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This is a hybrid position (3 days per week in-office + 2 days' work at home).
The incumbent candidate can be based out of any US Cigna Healthcare office.
This position is a Hybrid role where the Cigna policy requires office alignment but is not restricted to locations that are identified in this posting.
POSITION SUMMARY
The Clinical Business Analyst assists and supports Clinical Program Management with the delivery of clinical products and services to clients.
Under general supervision, performs the primary functions of clinical data analysis, financial modeling, trend evaluation, and participation in project management.
This position develops skill sets necessary for clinical strategy planning, development, consultation, presentation, implementation, and ongoing management of clinical programs and services.
ESSENTIAL FUNCTIONS
* Assist with assigned business division projects.
(e.g., reviews and detects medication utilization and plan design trends, where findings are applied to client-specific clinical strategies and within the scope of utilization management initiatives)
* Supports formulary modeling and plan design analysis, in the context of building experience toward developing clinical strategies and business plans for existing and prospective clients.
* Works with clinical program management staff to successfully plan and implement clinical products and services on behalf of new and existing clients in support of business division work plan goals and objectives
* Works together with Sales/Marketing, Finance/Underwriting, Clinical and other organization departmental staffs in support of business division work plan goals and objectives
* Participates in formal and informal training programs and professional development activities
* Effectively participates in and contributes to staff meetings, committees and departmental work groups
QUALIFICATIONS
* Bachelor's degree in related field or 8 to 11 years of experience.
* 2-5 years relevant experience with Bachelor's Degree or Master's degree and 0-3 years of relevant experience
* Proficiency in Microsoft applications required
* Knowledge of pharmacy laws and regulations
* Proven leadership and ability to build strong team cohesion
* Ability to evaluate current state and analyze possible solutions in business workflow
* Detail oriented with strong organizational skills
* Excellent verbal and written communication skills
* Ability to adapt in a dynamic work environment learns quickly, solve problems and make decisions
* Able to work under pressure and meet tight deadlines
ABOUT THE DEPARTMENT
As a member of the Sales and Account Management team, you're the face of Express Scripts 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 recommendation...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:56
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Cigna is looking for talented people with prior information technology audit experience, who are interested in being a part of Cigna's rapidly evolving digital landscape strategy.This position provides exposure to key Cigna stakeholders, who are an integral part of ongoing technology initiatives, specifically as we leverage our data in new and revolutionary ways to serve our customers.
To achieve best in class service for our stakeholders, Internal Audit supports individual and team development through various trainings, coaching, and internal/external development opportunities.
Additionally, Cigna supports the attainment, and maintenance of, relevant certifications and memberships for ongoing professional growth.
The Digital, Data and Analytics Auditing Senior Advisor works with audit team members, business stakeholders, and IT management to identify internal areas or functions with high risk, and plans for necessary audits in line with Cigna's priorities.
These audits are prescriptive in nature and are strategically aligned to the most impactful initiatives across the enterprise to drive value for our stakeholders and Cigna as a whole.
To achieve that goal, this team conducts complex risk and control reviews around technology and related processes for high impact organizational and functional activities.
The team will report findings to business and IT management, and partner with business stakeholders to facilitate necessary corrective action planning and process improvements.
Additionally, this position includes ownership of the following activities:
* Actively networks and manages critical relationships with our business stakeholders.
* Independently surveys functions and activities in assigned areas under review to determine the nature of operations and the adequacy of the system of control in achieving established objectives.
* Plays a key role in planning the scope of team audits and the overarching audit program.
* Obtains, analyzes, and appraises evidentiary data as a basis for an informed, objective opinion on the adequacy and effectiveness of the system and of internal control.
* Owns the facilitation of oral or written presentations to management throughout each engagement, discusses deficiencies, recommends corrective actions, and suggests best practice improvements.
* Prepares formal written reports expressing opinions on the adequacy and effectiveness of the system of internal control as needed.
* Monitors ongoing remediation of deficient systems or processes and develops updates or modifications to recommendations and findings as needed.
* Drives escalation and management of issues requiring a higher degree of expertise or discretion to resolve and ensure timely resolution.
* Mentors less experienced team members to improve their understanding and skills.
Ensures they are familiar with resource materials including manuals and systems.
* Special projects as assigned.
Qualific...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:55
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The Senior Learning Design Consultant is a key member of the Enterprise Learning & Leadership Development Design team, responsible for designing and delivering impactful learner-centered solutions that support enterprise initiatives.
The role serves as a trusted partner and performance consultant, translating complex business needs into innovative learning experiences that build capability, drive behavior change, and improve performance outcomes.
Key Responsibilities:
* Consult with business leaders and stakeholders to identify strategic priorities, performance gaps, and learning needs, with a focus on enabling workforce readiness and transformation.
* Design and implement engaging outcome-based learning solutions using modern learning methodologies (e.g., microlearning, blended experiences, simulations) that drive skill development and measurable behavior change.
* Facilitate strategic learning engagements, such as learning strategy sessions, design workshops, and pilot programs to gather insights, validate needs, and iterate on learning experience.
* Collaborate cross functionally with internal teams (e.g., inhouse developer, communications, Learning Enablement) and external partners, to co-create learning that is timely, relevant, and aligned with enterprise goals.
* Apply instructional design and adult learning principles to ensure content is clear, actionable, and accessible to diverse healthcare audiences
* Adapt quickly and operate with agility, managing multiple priorities while maintaining quality, speed, and stakeholder alignments.
* Continuously measure learning effectiveness through feedback, data, and performance outcomes; recommend improvements to enhance impact and learner engagement.
* Stay current on trends in learning industry and bring forward innovative ideas to elevate learning solutions.
