position also collaborates with matrix partners, acting as a team lead and representative for specialized disruption reporting and processes based on product/network and/or market or segment requirements.
Responsibilities
* Data manipulation, cleansing and standardization functions for data validation and quality using Microsoft Excel and Access applications.
Requires attention to detail and intermediate to advanced skills managing and working with large and complex datasets.
Requires knowledge and understanding of processes and requirements related to the process and reporting for specialized products/networks and/or markets/segments
* Utilize independent judgment and discretion in analyzing the data supplied to determine best methodology on processing the information to yield the highest possible match results.
Delivering information in a timely and efficient manner
* Requires combining business knowledge (i.e., products, networks, and provider data) along with data visualization and technical skills to efficiently create the disruption reporting on a case-by-case basis
* Perform data quality audits of system match results (visual scan and quality review) and peer review audits to ensure accuracy of system and reporting results and identification of gaps and/or inaccuracies utilizing HCPM/PRDS data, Activity Manager and/or Oracle Review tools to validate provider contract status
* Work with Network Contracting to identify and resolve provider data quality issues and raise identified risks or data gaps to management in a timely manner
* Provide analytic support and consultation to core stakeholders (Sales, Repricing/Discounts, Data Analytics Teams) related to disruption methodology logic and reporting by collaborating with stakeholders to understand objectives and deliver meaningful disruption provider reporting
* Recommend improvements in disruption database tools for efficiency gains and ac...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:01
-
The Account Manager in Global Health Benefits will be responsible for managing a book of business within our small-to-medium group segment for existing global accounts.
This consists of managing renewals for the block of business, adding/selling additional business to existing accounts, and converting accounts to a higher level of products/services.
As owner of this block of business, there is a responsibility to manage client relationships, while providing consultative and proactive solutions, supporting their global needs.
Role is Incentive Compensation (IC) eligible.
Roles and Responsibilities
* Client and customer facing responsibility for day-to-day support of client needs.
* Provide consultative pro-active information/recommendations with clients on an on-going basis.
* Manage a block of business approximately 150-200 small-to-medium accounts and average of $7M-$9M in total premium.
* Possess knowledge of the practices, techniques, and tools associated with outstanding consultative service to clients and customers.
* Responsible for renewals on existing block of business.
* Upsell/cross-sell additional product lines within Cigna Global and other matrix partners.
* Educate clients about Cigna Global updates/changes related to compliance or processes.
* Handle and resolve escalated issues related to eligibility, premium/invoicing, and/or service-related matters.
* Thorough understanding of health service products & services, and the operating requirements to support client management plan goals and sales processes.
* Utilize organization's sales information systems to document pertinent client information.
Qualifications
* Bachelor's degree preferred or equivalent work experience; high school diploma or equivalent required
* 2+ years Account Management and/or client-facing sales experience required
* International experience with multinational clientele required
* Strong background or experience in marketing, account management, account service, sales, or other areas requiring significant client and customer interaction
* Excellent organization, efficiency, negotiation and presentation skills
* Ability to effectively manage productive meetings
* Strong written and verbal communication skills required
* Client and customer focus with the ability to build rapport and be a team player within the Cigna Healthcare organization
* Ability to analyze and solve problems created and presented by the business environment, regulations, internal processes, and system limitations.
* Ability to exercise independent judgment within established company guidelines
* Familiar with multiple software and system-based applications, such as Microsoft 365, Outlook, database & spreadsheets (i.e.
Excel), and Salesforce.
* Must be willing to travel in support of client and organizational meetings.
* Health and Life Insurance License or ability to obta...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:01
-
The Risk Adjustment Quality & Review Analyst in IFP brings medical coding and Hierarchical
Condition Category expertise to the role, evaluates complex medical conditions, determines
compliance of medical documentation, identifies trends, and suggests improvements in data and
processes for Continuous Quality Improvement (CQI).
Key Job Functions :
• Conduct medical records reviews with accurate diagnosis code abstraction in accordance with
Official Coding Guidelines and Conventions, Cigna IFP Coding Guidelines and Best Practices, HHS
Protocols and any additional applicable rule set.
• Utilize HHS' Risk Adjustment Model to confirm accuracy of Hierarchical Condition Categories
(HCC) identified from abstracted ICD-10-CM diagnosis codes for the correct Benefit Year.
• Apply longitudinal thinking to identify all valid and appropriate data elements and
opportunities for data capture, through the lens of HHS' Risk Adjustment.
• Perform various documentation and data audits with identification of gaps and/or inaccuracies in
risk adjustment data and identification of compliance risks in support of IFP Risk Adjustment (RA)
programs, including the Risk Adjustment Data Validation (RADV) audit and the Supplement Diagnosis
submission program.
Inclusive of Quality Audits for vendor coding partners.
• Collaborate and coordinate with team members and matrix partners to facilitate various aspects
of coding and Risk Adjustment education with internal and external partners.
• Coordinate with stake holders to execute efficient and compliant RA programs, raising any
identified risks or program gaps to management in a timely manner.
• Communicate effectively across all audiences (verbal & written).
