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Benefit Education Lead - East Region
Required Competencies:
* Customer Focus
* Plan and Align
* Action Oriented
* Organizational Savvy
* Resourcefulness
* Communicate Effectively
Execution
* Support the execution of key discipline within the Customer Event Operations organization, focusing on deployment of customer-facing events across all modalities
* Support designated vendors (contracted benefit educators), who support customer engagement activities/events
* Oversee the coordination of customer event deployment in aligned markets, including facilitation with internal and external stakeholders, material preparation, creation, and ordering of items
* Deliver cross -organizational collaboration regarding virtual or onsite customer educational events
* Engage in customer engagement reporting, project work and support to Cigna Healthcare sales and account management organization
* Focus on the achievement of assigned goals and support in achieving functional goals
* Inform direct managers and teams to address resource, capacity, workload balancing and operational needs
* Focus on short-term outputs and other work areas as assigned
* Able to self-manage assignments and execute applicable components to support customer events without direct supervision
Key Responsibilities
* Provide segment-agnostic, customer event support to Cigna Healthcare
* Support benefit educators in a designated geographic area.
Includes all aspects of benefit educator's hiring, onboarding and coaching
* Responsible for end-to-end coordination of customer events including material development and ordering
* Resolve inquiries, conduct research, collaborate, and provide information to various segment business partners regarding customer engagement touchpoints
* Identify ways to streamline procedures between departments/segments
* Escalate non-routine issues, consulting with leadership as appropriate
* Engage in customer engagement/enrollment planning by providing insights to supervisor/leadership on market needs to promote efficiency
* Support designated enrollment budget and escalation processes (where applicable) to align with appropriate resource deployment
* Maintain customer engagement activities within Salesforce and other applicable tools
* Fulfill local market report requests and analyze the local market customer engagement
* Follow established guidelines and procedures of benefit education events and other events as assigned
* Act as a liaison to the sales teams and client / producer as needed including coordination of materials for event support
* Contribute to projects to focus on efficiency and effectiveness of customer engagements processes, guidelines, and systems
Other
Qualifications
* Bachelor's degree; in health education, health administration, marketing, business, or related field preferred
* Ability to ...
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Type: Permanent Location: McLean, US-VA
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:51
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Home Infusion Registered Nurse - Accredo
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 within a designated area
* Ability to do patient visits 2-3 weekdays (day shift) per week, but may require some evening or weekend visits also
* Flexibility to work different shifts on short notice
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, ag...
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Type: Permanent Location: Keene, US-NH
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:50
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This production role delivers professional activities in the Provider Contracting job family.
The position is responsible for dental provider recruitment.
Conducts daily outreach to dental offices or providers to develop and maintain positive relationships with the purpose of negotiating a contract for participation in our dental networks (DHMO and DPPO).
Assists with new provider or location credentialing, contracting and recredentialing requests.
Respond to status requests and other non-routine contract questions.
Assists with preparation or modification of provider compensation or contracts.
Completes output in specific work area to appropriate time and quality targets.
Works under own initiative, prioritizes own work, and meets agreed timescales.
Work is subject to frequent review by more experienced professionals in Provider Contracting.
Responsibilities include, but not limited to:
* Identifying, recruiting, and contracting, qualified health care professionals in geographic area within established guidelines to meet health plan needs
* Handle incoming calls from dental providers, reroute misdirected calls
* Takes ownership of issues and works to resolve them over the phone with a "one and done philosophy".
* Perform research and interpret guidelines to respond to inquiries, complaints or disputes, ensuring compliance
* Outreach to providers to obtain missing or additional information to ensure applications and contracts meet compliance
* Collaborate with internal departments as needed
* Maintain positive relationships with health care professionals and their office staff extending high quality service
Qualifications:
* High School Diploma or GED Required
* Minimum of 3 months experience in dental office negotiations, relations or contracting
* Ability to multi-task and priorities workload
* Strong verbal and written communication skills
* Must be a current Cigna or Express Scripts contractor
* Basic to intermediate proficiency in Microsoft Office products
* Demonstrates ability to manage multiple tasks simultaneously while maintaining quality service
* Candidates must have a hard-wired internet connection to plug into the equipment - Wi-Fi will not suffice.
* Satellite internet is not compatible with the equipment and internet speeds must be at least 25Mbps Download/5Mbps Upload.
* Candidates MUST be available/focused consistently during working hours unless otherwise agreed upon with minimal distractions.
Computer knowledge should include being able to set up equipment and troubleshoot with IT regarding any issues as they will be responsible for the set up.
* Please indicate location on resume and confirm internet requirements are met.
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/5Mbp...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:50
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This is a hybrid role and will require the ability to work in-person at our St.
Louis, Missouri office.
The Reporting Lead Analyst will be primarily responsible for providing sales support for new and existing clients.
Modeling claims data to determine network participation in various standard and custom pharmacy network solutions.
Communicating the results to multiple groups and levels of management.
RESPONSIBILITIES
* Development of standard reporting, analysis, models and tools used to identify improvement opportunities and support decisions related to network solutions.
* Extract, analyze, and validate large sets of data used for reporting both internally and externally.
* Analyze trends, provide analysis, and develop recommendations for a variety of projects.
* Report information to management and decision makers.
May create presentations and/or reports to communicate key messages and recommendations.
* Provide ad-hoc reporting and analysis as required.
PREFERRED COMPETENCIES
* Strong analytical and problem-solving skills
* Communicates Effectively
* Develop and Implement Innovative and Nimble Solutions
QUALIFICATIONS
* Bachelor's degree in Business, Accounting, Economics or Finance preferred
* 2+ years' experience in reporting, finance analysis and/or accounting
* Excellent oral and written communication skills required
* Strong understanding of Microsoft Office needed.