Qualifications:
* Bachelor's or master's degree in Instructional Design, Learning Science, or related field.
* Minimum of 6 years of experience in learning and development, preferably within healthcare or regulated industry.
* Proven ability to work collaboratively, across cross functional teams and communicate effectively with a variety of audiences.
* Experience leading large-scale learning programs tied to measurable business outcomes.
* Highly organized, self-directed, and flexible in managing multiple projects in a fast-paced environment.
* Proficient in learning design tools (e.g., Articulate 360, Vyond, Adobe Creative Cloud Suite), LMS and LXP platforms, and Microsoft 365.
* Travel required:
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an annual salary of 98,600 - 164,400 USD / yearly, depending on relevant factors, including experience a...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:53
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If you are an RN and looking for a Telephonic role, this opportunity is for you! Read on to learn more.
How you'll make a difference:
Take ownership of patient experience via telephone: Provide telephonic education that includes (but not limited to) disease and drug specific education to both patients and caregivers.
Follow clinical protocols and work within the nursing scope of practice and guidelines while assessing and documenting clinical data and intervention.
Be a coach to empower your patients to be at their best.
Focus on the overall well-being of your patients.
Work with the patient's treating physician to inform them of any new symptoms and health-related matters with an entire network of nurses that you can lean on.
At Accredo, you are a part of an eco-system that will support you and advocate for you.
Grow alongside your peers in a patient-centered environment.
Aid our clinical departments with new hire training and mentoring as well as conduct peer-to-peer quality documentation checks to provide feedback to management.
Full time work from home - you MUST reside in a compact state.
Start Date: Monday, September 8, 2025
Shift for this role: 11:30 am to 8:00 pm CST Monday - Friday
Please note, the first 6 weeks of training will be varied and may start between 8am-11:30am EST depending on the week.
The primary responsibility of this role is to provide telephonic education to patients and caregivers following Clinical Protocols and working within the nursing scope of practice and guidelines.
This opportunity allows you to improve the health and well-being of others, while giving them a sense of security
Minimum Qualifications:
Registered Nurse (RN) compact license required
MUST reside in a compact state
Require at least 2 years of relevant experience with an RN License:
Requirements:
* The RN must have an active unencumbered license in the state that they reside and should have completed the NCLEX or a recognized state board exam.
* The RN will be required to apply for or have a compact license as well as the ability, with no restrictions, to apply for additional single state licenses
* Maintaining all nursing licenses required for this role is a condition of employment, and the failure or inability to do so will result in termination of employment.
* Must have taken Microbiology in order to obtain California licensure
* Knowledge and experience in the areas of Neurology / Multiple sclerosis, Rheumatology, Dermatology, Pulmonology, Gastroenterology, Infectious Disease, Asthma, Oncology, or Pediatrics.
* Proficient in using microsoft applications
* Minimum Internet speed: 5MBPS upload/2 MBPS download - Cable broadband or Fiber Optic.
* Excellent phone etiquette
Your Benefits as an Accredo Telephonic Registered Nurse (RN):
Internal Career Training Resources
Tuition Assistance
Medical, Prescription Drug, Dental, Vision and Life Insurance
401K with Company Match
Paid Time Off and ...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:52
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Are you passionate about working for a company on a mission to make health care more affordable, more personalized and more focused on helping the whole person achieve better health outcomes? Express Scripts is looking for a high-energy, positive individual to join our Regulated Markets team.
The leadership and strategic direction you'll provide will better educate our Medicare clients on the products we offer and give their members' access to health care options that fit their unique needs.
Join us in our mission to change lives.
WHERE YOU'LL WORK
In your role, you will serve as the primary contact for Medicare strategic initiatives and market development.
You will become a subject matter expert (SME) on Medicare Prescription Drug Coverage, Express Scripts Medicare Programs and Products and CMS Regulations.
This client-facing position will collaborate with our health plan account teams and clients to support client needs associated with Medicare regulation, Star Ratings, market and industry strategist perspectives.
You will contribute to product development and offerings by providing industry and client perspective allowing for and assisting with definition and development of future opportunities for the Medicare team.
The ideal candidate will be able to master complex and detailed Medicare rules and regulations in a manner that allows for consultation, idea generation, compliance consulting, and strategic support.
This person needs to have excellent relationship building skills as well as proven presentation and communication skills.
The individual must be capable of thought leadership and strategic consulting with clients.
This is an excellent career opportunity to join a dynamic team and to develop business skills to complement existing skills.
ESSENTIAL FUNCTIONS
* Upsell and renewal-related opportunities for applicable Medicare products.
* Develop selling strategies that help differentiate Express Scripts and Evernorth in the marketplace
* Deliver market message to account teams and clients
* Demonstrate thought leadership
* Championing and Advocating Strategic Initiatives
* Relationship Management
* Client Support
* Executive Presence
* Ability to work in a dynamic business environment
QUALIFICATIONS
* Bachelor's degree in related field (or equivalent work experience) 5+ years of relevant experience (or 4+ years of relevant experience with a Master's degree)
* Strong knowledge of the PBM industryand Government Regulated Programs such as Medicare, Medicaid, HCR
* Strong communication skills, including presentations and documentation
* Advanced problem solving skills with the ability to work cross-functionally to resolve issues and generate results among potentially conflicting constituencies
* Demonstrated ability toresearch, analyze, handle multiple projectsand clientsat once and prioritize to meet deadlines required
* Ability to work towards specific deli...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:51
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A great opportunity to help military members and their families!
This position is responsible for providing confidential behavioral health consultations and 1-12 fifty minute sessions of non-medical counseling (EAP) to members of the military and their family.
Non-medical counseling is focused on a specific issue or concern and includes developing strategies and solutions, building on the participant's strengths, accessing support systems, and utilizing community resources.