• Develop and implement internal program processes ensuring CMS/HHS compliant programs, including
contributing to Cigna IFP Coding Guideline updates and policy determinations, as needed.
Education & Experience :
The Quality Review & Audit Analyst will have a high school diploma and at least 2 years' experience
in one of the following Coding Certifications by either the American Health Information Management
Association (AHIMA) or the American Academy of Professional Coders (AAPC):
o Certified Professional Coder (CPC)
o Certified Coding Specialist for Providers (CCS-P)
o Certified Coding Specialist for Hospitals (CCS-H)
o Registered Health Information Technician (RHIT)
o Registered Health Information Administrator (RHIA)
o Certified Risk Adjustment Coder (CRC) certification or ability to obtain certification within 6 months
of hire.
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 25 - 38 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:00
-
Product Management Senior Advisor - Medicare Solutions, Express Scripts
Description of Position:
* The Product Management Senior Advisor provides leadership and strategic direction for capabilities and new product development within Regulated Markets.
This position will ensure their capabilities are compliant with the Center for Medicare and Medicaid Services (CMS) regulations, lead implementation of enhancements, provide subject matter expertise to internal/external stakeholders, deliver presentations in account team/client forums, and ensure metrics and performance guarantees are met.
This position will also support leading cross-functional initiatives that may be unrelated to the capabilities they own.
Position Details:
* Serve as the Regulated Markets business owner for specific capabilities
* Lead large initiatives for Regulated Markets to develop new capabilities and/or or enhance existing functionality
* Review and provide direction on CMS regulations to maintain compliance, partnering with Legal and Compliance
* Communicate strategic recommendations for supported capabilities and execute tactics to deliver the strategic vision
* Be the Subject Matter Expert and capability advocate with all cross-functional areas of the organization
* Influence account teams, clients, and external industry workgroups (NCPDP/PCMA)
* Develop and deliver training to clients and internal resources
* Oversee the product development life cycle leveraging agile methodology, partnering with Business and Technical Product Owners to communicate, document, and prioritize enhancements
* Analyze trends, develop, and implement recommendations to ensure client needs, compliance metrics, and/or internal support is met
* Ensure internal/external policies and procedures are documented, maintained, and followed
* Responsible for business documentation of compliance actions for routine guidance, execution of routine monitoring, and communication of client impacts
* Responsible for project scope, project plan, tracking project deliverables, and communicating project status
* Support internal/external audits as the subject matter expert for your capabilities
* Ability to see and apply business needs outside of one's own work area
* Serve as a mentor and support the development of junior team members
* Cross-train and support other team initiatives where appropriate
Qualifications:
* Bachelor's degree in related field or 5+ years relevant experience
* Familiarity with pharmacy adjudication and other PBM operations
* Experience in managing capabilities in Medicare and Medicaid preferred
* Preferred, but not required to have knowledge in one or more of the following Medicare Capabilities: Inflation Reduction Act (IRA), Medicare Prescription Payment Plan, or Part D Vaccines
* Strong strategic, analytical, problem solving, and project management skills required
* ...
....Read more...
Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2025-10-24 08:37:00
-
Pharmacy Technician Lead Representative - Whitestown, IN
The Quality Response Team members are essential in driving quality processes at Express Scripts Pharmacy.
They are responsible in mitigating quality related events and researching quality related issues that would affect overall pharmacy DPMO.
They support each department in various capacities depending on need in managing quality.
They assist in trouble shooting and rectifying issues that can also impact overall pharmacy productivity.
This is a dynamic position that requires critical thinking skills, quick decision making, and the ability to solve problems.
Shift: Monday through Friday - 2PM-10:30PM
What you'll do:
* Monitor automation lanes and support bottle spotting teams to identify potential quality issues with automated dispensing.
* Respond to floor calls for quality related issues in pharmacy including automation, manual dispensing, warehouse, and packing departments.
* Research patient medication events.
* Collaborate with all departments and research operational issues that can impact building operation and quality.
* Research in house quality events and report findings out to Director of Pharmacy Practice and relevant/impacted departments.
* Document and manage quality audit process for all departments/shifts.
* Assist in development, documentation, and updating of Standard Operating Procedures
* Assist in training/development of other team members
* Demonstrate leadership quality consistent with Cigna Values.
What you need to do the job:
* High school diploma or GED required
* Must be a Certified Pharmacy Technician (CPhT) and licensed in the state of Indiana
* At least three years' experience in a pharmacy dispensing setting required
* Exposure to quality based responsibilities a plus.
* General PC knowledge and skills: Microsoft Word, Excel, PowerPoint and Outlook
* Knowledge of standard concepts, practices, and procedures within dispensing pharmacy
* Strong attention to detail with good organizational skills
* Ability to stand for extended periods of time
* Ability to adapt in a dynamic work environment, learn quickly, solve problems and make decisions
* Ability and desire to assist team members
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 (in...
....Read more...
Type: Permanent Location: Whitestown, US-IN
Salary / Rate: Not Specified
Posted: 2025-10-24 08:36:58