* Basic SQL experience required, experience with Teradata, R a plus
* Ability to utilize independent judgment and discretion and recommend solutions
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality.
We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people.
Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require 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 application or to provide your resume as you will not receive a response.
The Cigna Grou...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:49
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Hybrid Schedule: Onsite Tuesday/Wednesday and a 3rd day of your choice
The Account Executive is primarily responsible for managing complex prospect strategies and ensuring sales goals are met through the development of new business.
The Account Executive educates prospective customers on Workers Compensation PBM, the market environment, and the interactions with claims payers.
The Account Executive works closely with Marketing, Clinical Team, Product, and Operations staff to ensure our tradition of excellent customer service.
Additionally, they will respond to RFP's, deliver a compelling price and service proposal, manage capabilities and finalist presentations, and demonstrate prospecting discipline.
ESSENTIAL FUNCTIONS
* Meet sales objectives in individual territory.
* Responsible for meeting sales goals as defined.
* Meet productivity requirements with regard to quality prospect interaction.
* Monthly goals for outreach and frequency as defined.
* Complete all administrative requirements on time.
* Accountable for account planning, development of sales strategy, routine weekly reports and upkeep of CRM.
* Perform at high level while being efficient and compliant with budget and policy.
* Attend industry and corporate meetings and events in and out of territory.
* Mentor, as part of initial field sales training, sales representatives upon request.
* Perform at high level while being efficient and compliant with budget and policy.
* Accountable for budget and reporting Attend industry and corporate meetings and events in and out of territory.
* Mentor, as part of initial field sales training, sales representatives upon request.
QUALIFICATIONS
* Bachelor's degree in related field or 14+ years of experience, 8+ years relevant experience with Bachelor's Degree or Master's degree and 6+ years of relevant experience
* Both to include 2+ years of medical sales experience with proven track record of success and 2 years with proven track record as a Sales Rep MS Office,
* Computer proficiency Knowledge of managed care operations
* Experience with business plan development
* Excellent organizational and problem solving skills Proven ability to self-motivate
ABOUT THE DEPARTMENT
As a member of the Sales and Account Management team, you're the face of myMatrixx for our clients.
Your team is responsible for relationship building, winning new business and retaining clients.
You'll educate clients on how our benefit offerings can help them achieve their business goals and make recommendations on products and services to best serve their 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 pharm...
....Read more...
Type: Permanent Location: Tampa, US-FL
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:49
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POSITION SUMMARY
The Chief of Staff provides counsel and advice to top management on significant Business Project Management matters, often requiring coordination between organizations.
Leads mid-sized time-limited project or components of a larger project and directs one or more teams of business consultants involved in the evaluation of systems requirements and/or the development of new procedures/processes/or policy solutions to address highly complex business needs.
May also assess impact and implications from a cost, efficiency, contractual, legal and/or regulatory standpoint.
Determines requirements, plans projects, establishes priorities and monitors progress.
Identifies and exposes the business opportunities and implications of re-engineering projects.
Identifies and facilitates process design changes and executes process improvement initiatives.
Analyzes and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements.
Provides measurement support (i.e.
development, reporting, validation and improvement).
May coordinate with other project managers.
Actions have significant impact on key Department objectives.
Focuses on providing thought leadership and technical expertise across multiple disciplines.
Recognized internally as "the go-to person" for the most complex Business Project Management assignments.
Candidates who reside within 50 miles of the following locations will be required to perform onsite 3 days per week: Bloomfield, CT; Chattanooga, TN; Denver, CO; St Louis, MO; and Scottsdale, AZ.
PRIMARY FUNCTIONS
Providing direct support to the Vice President, Workforce Management & Strategy Analytics (VP) while coordinating across the leadership team, the Chief of Staff will play a critical role driving effectiveness and efficiency across the organization's landscape.
Key accountabilities include:
* Supporting the Workforce Management & Strategy Analytics Vice President (VP) to drive critical initiatives - ensuring on-time delivery.
* Accountable to own and deliver key requests and initiatives in support of this VP's organization.
Acts as a connector within this organization 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 Workforce Management & Strategy Analytics organization to connect management processes, key initiatives and other endeavors.
This role is responsible for establishing and leading, cross-functional strategic project initiatives.
The successful incumbent will serve as a "force multiplier" by increasing the effectiveness and success of the Workforce Management & Strategy Analytics Senior Leadership Team across the organization and Cigna's enterprise.
Candidate will also be self-motivated, detail oriented, and have a willingness to adapt to strategic and tactical n...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:48
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This is a hybrid role and will require the ability to work in-person at our St.
Louis, Missouri office.
The Financial Analysis Lead Analyst provides advanced professional input to complex Financial Analysis assignments/projects.
The Financial Analysis Lead Analysis will also be responsible for analysis and interpretation of complex financial information.
Utilizing independent judgment and discretion, the Financial Analysis Lead Analyst identifies trends, variances, and key issues and provides recommendations for adjustments.
As a Financial Analysis Lead Analyst, you will be responsible for conducting moderate to complex financial analysis projects and/or reporting.
In addition, you will help answer pharmacy appeals and work directly with pharmacies on payment issues.
May conduct audits to ensure data controls are maintained.
May design, enhance and maintain system applications for processing and reporting financial information.
Works autonomously, only requiring "expert" level technical support from others.
Exercises judgment in the evaluation, selection, and adaptation of both standard and complex techniques and procedures.
Utilizes in-depth professional knowledge and acumen to develop models and procedures, and monitor trends, within Financial Analysis.