Sessions are provided telephonically, via video or secure chat and are intended to be solution focused and short-term.
Non-medical Counseling topics are varied but often include the following issues:
* Stress
* Transition/Relocation
* Grief and loss
* Employment issues
* Marital/couple conflict or communication
* Parent-Child Relational Problems
* Academic or Educational problems
* Problems related to Primary Support
The successful candidate will have demonstrated excellence with solution focused therapy with a passion to deliver a service experience that exceeds the participant's expectation.
The team works in a fast-paced environment, on a queue, taking non-medical counseling calls in the moment, as well as through scheduled appointments.
The team is staffed 24/7 in support of the schedules of miliary members around the world.
This role offers a great salary with an excellent benefits package that starts your first day of employment including a continuing education program with funding and extra leave time.
Duties and Responsibilities:
* Provide participants with confidential, non-medical counseling services
* Assess the participant's immediate risk and biopsychosocial needs
* Provide appropriate referrals for resources and treatment
* Use clinical expertise, professional judgment and best practices
* Execute duty to warn/mandated reporting processes
* Partner with peers and leaders promoting and embracing a culture of change; supporting all parties through the change process
* Demonstrate the ability to be agile and flexible in work process.
* Deliver excellent clinical judgment and interpersonal communication skills
* Understand confidentiality and privacy regulations
* Demonstrate excellent verbal and written communication
* Display knowledge and understanding of the military lifestyle and culture while maintaining the highest degree of sensitivity, compassion and respect for Service Members and their families.
Qualifications:
* Must be a U.S.
Citizen
* Master's degree or PhD from an accredited graduate program in a mental health related field such as social work, psychology, marriage/family therapy, or counseling
* Current, valid, unrestricted counseling license/certification from a State, D.C., a U.S.
Commonwealth, or a U.S.
Territory that grants the authority to provide counseling services as an independent practitioner in their respective fields.
Multi...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:49
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tbd
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an hourly rate of 17.98 - 26 USD / hourly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure.
That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health.
Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
For more details on our employee benefits programs, visit Life at Cigna Group .
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality.
We relentlessly innovate to make the prediction, 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 Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible.
Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment.
These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:47
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Do you crave an intellectually stimulating job that allows you to leverage your clinical expertise while developing new skills and improving the lives of others? Then look no further! As a Pediatric Otolaryngology Medical Director at EviCore, part of Evernorth Health Services, a division of The Cigna Group, you'll use your clinical know-how to provide evidence-based medical reviews for patient care.
Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases.
This role offers you the opportunity to build new skills while enhancing the health and vitality of others.
We're seeking a detail-oriented individual with good communication, technology, and typing skills, as well as strong clinical judgment.
Drive growth in your career with our innovative team.
How you'll make a difference:
* You'll start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success.
* Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on EviCore's case management software.
* Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence-based medical necessity and appropriateness of the requested service or treatment.
* Leverage your clinical expertise to recommend alternative services or treatments as necessary.
* Work collaboratively with over 500 EviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making.
What you'll enjoy about working here:
* Benefits start on day one
* Predictable work schedules
* 100% work from home
* 8 Paid Holidays + 23 PTO Days
* 401(K) with company match
* Reimbursement for continuing medical education
* Career growth opportunities across the enterprise
* Networking with peers across multiple medical specialties
Requirements:
* M.D.
or D.O.
with a current, active, U.S.
state medical license and board certified in Pediatric Otolaryngology recognized by the American Board of Medical Specialties, or American Osteopathic Association
* Eligible to acquire additional state licensureas required
* Prefer one of the following state medical licenses but is not required: DC, MD or VA
* 3 years of relevant clinical experience post residency/fellowship
* Knowledge of applicable state federal laws
* Utilization Review Accreditation Commission and National Committee for Quality Assurance standards is a plus
* Ability to commit to a set, weekly work schedule (Monday through Friday)
* Strong computer skills: ability to work autonomouslywith automated processes, computer applications, and systems
* Meet physical demands of the role including, but not limited to, typing, speaking, and listening 100% of time
* In accordance with our HITECH Security Accreditation, company provide...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:46
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Do you crave an intellectually stimulating job that allows you to leverage your clinical expertise while developing new skills and improving the lives of others? Then look no further! As a Colon & Rectal Surgery Medical Director at EviCore, part of Evernorth Health Services, a division of The Cigna Group, you'll use your clinical know-how to provide evidence-based medical reviews for patient care.
Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases.
This role offers you the opportunity to build new skills while enhancing the health and vitality of others.
We're seeking a detail-oriented individual with good communication, technology, and typing skills, as well as strong clinical judgment.
Drive growth in your career with our innovative team.
How you'll make a difference:
* You'll start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success.
* Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on EviCore's case management software.
* Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence-based medical necessity and appropriateness of the requested service or treatment.
* Leverage your clinical expertise to recommend alternative services or treatments as necessary.
* Work collaboratively with over 500 EviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making.
What you'll enjoy about working here:
* Benefits start on day one
* Predictable work schedules
* 100% work from home
* 8 Paid Holidays + 23 PTO Days
* 401(K) with company match
* Reimbursement for continuing medical education
* Career growth opportunities across the enterprise
* Networking with peers across multiple medical specialties
Requirements:
* M.D.
or D.O.
with a current, active, U.S.
state medical license and board certified in Colon & Rectal Surgery , recognized by the American Board of Medical Specialties, or American Osteopathic Association
* Eligible to acquire additional state licensureas required
* 3 years of relevant clinical experience post residency/fellowship
* Knowledge of applicable state federal laws
* Utilization Review Accreditation Commission and National Committee for Quality Assurance standards is a plus
* Ability to commit to a set, weekly work schedule (Monday through Friday)
* Strong computer skills: ability to work autonomouslywith automated processes, computer applications, and systems
* Meet physical demands of the role including, but not limited to, typing, speaking, and listening 100% of time
* In accordance with our HITECH Security Accreditation, company provided encrypted-workstation is required to be hard-wire connected to a modem or router.
