-
This position will be responsible for providing legal advice on a variety of topics related to pharmacy networks.
The qualified candidate must be able to develop a detailed and strategic understanding of the PBM business model and the various state and federal laws impacting pharmacy networks and network management.
The position requires an understanding of the health care industry as well as the interpersonal skills necessary to understand and manage complexity, influence business colleagues, foster collaboration and drive results in a fast-paced environment.
Responsibilities:
* Draft, review and negotiate pharmacy provider agreements.
* Provide day-to-day legal support relating to the pharmacy network management.
* Research and provide interpretative and practical advice regarding a variety of state and federal laws impacting pharmacy networks.
* Effectively collaborate with internal partners to advise and respond to a variety of legal issues impacting the pharmacy network.
* Develop strong business relationships with stakeholders involved with the Company's pharmacy network operations.
Qualifications:
* J.D.
from accredited law school/Bar membership required
* At least 5 years corporate legal department or law firm experience
* Broad knowledge of the health care and health services industry needed; knowledge of HIPAA and health care fraud, waste and abuse laws needed.
* Experience in regulatory is preferred
* Experience with provider networks is a plus
* Strong analytical, written and oral communication skills, including negotiation skills
* Demonstrated strong interpersonal skills to develop and manage relationships and collaborate effectively
* Ability to identify issues and propose actionable legal and business solutions
* Strong work ethic with effective time-management skills and ability to manage competing priorities
* Demonstrated good judgment and attention to detail
* Ability and desire to learn new subject areas and willingness to take on new responsibilities
* Open to remote for the right candidate or hybrid.
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 132,700 - 221,100 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure.
That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health.
Starting on 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 matc...
....Read more...
Type: Permanent Location: Philadelphia, US-PA
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:47
-
The job profile for this position is Software Engineering Senior Manager, which is a Band 4 Contributor Career Track Role with Cigna-Evernorth Services Inc.
Responsibilities-
• Provide technology leadership and delivery accountability for technology solutions for multiple concurrent projects within an application family (i.e.
Claims, Reimbursement, Accounting, Inventory Management);
• Lead teams in analyzing, estimating, writing, modifying and implementing solutions to complex software application programs and business problems;
• Advise and lead efforts to design and develop enterprise systems such as Front-end Pharmacy, Dispensing, Inventory and Billing, that will facilitate operations, reduce cost and resource dependencies;
• Set overall direction regarding technical solutions and architecture and ensure teams deliver such solutions reliably, on time, and on budget;
• Provide high level software solutions to complex business problems and oversee teams to deliver these solutions;
• Provide guidance towards enterprise-wide technology direction and architecture;
• Create detailed specifications or designs for software development, conduct quality assurance reviews of application programming and act as a mentor to others in these programs;
• Maintain programs by coding, testing and debugging as necessary;
• Collaborate with other units in the company to resolve technical, organizational or management problems;
• Manage partner vendors and ensure smooth collaboration with internal teams;
• Partner with systems architects to set direction for maturing use of/retiring/adding technology components; and
• Lead actions to determine root cause of technology problems and drive resolution.
• Work from home benefit available.
• Domestic business travel required at least 4 times a year for up to 5 days per trip.
Qualifications-
• Bachelor's degree or foreign equivalent in Computer Engineering, Electronic Engineering, or related field;
• 5 years of experience in a related occupation;
• Experience designing, developing, and deploying software applications in distributed systems and cloud environment;
• Experience creating ad-hoc reporting systems, Business Intelligence systems, Machine Learning and Generative AI;
• Experience using compliance expertise with financial and regulatory frameworks, HIPAA, CIP, Sarbanes-Oxley, PCI;
• Experience with application of latest security standards such as OWASP, NIST, CWE, PCI;
• Experience with EDI frameworks and standards such as NCPDP D.0, X12, VDA, and ad hoc transformation of electronic documents in non-standard frameworks;
• Experience with network architecture, protocols and security such as LAN, WAN, VPN, FW;
• Experience migrating legacy data, and modernization of legacy code, like PLSQL to Java; and
• Experience using: SQL, PLSQL, Oracle APEX, Oracle Reports, Oracle WebLogic, PHP, Rest, Soap, Pega System architect, Swift, Ruby-on-Rails, T...
....Read more...
Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:46
-
Cigna Investment Management (CIM) manages over $35 billion in assets on behalf of Cigna, a publicly traded global health services company.
CIM's assets are invested in public bonds, private placement securities, commercial mortgages, real estate equity, mezzanine debt, private equity, equity securities, warrants, commercial paper, certificates of deposit, municipal securities, mutual fund shares, United States government securities, options contracts on securities, futures contracts on intangibles, money market funds, derivatives, structured notes, exchange traded funds and hedge funds.
The Investment Operations Analyst will report to the will report to the Investment Operations Director in support of the broader Investment Operations team.
This is an entry-level position, providing an excellent opportunity to gain hands-on back-middle office experience in an Investment Management firm with a variety of asset class exposure.
The Investment Operations Analyst will be involved in a variety of including processing and maintaining investment trade, cash, position and security reference data.
In addition, this candidate may support our investment compliance team in portfolio guideline monitoring, state deposit management, cash and asset reconciliations, derivative payment processing, collateral management or other investment support activities.
Major Duties
* Become deeply familiar with existing investment business infrastructure, data flows, processes, business needs and practices
* Support a middle/back office role that addresses, where necessary, proper transaction processing, analytics and pricing, and reconciliations
* Assist compliance team with KYC and compliance calendar tasks, including support of state deposits
* Become a valued partner to business stakeholders by anticipating needs and driving solutions
Qualifications
* Bachelor's degree in a financial discipline
* 0-3 years of financial experience within investment discipline
* Strong excel skills (v-lookups and pivot tables)
* Ability to work well in a team environment
* Working knowledge of investment management and interest in investment operations
* Detail orientated, organized, intellectual curiosity and proactive problem solver
* This position is located at our corporate headquarters in Bloomfield, CT with a hybrid, in office/work from home, flexible arrangement.
This position supports Cigna Investments, Inc., an investment adviser registered with the United States Securities and Exchange Commission ("SEC").
The successful candidate will become an Access Person of CII required to comply with the personal trading requirements and restrictions contained in CII's Code of Ethics.
These requirements and restrictions apply to the Access Person and all securities transactions in accounts in which an Access Person has a Beneficial Interest.
If you will be working at home occasionally or permanently, the internet connection must b...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:45
-
As aPACE Pharmacy Technician, you will be assisting patients in receiving needed medications to help manage rare and/or chronic diseases.
You'll be empowered to engage patients, insurance companies, and multiple departments to process orders and ensure timely shipment of medications.
This role is very detail oriented, and you'll spend the majority of your day working on ourcomputer system.
Here's a little more on how you'll make a difference:
* Accurately enter prescriptions into our system.
Use the knowledge you gain from training, your problem-solving skills and support from your team to accurately enter patient prescriptions.
* You'll ensure that the medication prescription is accurately entered so it can be evaluated under insurance coverage and dispensed correctly.
* Interact directly with healthcare providers.
You'll research issues on with pharmacist and doctors' office and provide guidance to our patients about medication coverage.
* Juggle multiple tasks without sacrificing attention to detail.
You will be busy handling multiple requests at any given time as well as documenting information in ourcomputer system.
What you need to do the job:
* High School Diploma, or GED required.
* Minimum of six months related experience.
* Valid Pharmacy Technician license/certification/registration as required by state laws.
* Pharmacy Technician Certification preferred.
* Microsoft Officeproficiency anddata entryskills
* RxHome experience a plus
* Basic math skills (addition/subtraction/multiplication)
* Strong attention to detail, accuracy and quality
* Excellent verbal and written communication skills
Why Join Us?
Health coverage effective day 1 (including medical, dental, vision)
Holiday and PTO pay
401K with company match
Tuition reimbursement
Fun, friendly and unique culture- bring your whole self to work every day!
Growth and advancement potential
Work Schedule:recruiting for the following Monday through Friday shifts:
* 7 AM to 4 PM CT
* 8 AM to 5 PM CT
* 9 AM to 6 PM CT
* 10 AM to 7 PM CT
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, religi...
....Read more...
Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:45
-
POSITION SUMMARY
The Accounting Analyst is responsible for many aspects of revenue recognition and general ledger-related activities in accordance with US GAAP, and ensuring compliance with company policies.
Responsibilities include (but not limited to): Reviewing customer arrangements to ensure the appropriate revenue recognition treatment and to identify and document any issues in order to accurately complete monthly invoicing, analysis and reconciliation of customer accounts.