Essential Functions
• Extract, analyze, validate, and communicate intelligence from large sets of data
• Develop new analytic resources and views of data from in-depth analysis and understanding
• Communicate externally with pharmacies and pharmacy managers
• Develop, help maintain, and troubleshoot complex internal MS Excel spreadsheets
• Assist with Ad-Hoc request
Qualifications
• Bachelor's Degree in Finance, Accounting or related field preferred
• 2+ years in a finance, accounting or highly analytical position
• Experience in healthcare / insurance industry preferred
• Technical knowledge of relational database concepts, querying, data warehouses and decision support tools, including but not limited to: SQL and Excel
• Ability to utilize independent judgment and discretion, identify variances, and recommend solutions
• Experience in a highly regulated business environment
• Ability to communicate results of analytics to a multitude of individuals/groups
• Strong analytical and problem solving skills
• A self-motivated team player who thrives on challenges, is comfortable working in a fast-paced, dynamic environment, and is ready for development within our Company
• Innovative and strong desire to learn
• MBA a plus
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About 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 ma...
....Read more...
Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:48
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WORK LOCATION: HYBRID / REMOTE
The National Ancillary and Out of Network Protection Team (NA/ONPT) plays a significant role in Cigna's Enterprise Affordability strategy.
Our team manages over 400 national contracts across US Commercial and US Government lines of business and roughly $9B in annual medical spend across National Ancillary, Direct Provider and Non-Par Cost Containment partnerships.
The Business Analyst is a key role working closely with project management, contracting, vendor partners, and enterprise wide stakeholder SME's to develop, improve, monitor, and maintain delegated UM programs for Cigna HealthCare.
The work will be a mix of project and production support including program configuration, compliance, performance management, root cause analysis, data stewardship, business requirements definition, testing support and validation.
This role will report to the BA/OPS Senior Manager focusing primarily on broadening Cigna's network, revenue and affordability opportunities for Cigna clients and customers.
This role has visibility to and regular interactions with our Senior Leadership team and other key internal and external stakeholders.
Work can range in content including (but not limited to) Root cause analysis of systemic issues that impact prior the prior authorization process.
scope and assess analysis, organizational realignment, medical cost initiatives, program implementations, performance management, or process improvement.
Job Components and Deliverables
PROGRAM MANAGEMENT:
* Production Support of program configuration and - Monitor controls and Identify issues, root cause analysis, solutioning, document and maintain log of issues, propose fixes, test fixes (including use case definition, expected results, defect logging, validation and governance of process)
* Project Support - Develop and manage detailed business requirements using a combination of stakeholder input and subject matter expertise, test requirements (including use case definition, expected results, defect logging, validation and governance of process)
DRIVING SOLUTIONS:
* Root Cause Analysis - dive into data, system workflows, requirements and feeds to determine issue cause and appropriate solutioning suggestions
* Facilitation - lead and document idea sessions around problem resolution to address business needs
* Prioritization - evaluate business-specific requirements
* Process - follow portfolio and production processes to resolve issues and project needs.
Including but not limited to Intake creation, project request forms and collaterals, business case support, status reporting updates, communications surrounding issues and fixes, and governance support (logs, materials, decision support)
RISK MANAGEMENT:
* Risk Identification - Clearly quantify / qualify risks and engage with impact partners to prioritize related to cost, timing and features
* Mitigation - Eliminate barriers to success or develop alterna...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:47
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Underwriting at Cigna: If you're looking to use strong analytical, risk management, and portfolio management skills in a competitive, fast-paced environment, an Underwriting career at Cigna will allow you to do all this and more.
Underwriters evaluate the risk of insuring a potential Cigna customer and use that information to set premium rates for insurance policies.
As part of our Underwriting team, you will directly impact our business on a daily basis, protecting Cigna's sound financial position which enables us to meet our financial commitments to our customers.
Core Responsibilities:
* Ability to quickly learn manual and claim experience rating models and related pricing tools.
* Perform case-specific risk assessments and rate development for presale and inforce business for large and complex cases independently.
* Develops strategic recommendations related to market competition, product development, and market pricing decisions.
* Drive consultative engagement with Sales and Producers/Clients through presale and inforce case level strategies, and market discussions
* Assist Sales as financial consultant on case-specific issues.
Possesses an in depth understanding of manual rating models, claim experience projections, pricing tools, pricing adjustments and available plan designs.
* Managesa complex book of business, with a variety of funding types, focused on attaining profitable growth, persistency, and earnings.
* Responsible for driving engagement with other Underwriting areas to optimize cross-sale opportunities with a whole-case underwriting view.
* Actively collaborates with product/pricing matrix partners to provide expertise/input on market level product and pricing needs.
* Works autonomously.
Exercises judgment in the evaluation, selection, and adaptation of both standard and complex techniques and procedures.
* Independently hold calls with Sales, brokers, or clients.
* Mentors less experienced underwriters serving as technical and strategic subject matter expert on complex issues.
* Influences underwriting best practices and leads by example to the rest of the team.
* Leads or provides advanced professional input to complex Risk & Underwriting assignments/projects, partnering with management to provide innovative ideas and strategic input to continuously improve processes and efficiencies.
* This role includes internal project work which makes up 10-15% of the time in role.
Projects focus on strategy and process improvement.
Minimum Qualifications:
* Minimum of 5 years related experience, with at least 3 years of medical underwriting
* All or part of the 5+ years of experience must have been accumulated within the past 5 years
* Bachelor's degree in the following majors and/or minors are preferred, but not required: Risk Management, Economics, Finance, Accounting, Management, Mathematics, and/or Business
* Strong analytical and problem ...
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Type: Permanent Location: Chattanooga, US-TN
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:47
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POSITION SUMMARY
Leads and provides subject matter expertise in collaboration with client services, claims, implementations, clinical, Non-Clinical, and IT organizations to manage new and existing workflows.