Wireless c...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:45
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Role Summary
Responsible for implementing the Go To Market Pharmacy Pricing Strategy through account level rate development and conducting customer negotiations with Sales on intermediate complexity book of business.
Develops strategic recommendations related to market competition and pricing.
Acts as financial consultant on case-specific issues.
Influences underwriting best practice and provides input to matrix partners on product development and pricing.
Responsibilities
* Manages an assigned book of business, focused on attaining profitable growth, persistency, and earnings.
* Performs case-specific risk assessments.
* Responsible for account level rate development and conducting customer negotiations with Sales on an intermediate complexity book of business.
* Develops and monitors account plans to achieve growth and profitability.
* Develops strategic recommendations related to market competition, products and pricing.
* Influences underwriting best practice and provides input to matrix partners on product development and pricing.
Minimum Qualifications:
* 5+ years of pharmacy underwriting experience preferred or related experience
* 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 solving skills
* Ability to manage complex cases and thrive in an ever-changing market segment.
* Excellent decision making and negotiation skills
* Excellent verbal and written communication skills
* Passion and dedication to become a leader in the health service industry
* Innovative thinking, customer-centricity and analytical problem-solving skills
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 86,700 - 144,500 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, 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 c...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:44
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Home Infusion Registered Nurse - Accredo
The primary territory for this position is the region northeast of Atlanta, but travel could be up to 2 hours.
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.
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 disea...
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Type: Permanent Location: Atlanta, US-GA
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:42
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Position Summary:
US Employer is committed to delivering strong growth and financial contributions to Cigna's bottom line.
We are looking for a technically strong, financially minded individual to oversee and continuously enhance the US Employer quarterly projection process.
The results of this process support the quarterly BFO package and monthly MBR package, and drive business decisions to achieve our growth goals.
The role partners with US Employer Accounting, Segment BFOs, Product BFOs, Specialty Finance leads, Enterprise FP&A, and the Hyperion IT team.
In addition, this role will prepare and maintain the Capital Plan process for Cigna Healthcare.
This is an exciting opportunity that provides great exposure across US Employer, and an opportunity to work with Finance, Accounting and business leadership.
Responsibilities:
* Consolidate US Employer's projection and actual results within Hyperion, ensuring accuracy and reconciliation by product.
* Serve as the primary finance partner for Hyperion support during quarterly projections, assisting finance partners on input or system related issues.
* Support development of monthly and quarterly reporting packages, including BFO and MBR packages, supplemental exhibits and segment BFO scorecards for senior leadership.
* Support identification of key drivers of variances across product projections and ensure narrative is consistent with projection.
* Understand US Employer business fundamentals to be able to review and challenge projections to ensure forecasts are 'closest to the pin'.
* Collaborate with Accounting, Product Finance and segment BFOs to inform earnings forecasts for US Employer.
* Partner with FP&A counterparts in other Cigna Healthcare platforms to support timely delivery of key deliverables and ensure alignment.
* Identify and implement changes to processes or models to improve efficiency and provide enhanced insights.
* Lead the Capital Plan process through effective partnership with key stakeholders and analysis of legal entity results and projections.
Ensure that the capital requirements are met for the HMOs including preparing dividends, infusions and state requests.
* Support ad-hoc financial and accounting requests and key projects for senior leadership.
Requirements:
* Bachelor's degree in Finance, Accounting or related field
* Minimum of 5 years' experience in financial analysis, financial modeling, accounting or related
* Experience working with financial database reporting systems, with a strong preference for Hyperion
* Strong organizational skills with ability to track changes, manage version control and ensure financial data reconciles
* Ability to manage projections and deliver accurate and time sensitive results
* Strong financial background with ability to analyze and interpret complex financial data
* Comfortable working in a matrix environment with diverse objectives
* Techn...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:40
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The Genetic Counselor is responsible for the following:
* Laboratory molecular and genetic testing clinical case review activities.
* Evaluate telephone, fax, or web requests for authorization of coverage of molecular and genetic laboratory requests from physician offices; comparing requests against established clinical protocols; and authorizing coverage of services or referring requests for expert clinical review as appropriate.
* Be available as an expert advisor for physicians and labs on the appropriate use of genetic testing, including new and cutting-edge tests entering the market.
Minimum Education, Licensure and Professional Certification Requirement :
* Master's degree in genetic counseling.
* Board certified American Board of Genetic Counseling or American Board of Medical Genetics.
* Licensure (if available) in state of residence.
Minimum Experience required:
* 2+ years of experience as a Genetic Counselor.
* Experience with computer data entry, customer service, and managed care beneficial.
Required Skills:
* Strong interpersonal skills with the ability to clearly explain complex medical information in both verbal and written form.
* Ability to work independently, be flexible and adaptable.
* Comfort and familiarity with pediatric, adult, and perinatal genetics and related genetic tests.
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 71,100 - 118,500 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, balanced, and feel secure.
That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health.
Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
For more details on our employee benefits programs, visit Life at Cigna Group .
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality.
We relentlessly innovate to make the prediction, 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 o...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:39
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POSITION SUMMARY
The Warehouse Associate-Receiving is responsible for performing tasks related to receiving product, stocking and replenishment, and inventory control.
This includes safely unloading trucks and unpacking received product, comparing the purchase order to the product received for accuracy, counting quantities of product received and ensuring the quality of the product is at an acceptable level, and removing damaged or non-conforming product using data entry and retrieval devices to record receipt transaction (using scanners and computer input).
In addition, this position safely transfers material from receiving area to warehouse or dispensing locations and ensures proper stock rotation-utilizing PDAs to update the inventory system.
The Warehouse Assistant also audits shelf counts for accuracy, reviews inventory for short-dated and expired product, and reports discrepancies to the supervisor.
SHIFT
Monday - Friday, 8AM - 4:30PM
ESSENTIAL FUNCTIONS
* Safely unpack and evaluate incoming product for correct count and condition in comparison to purchase orders
* Safe operation of material handling equipment and hand tools such as forklifts, pallet jacks (manual and electric), carts, dollies, box cutters, wire cutters, etc.-to unload trucks and stock the warehouse/pharmacy
* Accurate data entry and retrieval using computers, and scanners (PDA)
* Bin and shelf inventory maintenance and stock rotation-including shelf counts, short shelf life and expired product audits
* Communicate discrepancies or issues as they are occur to the appropriate personnel
* Maintain organization and cleanliness of assigned work stations and areas
* Other duties as assigned
QUALIFICATIONS
* High School degree or equivalent is required
* Warehouse experience preferred
* Ability to accurately compare two sets of data
* Basic math, organization, computer, and communication skills
* Ability to do repetitive bending, squatting, standing, walking, pushing, pulling and hand motions
* Ability to walk/stand for full shift
* Willingness to work a flexible schedule to accommodate heavy work volumes
* Ability to read and differentiate small print
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an hourly rate of 17.75 - 24 USD / hourly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want 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...
....Read more...
Type: Permanent Location: Grove City, US-OH
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:38
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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.
For this position, we anticipate offering an hourly rate of 40 - 67 USD / hourly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure.
That's why you'll enjoy a comprehensive range of benefits, with a focus on suppor...
....Read more...
Type: Permanent Location: Oceanside, US-CA
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:37
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The job profile for this position is Application Development Advisor, which is a Band 4 Contributor Career Track Role with Cigna-Evernorth Services Inc.
Responsibilities-
* Develop software applications within AAPS (Affordability & Accuracy Pre/Post Pay Solutions) to support payment integrity programs, produce accurate claim payments, and reduce medical cost expenditures.
* Contribute to software development, strategy, and product roadmap.
* Use system development life cycle methodologies, including Scaled Agile Framework SAFe.
Assist with the re-writing of end-to-end (E2E) vendor programs and the Coordination of Benefits tracking applications.
* Utilize E2E vendor programs to enhance automation and eliminate maintenance.
* Enable direct connectivity and leverage new claims workflow.
* Re-write .net applications to track coordination of benefits.
* Manage vendor feeds and track claims identified by post-payment vendors.
* Validate for incorrect payments.
* Identify, suggest, research, and evaluate alternative solutions to recommend and implement best practices, as well as efficient and cost-effective solutions.
* Design, develop, and implement processes to achieve objectives, and assist with the design, development, and maintenance of business tools.
* Perform technical documentation and test support, coordinate with internal and external resources, analyze issues, and work with matrix partners to determine opportunities and implement solutions.
* Bring external applications in-house when needed.
* Hybrid work schedule.
Qualifications-
Position requires a bachelor's degree or foreign equivalent in Computer Science, Electronics and Communication Engineering, or related plus four years of experience in software development.
Experience must include .Net Framework, C#, ASP.NET MVC, TFS, Oracle, SQL, and SQL Developer.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives.
At The Cigna Group, we're dedicated to improving the health and vitality of those we serve.
Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients.
Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protect...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:35
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*$10,000 Sign-on Bonus for external hires
*
The shift for this position is Monday-Friday 1:00pm-9:30pm.
Portions of this shift are eligible for a shift differential.
POSITION SUMMARY
Accredo Specialty Pharmacy, part of Evernorth Health Services , is seeking full-time staff pharmacists to join their team in Whitestown, IN.
As a Staff Pharmacist at Accredo,youwill be responsible for verifying and dispensing medications in compliance with corporate and regulatory guidelines.Youwill track order status and may also be involved in training less experienced pharmacists.
This role requires product verification and a flexible approach to your work.
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:
* Provide oversight and quality assurance to pharmacy technicians.
* Interpret physicians' or prescribers' prescriptions.
* Verify and confirm validity of controlled substances.
* Verify prescription information entered in the system by data entry or order entry.
* Back up other pharmacists as needed, perform additional duties as assigned by management, or train less experienced pharmacists.
Requirements:
* Current resident pharmacist license in good standing.
* Minimum of 1 year of experience preferred; however, newly licensed graduates are encouraged to apply.
* Advanced problem solving skills and the ability to work collaboratively with other departments to resolve issues.
* Good oral and written communication skills.
* Ability to read and interpret prescriptions.
* Strong focus on customer service, quality and accuracy.
* Ability to manage timelines and meet tight client deadlines.
* Ability to adapt in a changing environment.
* Ability to work a flexible schedule for peak volume times.
This position is work site dependent and can only be performed onsite at our Whitestown, IN location.
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 exp...
....Read more...
Type: Permanent Location: Whitestown, US-IN
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:34
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Evernorth Behavioral Health
Job Description Case Management Lead Analyst (Licensed Telephonic Counselor)
JOB TITLE: Case Management Lead Analyst (Licensed Telephonic Counselor)
JOB BAND: 3
DEPARTMENT: Clinical Operations-Clinical
UNIT/SECTION: 24/7 Military OneSource, Non-medical Counseling
REPORTS TO: Non-medical Counseling Manager (Supervisor)
ROLE SUMMARY:
A great opportunity to help military members and their families!