Monitors overall operations including review of internal reports and ad-hoc data analysis associated with operational workflows.
Identifies ways to improve or enhance operational performance.
RESPONSIBILITIES
• Gains an understanding for utilization management, claims operations, IT operations, and call center operations
• Develops operational specific expertise in becoming a subject matter expert in the technical and operational aspects of the company
• Provides subject matter expertise during the implementation of new clients by integrating workflows into current operations
• Assists with functionality and regression testing for program specific enhancements, implementations and code
• Provides operational expertise to client services and client operations managers in research and resolution of issues and requests
• Builds presentations and completes analyses to assist the program lead in communications to senior management
• Manages designated special projects, process improvements and project plans
• Create reports using Microsoft SQL; write SQL queries against SQL server database to validate reports; and provide performance tuning and maintenance of existing reports.
• Translates business request into system rules; evaluates existing functionality for operational efficiencies and maintains historical record of system development
• Documents and maintains business workflows, requirements or supports central teams that manage these functions
• Coordinates with key leaders to execute projects
• Assist in preparing internal and external training and direction for clinical and Non-Clinical staff
QUALIFICATIONS
• High School diploma required
• Must have proficiency with MS Word, Excel and MS PowerPoint (Visio preferred as well)
• Ability to manage multiple priorities independently
• Ability to learn basic SQL queries as needed
• Ability to collaborate with various business partners & organize effectively
• Strong verbal and written communication skills
• Understanding of requirements creation and development
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 pre...
....Read more...
Type: Permanent Location: Tampa, US-FL
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:46
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SUMMARY:
The Account Executive (Centene Med D and Exchange) manages the overall contract and relationship with existing complex clients and their consultants.
This position is the owner of the strategic renewal plan, development of long-term account strategy and leads the growth & retention of current clients.
The Account Executive is responsible for leading the identification of business solutions that meet client needs and incorporating such into strategic business reviews using their in depth knowledge and specialized expertise.
They are also responsible for client retention, customer satisfaction and achieving corporate strategic goals relative to their book of business.
The Account Executive serves as the client expert and a resource for others within the organization.
They share best practices to contribute to development of others and provide forward-thinking leadership designed to move the business forward and lead projects/corporate initiatives.
ESSENTIAL FUNCTIONS:
Sales Ability/Selling:
* Uses influence & persuasion to gain the support & commitment of others.
Advocates and uses relationship building to obtain support.
* Convinces others to take action.
* Negotiates skillfully in tough situations.
* Responds effectively to positions/reactions of others.
* Efficiently & effectively sells solutions.
* Uses structured training to educate and influence clients, customers, & consultants.
Maximizes Results:
* Systematically manages accounts to maximize results.
* Consistently meets or exceeds sales targets through personally controlling the critical aspects of the sales and delivery processes.
* Leads & coordinates overall team effort.
* Driven to win customers' attention and treats their business as an honor, never letting them feel taken for granted.
* Produces by increasing profitable sales to existing accounts.
* Concentrates on finding avenues to generate increased sales from established accounts.
* Uses broad knowledge of multiple business areas and the marketplace to advance the organization's goals.
* Knows how the business works and how organization makes money.
* Keeps up with current and possible future policies, practices, innovations, and trends in the organization, with the competition, and in the marketplace.
* Conducts/Uses financial analysis to generate, evaluate, and act on strategic options and opportunities.
* Has clinical knowledge and can apply understanding in interactions with clients.
Customer Focus:
* Builds strong customer relationships & delivers customer-centric solutions.
* Gains insight into customer needs and helps ensure a better member experience.
* Identifies opportunities to benefit the customer.
* Builds/Delivers solutions that meet the customer's expectations.
Builds and maintains effective customer relationships.
* Balances short- & long-term relationship needs to effectively execute rene...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:46
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The National Sales Analyst (NSA) is an integral member of the National Accounts sales team and partners closely with the new and existing business sales team members to enable and support the growth of client and consultant relationships within the segment.
The NSA owns the end-to-end RFP/RFI process and coordinates and drives activity and communication across all internal matrix partners to ensure alignment with client strategy and Cigna's value proposition.
ROLE COMPONENTS:
RFP Project Manager
* Manages new and existing business RFPs end-to-end for all Lines of Business (including but not limited to medical, clinical, dental, pharmacy, behavioral, vision, and stop loss).
Responsible for RFP from initial review and down streaming to final review and submission, follow-up questions, Best and Final Offer, and other RFP-related requests
* Manages multiple complex RFPs concurrently with aggressive deadlines and diverse formats
* Facilitates How to Win (HTW) / Prospect Qualification process as a consultative partner; which includes initial strategy call with leadership and matrix partners with reliance on NSE (New Business Sales Executive) /NAE (National Account Executive - Existing Business) support
* Assists NSE/NAE to build client-specific strategy; applies and disseminates during RFP process
* Engages standard matrix partners as needed based on RFP specifications
* Edits/Manipulates matrix partner output, i.e., plan designs from PBAB, disruption results from RSU, etc.
* Reviews proposal components prior to submission to ensure best in class RFP responses (or client specific strategy) reflecting Cigna solutions and capabilities
* Provides RFP data to NST/NAE for finalist meeting
* Ensure salesforce.com entry and accuracy
Strategic Partner - Internal & External
* Manages relationships with sales and account team members, Underwriting, other matrix partners
* Communicates externally with consultants, including related to missing data, logistical elements of RFPs
Subject Matter Expert
* Maintains and enhances knowledge of Cigna products and capabilities to include in RFPs
* Identifies applicable solutions to quote in RFPs based on consultant/client issues and requests
* Demonstrates a foundational level of understanding of Cigna's processes, solutions, and strategy
* Understands and applies all established processes and Standard Operating Procedures (SOP)
* Proactively participates in segment-wide trainings and discussions as an active learner to establish and uphold baseline knowledge
Team Contributor
* Supports off-season process improvement projects, segment initiatives
* Collaborates with new team members as needed
* Shares recommendations on updates to existing documentation of best practices
* Actively participates in team meetings
QUALIFICATIONS
* Experience with healthcare RFPs for some or all of the following lines of business: m...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:45
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POSITION SUMMARY
This role is a full-time employee Business Analytics Lead Analyst for the Client Reporting team.