This position is responsible for providing confidential behavioral health consultations and 1-12 fifty minute sessions of non-medical counseling (EAP) to members of the military and their family.
Non-medical counseling is focused on a specific issue or concern and includes developing strategies and solutions, building on the participant's strengths, accessing support systems, and utilizing community resources.
Sessions are provided telephonically, via video or secure chat and are intended to be solution focused and short-term.
Non-medical Counseling topics are varied but often include the following issues:
* Stress
* Transition/Relocation
* Grief and loss
* Employment issues
* Marital/couple conflict or communication
* Parent-Child Relational Problems
* Academic or Educational problems
* Problems related to Primary Support
The successful candidate will have demonstrated excellence with solution focused therapy with a passion to deliver a service experience that exceeds the participant's expectation.
The team works in a fast-paced environment, on a queue, taking non-medical counseling calls in the moment, as well as through scheduled appointments.
The team is staffed 24/7 in support of the schedules of miliary members around the world.
This role offers a great salary with an excellent benefits package that starts your first day of employment including a continuing education program with funding and extra leave time.
Duties and Responsibilities:
* Provide participants with confidential, non-medical counseling services
* Assess the participant's immediate risk and biopsychosocial needs
* Provide appropriate referrals for resources and treatment
* Use clinical expertise, professional judgment and best practices
* Execute duty to warn/mandated reporting processes
* Partner with peers and leaders promoting and embracing a culture of change; supporting all parties through the change process
* Demonstrate the ability to be agile and flexible in work process.
* Deliver excellent clinical judgment and interpersonal communication skills
* Understand confidentiality and privacy regulations
* Demonstrate excellent verbal and written communication
* Display knowledge and understanding of the military lifestyle and culture while maintaining the highest degree of sensitivity, compassion and respect for Service Members and their families.
Qualifications:
* Must be a U.S.
Citizen
* Master's degree or PhD from an accredited gra...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:33
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OVERVIEW
The Category Management and Strategic Sourcing Senior Advisor is a sourcing professional accountable for some of the following categories:Corporate Services, Legal Services, and Human Resource Services.
The Category Management & Strategic Sourcing Senior Advisor is a category manager, sourcing professional, senior negotiator, and project manager accountable for end-to-end sourcing and contracting for assigned internal clients across Cigna as it relates to the procurement of various categories used by The Cigna Group businesses globally.
This includes owning a Sub-Category(s) for the Category Management & Strategic Sourcing Organization and driving sourcing strategies across the global organization for the assigned sub-category.
The Senior Advisor will lead sourcing and negotiation projects of varying sizes including highly complex competitive bids and direct negotiations in multi-year agreements with suppliers.
This resource must have experience in dealing with dynamic requirements that are tied to strategic level business and procurement objectives.
The Senior Advisor must have experience building relationships, communicating effectively, and effectively supporting both their internal customers and procurement objectives.
MAJOR OBJECTIVES
* Develop and execute sourcing strategy and category plans for assigned sourcing subcategories in conjunction with Procurement Third Party Management peers
* Drive cost savings through negotiations, competitive bids and execution of sourcing strategies
* Mentor 2-3 resources supporting assigned subcategories
* Resolve issues and handle external and internal escalations
* Coordinate involvement of internal stakeholders in all stages of the sourcing process
* Identify, evaluate, and implement the use of diverse suppliers
Requirements:
* Minimum of five years' experience in strategic sourcing and/or category management
* Thorough understanding and experience sourcing some or all the categories listed above
* Bachelor's Degree, strongly preferred
Sourcing and Negotiation:
* Structured problem solving, critical thinking, and decision-making skills
* Excellent sourcing strategy and negotiation skills
* Proven ability to lead a diverse negotiation team
* Highly collaborative and collaborates with appropriate experts to solve problems
* Makes decisions and takes action to solve a problem for a team or a unit in the organization
* Proven ability to work well in a dynamic, fast paced, and rapidly changing environment
* Articulates potential solution(s) effectively to key executives
* Excellent project management skills
* Proven ability to plan and manage large and complex projects
* Driven to meet or exceed business and financial milestones
* Proven ability to apply fact-based negotiation principles and tactics
* Proven ability to provide fact-based advice to decision makers and oversee development...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:31
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Business Development Principal - Hybrid
This Accredo Business Development Principal is responsible for building and maintaining key strategic relationships within their respective client portfolio inclusive of Specialty Pharma Manufacturers.
This position has ownership of the contract, development and execution of short- and long-term account strategy, retention and achieving business unit strategic goals within their respective manufacturer portfolio.The Director is required to be a subject matter expert of their Pharma contracts and have a solid understanding of Specialty services to successfully identify program improvement, up sell and strategic expansion opportunities.
This includes renegotiating contracts as needed.
The Director serves as an escalation point for the client, as well as collaborates with the Specialty Product Team, Specialty Operations and other internal stakeholders to resolve issues and achieve strategic client specific opportunities.
Responsibilities
* SME for full book of clients, clients' pipeline, and value opportunities
* Collaborates across the enterprise to ensure appropriate client support, performance, and focus on core initiatives that drive value and enhance performance to position Accredo as the top SP
* Builds and maintains strategic relationships with book of clients
* Leads strategic quarterly business reviews and incorporates key initiatives and feedback to grow partnership with clients
* Owns contracting, renegotiation, program improvements, and year over year value creation
* Develops and executes account strategies focused on driving value and maintaining a positive relationship with clients
* Able to prioritize and direct focus to strategic initiatives and opportunities
* Primary point of contact for clients internally and externally
* Mentors Sr.
Advisor employees
* Oversees resolution of client issues
* Effectively collaborates internally and externally to achieve results
* Showcases effectiveness of client spend; highlighting connection of spend to value
Qualifications
* Bachelor's degree, or equivalent work experience.