The Lead Analyst will be expected to understand the needs of business functions and implement solutions to analytic challenges using eviCore's robust data infrastructure.
Proactive collaboration with both technical and non-technical business partners will be essential to success.
This individual will be influential in shaping the direction of enterprise-scale solutions, thus enhancing eviCore's core capabilities in the industry.
ESSENTIAL FUNCTIONS
* Provides expert content/professional leadership on complex Business Analytics assignments/projects.
* Works in collaboration with business leaders to provide strategic partnership in analytics, identify and prioritize opportunities for impact, develop analytic solutions, leverage data science and technology capabilities, embed analytics-driven processes, operationalize and measure impact, to support decision making and execution based on data, facts and analytical findings across different parts of the organization.
* Exercises considerable creativity, foresight, and judgment in conceiving, planning, and delivering initiatives.
* Uses deep professional knowledge and acumen to advise functional leaders.
* Focuses on providing thought leadership within Business Analytics but works on broader projects, which require understanding of wider business.
* Recognized internally as a subject matter expert.
QUALIFICATIONS
* Bachelor's degree in Mathematics, Statistics, Computer Science, Data Science, or related scientific/technical field strongly preferred or equivalent work experience.
* 3+ years of experience in business analytics, healthcare data analysis, reporting, data warehousing or related experience.
* Demonstrated understanding of the healthcare insurance industry preferred.
* Experience with SAS is required.
* Experience with BI tools, particularly SQL Server Reporting Services (SSRS) and/or Tableau preferred.
* Highly organized and able to track & prioritize multiple tasks.
* Advanced analytical and problem-solving skills.
* Effective communication and collaboration skills with both technical and non-technical parties.
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 77,300 - 128,800 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 h...
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Type: Permanent Location: Franklin, US-TN
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:45
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Home Infusion Registered Nurse - Accredo
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 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.
For this position, we anticipate offering an hourly rate of 36 - 61 USD / hourly, depending on relevant factors, including experience and geographic location.
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...
....Read more...
Type: Permanent Location: Bethesda, US-MD
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:44
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Implements medical policy.
Establishes and implements policies and standards, evaluate new treatments, and conduct medical research to ensure the quality of the medical care provided to patients.
Implements utilization and financial initiatives.
Develops and manages efforts to improve and maintain cost and utilization trends.
May manage a single management entity that is responsible for primary care center.
Requires an MD, DO or DC.
SUMMARY: The Medical Director performs medical review and case management activities.
The physician provides clinical insight to the organization through peer review, benefit review, consultation, and service to internal and external customers.
Will serve as a clinical educator and consultant to utilization management, case management, network, contracting, pharmacy, and service operations (claims).
Primarily regional with national level case work for Cigna Healthcare.
RESPONSIBILITIES:
- Performs benefit-driven medical necessity reviews for coverage, case management, and claims resolution, using benefit plan information, applicable federal and state regulations, clinical guidelines, and best practice principles.
- Works to achieve quality outcomes for customers/members with a focus on service and cost
- Improves clinical outcomes through daily interactions with health care professionals using active listening, education, and excellent communication and negotiation skills.
- Balances customer/member needs with business needs while serving as a customer/member advocate at all times.
- Participates in all levels of the Appeal process as appropriate.
- Participates in coverage guideline development, development, and maintenance of medical management projects, and committees.
- Participates in quality processes such as audits, inter-rater reliability clinical reviews, and quality projects.
- Serves as a mentor or coach to other Medical Directors and other colleagues in quality and performance improvement processes.
- Improves health care professional relations through direct communication, knowledge of appropriate evidence-based clinical information, and the fostering of positive collegial relationships.
- Addresses customer service issues with mentoring and support from leadership staff.
- Investigates and responds to client and/or regulatory questions to assist in resolving issues or clarifying questions with mentoring and support from leadership staff.
- Achieves internal customer satisfaction and regulatory/accreditation agency compliance goals by assuring both timely turn-around of coverage reviews and quality outcomes based on those review decisions.
- Provides clinical insight and management support to other functional areas and matrix partners as needed or directed.
Qualifications:
Required - Current unrestricted medical license in US state or territory.
- Current board certification in an ABMS or AOA recognized specialty (grandfathered by the board or maintained by the MOC program) - Oncology...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:44
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* Flexible Onsite Location: San Francisco, CA, Walnut Creek, CA, Glendale, CA, Irvine, CA, San Diego, CA, Seattle, WA
* Region/Territory: West Region- Alaska, California, Idaho, Montana, Nevada, Oregon, Washington
BACKGROUND:
Our mission is to improve the health, well-being and peace of mind of those we serve.
We do that by making health care affordable, predictable and simple.
In an effort to deliver the differentiated value needed to compete in the marketplace, o ur evolved growth framework will bring our mission and strategy to life and position our company for the next era of growth.
The key pillars to achieve our goals will be:
Grow : we will grow our existing businesses by delivering differentiated value for the customer and clients we serve today.
Expand : we will broaden our reach to impact more lives beyond our current footprint by entering new businesses, geographies and buyer groups.
Strengthen : we will continue to invest in our future by enhancing key enterprise capabilities that accelerate efficiency, decision-making and innovation.
How we win in the marketplace will be by retaining, deepening and adding client and customer relationships all the while growing the value of new and existing distribution channels through segment expansion, capability development, broker engagement and successful execution of sales and retention strategies.
OVERVIEW:
Reporting to the Senior Vice President Segment Leader, this role will function as a key member of the sales leadership team and be responsible for driving a profitable regional growth strategy in both new and existing sales channels within Region for the Select & Middle Market Segment (25 - 3,000 lives).This leader will have direct ownership of earnings and portfolio management of assigned Region, executing the overall sales strategy and implementing effective management processes needed to generate new sales and drive deeper penetration into existing accounts.
Working through and with the Market Growth Leaders and Underwriting Leaders, this position will look to maximize the local market value proposition to direct the overall expansion, sale and retention of new and existing business as well as identify key opportunities for integrated growth to expand market share.
This leadership role will be "mission driven" and instrumental building and maintaining effective (and profitable) long-term relationships with a variety of high-value external partners at the broker and client level, ensuring high levels of customer and client satisfaction are achieved across multiple books of business; as well as setting the tone for a high-performing sales.
RESPONSIBILITIES:
- Be a visible leadership presence within the Region, building and growing external relationships and partnerships.
Oversee day to day sales and portfolio earnings, ensuring there is continued focus on execution towards growth and earnings goals as well as new sales, account persistency and client satisfaction.
- Serves ...
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Type: Permanent Location: San Francisco, US-CA
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:43
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Home Infusion Registered Nurse - Accredo
Candidates for this position must live in the Waynesfield, OH area.
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 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.
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.
Tha...
....Read more...
Type: Permanent Location: Lima, US-OH
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:43
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If living in AZ, the hours will be 11:30-8pm ET.
If living in FL, OH, PA or MO, the hours will be be 9:30-6pm ET Monday-Friday
Position Summary
Provide operational support for multiple programs within the Express Scripts clinical product portfolio, including but not limited to ScreenRx, Health Connect 360, Advanced Opioid Management, and several other programs that engage patients, providers, caregivers and clients to promote better health outcomes.In doing so, the Staff Pharmacist will need to be fluent about the intricacies of each program and provide appropriate patient counseling.
Essential Functions:
* Perform comprehensive evaluations of available patient health records and using evidence based medicine, proactively reach out to patients to educate and engage them in successfully managing their drug regimen and to advise them of cost saving opportunities available in their prescription drug plan.
Respond to incoming inquiries regarding drug therapy.
Follow up with patients to ensure continuity of care and provide clinical counseling as needed
* Reach out to patients new to their therapy to ensure early success in treatment by educating and engaging them in managing their medication regimens, including advising them on over the counter products and devices that may assist them in achieving their treatment goals
* Establish credibility as the trusted advisor to physicians and other healthcare professionals, including consultations to address omission of therapy concerns and recommend alternate treatment plans based on evidence-based protocols and guidelines
* Use specialized knowledge to conduct drug utilization review for patients with complex conditions or co-morbidities tied to TRC specific patient outcomes.
Consult with other specialist pharmacists, physicians and patients to resolve therapy concerns, including making Gap In Care (GIC) calls and other appropriate interventions
* Represent Express Scripts and the Therapeutic Resource Centers at meetings to educate clients on the TRC process and the value of the TRC's in improving the health of their members and saving costs
* Participate in pilot studies with specialized clinics or with other business partners
* Maintain leading edge knowledge in area of specialization through self-study and continuing education.
Contribute to the specialized knowledge of other pharmacists through participation in journal clubs, leadership of grand rounds and other opportunities as they arise
* Works to continuously improve TRC outcomes including suggesting improvements to processes and systems, approaches to therapy, improved methods of communication and new services that enhance value to the patient, client or physician.
* Performs related duties as assigned
Required:
* Registered pharmacist in the state of practice
* Highly-evolved clinical pharmacy skills and/or clinical knowledge of a specific disease state
* Superior written and verb...
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Type: Permanent Location: Tempe, US-AZ
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:42
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As an Eligibility Representative, you'll be part of a dedicatedteam whichhelps our specialty pharmacy patients coordinate their medication needs and pharmacy insurance coverage for complex medical conditions such as HIV, rheumatoid arthritis, and cancer.
This role handles each inquiry with care, detail, and most importantly, empathy.
Here's a little more on how you'll make a difference:
Responsibilities
* Help patients get the medication they need.Use the knowledge you gain from training, your problem-solving skills and support from your teamto coordinate and ensure services are covered under insurance coverage.
* Interact directly with plan providers.
You'll research and solve issues on benefits coverage with pharmacist and doctors' offices.
* Juggle multiple tasks without sacrificing attention to detail.You will be busy handling multiple requests at any given time as well as documenting information from your conversations in our computer system.
Qualifications
* Previous Customer Service experience
* Health care experience withknowledge ofmedical insuranceand terminology is preferred and will make you successful in this role!
* General PC knowledge includingexperience working withMicrosoft Office
* Excellent communication skills (verbal and written)
Requirements
* High School Diploma / GED required, a bachelor's degree is preferred.
* Must have reliable internet connectivity through a wired internet connection.
(Hot spots or mobile internet are not allowed)
* Must have a private dedicated workspace that is free of distractions.
* Availability to attend 100% of training within the first 90 days of employment.
Why you'll love working here
* Fun, friendly, and unique culture - Bring your whole self to work every day!
* Choice of 3 unique medical plans
* Prescription Drug, Dental, Vision, and Life Insurance
* Employee contributions for HRA and HSA accounts
* 401K with Company Match
* Paid Time Off and Paid Holidays
* Tuition Assistance
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, genet...