* 10-14 years relevant experience with Bachelor's degree, 8-12 years relevant experience with Masters.
* Strong project management skills.
Superior written and verbal communication and presentation skills.
* PC skills including Microsoft Word, Excel, and PowerPoint.
* Working knowledge of financials with ability to assess product and program metrics and financials.
* Negotiation and leadership skills are essential.
* Superior analytical and problem-solving skills.
* Excellent organization skills.
* Experience leading client meetings.
* Demonstrated experience negotiating and managing contracts with utmost integrity.
* Demonstrated ability to understand the broader market segment/product lifecycle and use that information to drive strategic planning.
* Knowledge ...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:28
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The Warehouse Associate Representative is responsible for performing tasks related to receiving products, stocking and replenishment, and inventory control.
This includes safely unloading trucks and unpacking received product, comparing the purchase order to the product received for accuracy, counting quantities of product received and ensuring the quality of the product is at an acceptable level, and removing damaged or non-conforming product using data entry and retrieval devices to record receipt transaction.
What you'll do:
* Unpack safely and evaluate incoming products for correct count and condition in comparison to purchase orders
* Operate material handling equipment and hand tools such as forklifts, pallet jacks (manual and electric), carts, dollies, box cutters, wire cutters, etc.
Safely to unload trucks and stock the warehouse/pharmacy
* Transfer material safely from the receiving area to warehouse or dispensing locations and ensure proper stock rotation-utilizing PDAs to update the inventory system
* Enter data accurately and retrieve using computers, and scanners (PDA)
* Bin and shelf inventory maintenance and stock rotation-including shelf counts, short shelf life and expired product audits
* Communicate discrepancies or issues as they occur to the appropriate personnel
* Maintain organization and cleanliness of assigned workstations and areas
* Basic Computer knowledge, Microsoft Office: Excel, WORD, Outlook, Share Drive
* Other duties as assigned.
What you need to do the job:
* 1 + years of relevant work experience
* Ability to accurately compare two sets of data.
* Basic math, organization, computer, and communication skills
* Ability to do repetitive bending, squatting, standing, walking, pushing, pulling and hand motions.
* Willingness to work a flexible schedule to accommodate heavy work volumes.
* Ability to walk/stand for full shift
* Bend, stoop, and lift up to 50 lbs
* Ability to read and differentiate small print
* Should have a strong background in warehouse clerical work.
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, n...
....Read more...
Type: Permanent Location: New Castle, US-DE
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:27
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Job Summary:
Responsible for coordination and implementation of daily processes related to IFP Risk Adjustment (RA) programs, including the Risk Adjustment Data Validation (RADV) audit and the Supplement Diagnosis program.
Responsible for liaising with the Initial Validation Audit Entity to ensure compliant, efficient, and successful audit processes, including but not limited to file reconciliation and appeals processes.
Responsible for coordinating with Quality Mgmt to effectively and compliantly execute daily RA program operations, as identified.
Participates in coding reviews of medical documentation for RA programs, as needed.
Responsible for communication and reporting of daily productivity and risks associated with IFP RADV audits and other RA programs, as needed, and collaborates with internal educational team to develop necessary curriculum to ensure compliance and program excellence.
Contributes to Cigna IFP Coding Guideline updates and policy determinations, and liaises with Matrix Partners, as required, to develop and promote shared goals.
The Quality Review and Audit Senior Analyst position recognizes experience in Risk Adjustment Data Validation audits (RADV), Risk Adjustment operations, Risk Adjustment medical record and diagnosis coding excellence, implementation of Quality Improvement processes, and the ability to communicate experience and knowledge to peers, colleagues, and Matrix Partners.
Core Responsibilities:
* Oversight and coordination of daily operations for IFP Risk Adjustment Data Validation (RADV) audits,
* Support of Supplemental Diagnosis programs, as required
* Demonstrates comprehensive understanding and proficiency with the Complete Official Code Set, Coding Clinic, and CMS guidelines for IFP code abstraction and medical record compliance
* Demonstrates comprehensive understanding of RADV Protocols and Compliance Requirements for RA programs, including EDGE Server Business Rules, where applicable
* Demonstrates ability to coordinate with external partners to execute efficient and compliant programs
* Demonstrates ability to identify risks or program gaps and communicate effectively to management in a timely manner
* Demonstrates ability to report productivity, progress, and risks to leadership on a timely basis
* Develops and implements internal program processes, as required
* Coordinates with Quality Mgmt to determine priorities and demonstrates ability to prioritize projects to meet deadlines, as determined
* Demonstrates the ability to remain current on Federal regulations related to diagnosis coding and the HHS Risk Adjustment program, including audit protocols
* Demonstrates effective communication skills with peers and matrix partners to ensure Continuous Quality Improvement and ensure compliance with all CMS guidelines and regulations
* Engages in Continuous Quality Improvement (CQI) of IFP programs, as applicable
* Demonstrates ability...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:26
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Do you crave an intellectually stimulating job that allows you to leverage your clinical expertise while developing new skills and improving the lives of others? Then look no further! As a Pediatric Cardiology Medical Director at EviCore, part of Evernorth Health Services, a division of The Cigna Group, you'll use your clinical know-how to provide evidence-based medical reviews for patient care.
Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases.
This role offers you the opportunity to build new skills while enhancing the health and vitality of others.
We're seeking a detail-oriented individual with good communication, technology, and typing skills, as well as strong clinical judgment.
Drive growth in your career with our innovative team.
How you'll make a difference:
* You'll start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success.
* Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on EviCore's case management software.
* Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence-based medical necessity and appropriateness of the requested service or treatment.
* Leverage your clinical expertise to recommend alternative services or treatments as necessary.
* Work collaboratively with over 500 EviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making.
What you'll enjoy about working here:
* Benefits start on day one
* Predictable work schedules
* 100% work from home
* 8 Paid Holidays + 23 PTO Days
* 401(K) with company match
* Reimbursement for continuing medical education
* Career growth opportunities across the enterprise
* Networking with peers across multiple medical specialties
Requirements:
* M.D.
or D.O.
with a current, active, U.S.
state medical license and board certified in Pediatric Cardiology , recognized by the American Board of Medical Specialties, or American Osteopathic Association
* Eligible to acquire additional state licensureas required
* Prefer one of the following state medical licenses but is not required: DC, MD or VA
* 3 years of relevant clinical experience post residency/fellowship
* Knowledge of applicable state federal laws
* Utilization Review Accreditation Commission and National Committee for Quality Assurance standards is a plus
* Ability to commit to a set, weekly work schedule (Monday through Friday)
* Strong computer skills: ability to work autonomouslywith automated processes, computer applications, and systems
* Meet physical demands of the role including, but not limited to, typing, speaking, and listening 100% of time
* In accordance with our HITECH Security Accreditation, company provided encr...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:25
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Launch Your HR Career with Purpose: HRLDP Full-Time Associate at The Cigna Group
Are you ready to shape the future of work while growing into a bold, strategic HR leader? The Cigna Group'sHuman Resources Leadership Development Program (HRLDP)is your launchpad to a dynamic, purpose-driven career in Human Resources.
This full-time program is designed for high-potential talent who are passionate about people, eager to lead, and ready to make a real impact.
Through a series ofthree immersive rotations(each lasting approximately 12 months), you'll gain hands-on experience across key areas of HR-from Centers of Expertise (COEs) to HR Business Partner roles-building the skills and perspective needed to thrive in a fast-changing, global business.
What Makes HRLDP Different?
We don't just develop HR professionals-we developfuture leaders.
Here's how:
* Diverse Rotational Experiences: Explore the full spectrum of HR through COE roles in talent management, total rewards, employee relations, and more, as well as the opportunity to rotate through an HRBP role.
* Leadership Development: Dive into a curriculum grounded in real-world leadership challenges, best practices, and cutting-edge research.
* Enterprise Learning: Gain a deep understanding of our business, customers, and culture through enterprise-wide learning and relationship-building opportunities.
By the end of the program, you'll be ready to lead teams and drive initiatives that support our mission to improve the health and vitality of those we serve.
What You'll Do:
* Step into a full-time HR role that aligns with your strengths, interests, and our business needs.
* Build relationships with senior HR and enterprise leaders through mentorship, networking, and targeted development experiences.
* Collaborate with peers across the organization in a supportive, high-energy community.
* Work in one of our key locations:Bloomfield, CT,Philadelphia, PA, orSt.
Louis, MO(hybrid schedule: 3 days in-office, 2 flexible).
What We're Looking For:
* Successful completion of the HRLDP Summer Associate Program is required.
* Currently pursuing aMaster's in Human Resourcesor anMBA with an HR concentration.
* 1-3 years of relevant professional experience (HR experience preferred).
* Proven leadership potential with the ability to influence, collaborate, and drive results.
* Strong analytical, strategic thinking, and problem-solving skills.
* Excellent communication skills-confident, clear, and courageous.
* A curious mindset, a passion for innovation, and the agility to thrive in a matrixed 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.
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives.
At The...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:24
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Case managers are healthcare professionals, who serve as customer advocates to coordinate, support, and guide care for our customers, families, and caregivers to assist with navigating through the healthcare journey.
Additionally, the candidate will be responsible for the adoption and demonstration of the Care Solutions cultural beliefs.
They will be responsible for role modeling the six cultural beliefs to drive personal accountability and organizational results.
* Customer Strong: I deliver world-class experiences for all my customers.
* Me to We: I take accountability to trust, partner, and deliver.
* Own It: I see a need and deliver value because I care.
* Evolve and Adapt: I learn and adapt to meet evolving business needs.
* Be Bold: I pioneer and think broadly to solve challenges.
* Take Care: I prioritize self-care and act with compassion toward colleague.
Day in the Life Responsibilities
* Collaborates with customer in creation of care plan and documents plan in medical management system.
* Partners with each customer to establish goals and interventions to meet the customer's needs.
* Establishes plan of care in conjunction with the customer and provider then document into a medical management system.
* Utilizes motivational interviewing, behavior change, and shared decision making to help customers achieve optimal health and well-being.
* Empowers customers with skills to enhance interaction with their providers.
* Interfaces with the customer, family members/caregivers, providers, and internal partners to coordinate the needs of the customer through telephonic, email, text, and chat interactions.
* Collaborates with nutritionist, pharmacist, behavioral clinician, Medical Director and customer's provider and other Cigna Medical Management programs to provide whole-person health support.
* Tracks daily activities to trend volume and outcomes.
* Follows standard operating procedures.
* Toggles between multiple systems and applications.
* Research relevant topics in health promotion and disease prevention, as required for specific customers.
* Prioritizes work to meet commitments aligned with organizational goals.
* Understands and adheres to Case Management performance measures to deliver on key results.
* Completes training within the communicated time limit as required per role.
* Demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate.
Minimum requirements:
Active unrestricted Registered Nurse (RN) license in state or territory of the United States.
Minimum of two years full-time direct patient care as an RN required.
Preferred requirements:
* Complex Case Management experience preferred.
* Must have an active and unencumbered RN License
* Within four (4) years of hire as a case manager will possess a URAC-recognized certification in case management.
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-07-31 09:36:22