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Type: Permanent Location: Memphis, US-TN
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:42
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Pharmacy Account Executive (Non-IC) Advisor - Carolinas Market
Work from Home: Preferably in North or South Carolina
As part of Cigna Pharmacy Management, the Pharmacy Account Management Advisor serves as the primary pharmacy benefits subject matter expert supporting Cigna Pharmacy clients & market segments
The Pharmacy Account Executive position will be responsible for developing and maintaining relationships with internal stakeholders, clients, brokers/consultant by supporting the medical sales teams with the Cigna Pharmacy Management client retention & growth strategies as well provide expertise with implementation, reporting, and day-to-day service functions.
In addition, the Pharmacy Account Management Advisor will be working on complex client accounts with unique custom requirements, custom service guarantees - and partnering with multiple in-house experts (e.g.
consultants and clinicians).
The primary roles of the Pharmacy Account Management Advisor are:
Retain their the assigned book of business Educate & consistently advance the knowledge of pharmacy within the Cigna Medical sales organization Participate in client meetings and presentations to review client performance and to offer and successfully sell in a suite pharmacy management programs and solutions that align to Cigna's overall value proposition of lowering total health cost.
Uncover and promote opportunities to expand the pharmacy earnings contribution to the broader Cigna organization through individual client and medical sales organization initiatives and efforts.
Partner with medical sales, underwriting and others as the pharmacy subject matter expert for pricing, competitive intelligence and pharmacy carve-out defense strategies to retain and grow assigned book of business
Additional Responsibilities:
* Accountable for coordinating core service delivery external messaging working cross functionally with all operational support areas.
* Facilitate service concern resolution meetings with clients and brokers; act as escalated issue contact for pharmacy issues when contacted by the medical sales teams.
* Actively participates in best in finalist meetings for new and existing business where necessary
* Analyze pharmacy utilization in order to provide clients with consultative solutions as well as manage follow-up questions that may arise.
* Develop a clear understanding into clients' needs, goals and objectives.
* Pricing, audit, and contract support to our clients and internal medical partners.
* Translate pharmacy coverage rules based on Cigna policies or with support of a Clinical partner.
* Any other tasks as defined by management and/or client needs not named above as required to support our internal and external clients and partners
Qualifications:
* Bachelor's degree required
* 5 years or more of Pharmacy Benefit Management (PBM) experience supporting client expectations
* Experience with consultative clien...
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Type: Permanent Location: Raleigh, US-NC
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:41
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This role reports into the Sr.
Manager of the Transformation Management Office (TMO) team and will be responsible for leading key projects and programs within the EviCore organization.
The individual in this role will work with a variety of stakeholders to drive success within the EviCore portfolio.
Strong collaboration across Business, IT, and cross-functional teams is required to ensure work is aligned and strategic objectives are met to maximize value and deliver results to customers and clients.
Key Responsibilities
* Manage end-to-end projects and ensure stakeholder engagement throughout project lifecycle
* Successfully assess and analyze the impact of assigned projects/programs to determine organizational readiness
* Develop and maintain appropriate project/program documentation
* Partner with Business, IT and cross-functional partners to ensure requirements and deliverables are created and executed
* Provide leadership to the program/project team and matrix partners to promote effective communication and collaboration
* Effectively and timely report project/program health, including status, risks and key dependencies
* Prepare for and participate in key planning sessions and cross-functional meetings
* Support strategic planning and execution efforts across the EviCore portfolio
* Remain aware of external industry environment to inform organization impacts
* Assist with other initiatives and provide support across the TMO team, as needed
Qualifications:
* High School Diploma required
* Bachelor's degree strongly preferred
* 5+ years of project / program management experience, preferably within a healthcare environment
* PM certification (CAPM, PMP or equivalent Agile certification) required
* Proven ability to work collaboratively in a matrixed environment managing end-to-end project/program deliverables
* Experience facilitating productive meetings with multiple levels of leadership, including senior leaders and frontline staff members
* Strong skills in crafting and delivering clear, concise messages to diverse stakeholder groups
* Ability to balance strategic concerns with day-to-day activities
* Must possess the ability to take initiative and navigate varying levels of ambiguity while effectively delivering results
Key Competencies:
* Strategic Mindset
* Manages Ambiguity
* Drives Results
* Collaborates
* Customer Focus
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 113,600 - 189,300 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 ...
....Read more...
Type: Permanent Location: Franklin, US-TN
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:41
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Location: Remote Opportunity - Must live in Arizona, Ohio, Indiana, Georgia, Pennsylvania, Texas, Oregon, or Virginia.
Summary: Are you passionate about assisting others andready to thrive in a fast-paced, highly structured virtual environment? Join our team at Accredo Specialty Pharmacy, a leading specialty pharmacy serving patients with complex and critical health conditions.
As aCustomer Service Call Center Representative, you'll play a vital role in supporting patients, ensuringtimely access to life-impacting medicationswhile representing Accredo with professionalism and empathy.
This is not a typical customer service role - our work directly impacts patients' health and well-being.
We are looking for individuals who are dedicated, detail-oriented, and committed to making a difference.
Key Responsibilities
* Answer inbound phone calls in ahigh-volume contact centersetting with professionalism and efficiency.
* Support patients with medication orders, benefits explanations, billing inquiries, and complex issue resolution.
* Follow structured workflows andadhere to a scheduled, continuous call-taking environment until designated breaks.
* De-escalate concerns and provide empathetic solutions within standard operating procedures.
* Maintain patient confidentiality and comply with healthcare regulations.
* Meet monthly performance metrics and actively participate in ongoing training and feedback.
Role Expectations
* Attend a paid 9-week virtual training program (on camera) with required participation in live call-taking and assessments.
* Maintain reliable internet and a distraction-free home workspace.
* This is ahighly structuredrole requiring the ability to remain focused and engaged while takingback-to-back calls for the duration of each shift.
* The position involves handlingsensitive health-related issues, not casual customer service requests.
* Ideal candidates will understand theserious natureof the work and the importance ofaccuracy, empathy, and responsibility.
* This is a desk-based role that requires the ability to sit for extended periods and work at a computer screen throughout the entire shift.
Qualifications
* High School Diploma or equivalent required.
* 1+ years of customer service experience.
* Ability to excel in a high-volume call center environment.
* Flexibility with a changing environment of call types, processes, and procedures.
* Strong problem-solving skills with the ability to analyze situations, identify solutions, and take appropriate action in real-time.
* Strong communication skills, both written and verbal.
* Organized with excellent time-management abilities.
* Customer-oriented with the capacity to adapt to various patient perspectives.
* Proficient in Microsoft Office Suite and navigating multiple systems simultaneously.
* Must be available to work within Contact Center hours: Monday through Frid...
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Type: Permanent Location: Grove City, US-OH
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:40
-
Home Infusion Registered Nurse - Accredo
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 ...
....Read more...
Type: Permanent Location: Lima, US-OH
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:40
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Medical Director - Gastroenterology - Evicore by Evernorth - Remote
We have both full-time and part-time opportunities available.
Do you crave an intellectually stimulating job that allows you to leverage your clinical expertise while developing new skills and improving the lives of others? Then look no further! As a Gastroenterology Medical Director at eviCore, part of Evernorth Health Services, a division of The Cigna Group, you'll use your clinical know-how to provide evidence-based medical reviews for patient care.
Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases.
This role offers you the opportunity to build new skills while enhancing the health and vitality of others.
We're seeking a detail-oriented individual with good communication, technology, and typing skills, as well as strong clinical judgment.
Drive growth in your career with our innovative team.
How you'll make a difference:
* You'll start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success.
* Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on eviCore's case management software.
* Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence-based medical necessity and appropriateness of the requested service or treatment.
* Leverage your clinical expertise to recommend alternative services or treatments as necessary.
* Work collaboratively with over 500 eviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making.
What you'll enjoy about working here:
* Benefits start on day one
* Predictable work schedules
* 100% work from home
* 8 Paid Holidays + 23 PTO Days
* 401(K) with company match
* Reimbursement for continuing medical education
* Career growth opportunities across the enterprise
* Networking with peers across multiple medical specialties
Requirements:
* M.D.
or D.O.
with a current, active, U.S.
state medical license and board certified inGastroenterology recognized by the American Board of Medical Specialties, or American Osteopathic Association
* Eligible to acquire additional state licensureas required
* 5 years of relevant clinical experience post residency/fellowship
* Knowledge of applicable state federal laws
* Utilization Review Accreditation Commission and National Committee for Quality Assurance standards is a plus
* Ability to commit to a set, weekly work schedule (Monday through Friday)
* Strong computer skills: ability to work autonomouslywith automated processes, computer applications, and systems
* Meet physical demands of the role including, but not limited to, typing, speaking, and listening 100% of time
* In accordance with our HITECH Security Accredi...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:39
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Position Summary
Provides expert pharmacycontent/professional leadership on complex Sales assignments/projects.
Primary responsibility includes working in conjunction with internal sales and client managers to develop and execute strategy to sell integrated programs in the 0500 Segment.
Develops and implements sales strategies to achieve sales objectives.
Exercises considerable creativity, foresight, and judgment in conceiving, planning, and delivering initiatives.
Uses deep professional knowledge and acumen to advise functional leaders on the value pharmacy brings to the integrated model.
Focuses on providing thought leadership to support integrated sales and additionally works on broader projects, which require understanding of wider business.
Recognized internally as a subject matter expert.
This role is eligible for sales incentive compensation (IC).
Job Responsibilities
* Meets or exceeds annual territory sales goal as measured by new integrated and carve in customersby working with the Cigna Healthcare Sales channel partners
* Demonstrates strong understanding and the ability communicate effectively theuse of Cigna value prop in sales
* Provides consultative subject matter expert information when promoting Cigna pharmacy
* Meets or exceeds monthly, quarterly, annual sales meeting requirements which will demonstrate strong execution of sales processes
* Identifies and develops an in-depth understanding of each sales prospect's needs, goals, objectives, their buying and organizational influences and decision-making processes
* Records and manages all sales activities in SharePoint sites
* Creates and presents territory specific internal strategy documents
* Leads Pharmacy related internal and external sales meetings
* Owns the request-for-proposal (RFP) analysis and management to ensure best practices
* Represents Cigna Pharmacy Management at finalist meetings and in the market
* Remains current on PBM industry trends and competitive knowledge
* Maintains positive working relationships with internal Cigna departments and their team members
* Identification with client managers on identifying and pursuing vetted medical only clients to move to an integrated program
* Partner with brokers, TPA, employer groups, benefit consultants, and state and federal government with plan benefits.
* Holds monthly strategic meetings with client managers on pharmacy best practices
* Work with implementation team to insure a smooth transition
Qualifications
* Bachelor's degree preferred
* 2 plus years in the PBM sector including product and pricing
* Must be located in NY/NJ area
* Sales or direct client management experience
* Strong strategic and analytical skills
* Well-developed relationship management
* Excellent presentation skills to sell their value/competency both internally and externally
* Strong work ethic and a competitive ...
....Read more...
Type: Permanent Location: New York, US-NY
Salary / Rate: Not Specified
Posted: 2025-07-03 08:14:38