The Staff Accountant II will also be responsible for ensuring the accurate recognition of revenue in the general ledger by completing a monthly analysis of the outstanding Accounts Receivable aging, and comparing totals to budgeted/forecasted amounts.
Additional responsibilities include supporting the year-end financial audit, assisting internal customers understand the variables that drive revenue recognition and responding to ad hoc accounting requests.
ESSENTIAL FUNCTIONS
* Work closely with our Healthcare Economics team, Informatics, and Business Intelligence/Data Warehouse to analyze and reconcile key financial reporting measurements.
* The ideal candidate will come from a managed care, insurance or healthcare payor background.
* Tasks will include analyzing and recording capitated contracts, including revenue recognition, membership eligibility reconciliation, and claims analysis.
QUALIFICATIONS
* 2+ years expertise in general ledger accounting, full month-end close, journal entries and balance sheet reconciliation.
* Bachelor's Degree in Accounting, Finance, Audit.
* Prior healthcare industry experience strongly preferred.
* Strong analytic and communication capabilities.
* Demonstrate problem solving and critical thinking skills as well as attention to detail.
* Strong organizational and time management skills.
* Excel experience; Great Plains and SQL experience 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 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 e...
....Read more...
Type: Permanent Location: Franklin, US-TN
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:44
-
Admin.
Asst.
Sr.
Rep
Location: Work on site - Newark, DE
Hours: Hours - 8:00am - 5:00pm est (Monday Through Friday)
So you want to be our next Administrative Assistant? Great choice! We know that you don't have a lot of time, so we'll be brief....
* Do you love providing top notch multifaceted support to busy leaders?
* Are you ready to use your organization and technical skills to manage very busy calendars, track expenses, create agendas, make outstanding presentations and so much more?
* Do you thrive while working in a highly dynamic, fast paced environment?
* Do you want the opportunity to shine on a team that helps millions of patients annually?
What you'll do:
* Planning and scheduling meetings, teleconferences, prioritizing functions and appointments, ensuring that meetings, deadlines, presentations and logistics are handled seamlessly
* Maintain calendars in a timely and logical manner; proactively manage coordination of work to avoid conflicts
* Write reports on the status of major projects, after meeting action item reports, keeping this team informed at all times on the status of assignments, projects and general operations
* Creates spreadsheets and charts, PowerPoint presentations, visual representations and diagrams, using both data and graphics, for internal & external distribution
* Oversees the Contract execution process (coordinating signatures, mailing executed contracts, contract filing, etc.)
* Assisting with onboarding new team members
* Support to help manage organizational accountabilities, including headcount reports, org charts, interdepartmental communications, etc.
* Beyond basic administrative aspects, act as an important part of the leadership team through project support, market and online research, collecting and analyzing information, and initiating communications
* May attend meetings and travel as requested
What you need to do the job:
* HS Diploma or GED
* Minimum 5+ years of experience directly supporting and working with senior leaders
* Project management skills a plus
* Ability to not just handle "today", but critical intuitive ability to anticipate future needs and act proactively
* Must exercise good judgement, problem solving skills and maintain the highest levels of confidentiality and integrity
* Must have excellent written communications and interpersonal skills and the ability to interact positively with all levels within the organization
* Advanced- level expertise with the full MS Office Suite demonstrated ability to produce executive level documents in PowerPoint, Excel and Word
* Self-starter with excellent organizational skills and ability to work independently, remain focused and execute work with minimal supervision, able to multi-task effectively
* Meeting planning skills and demonstrated budget tracking/analyses skills
DE, Newark, 2051 Old Cooch Bridge Rd
If you will be wo...
....Read more...
Type: Permanent Location: Newark, US-DE
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:43
-
Help us automate and maintain our future.
Get ready for a job that encourages you to think strategically yet stay connected with your teams.
Do you have problem-solving or strategy experience? If so, prepare to innovate, create, and inspire.
The Pharmacy Automation Engineer (Automation Engineering Lead Analyst) is primarily responsible for providing first-level electrical and process Controls support for a highly-automated pharmaceutical filling and packaging system.
Perform emergency, corrective, and preventive maintenance activities to restore equipment.
In addition, key responsibilities will involve implementing equipment and system upgrades, engineering change controls, and continuous improvements.
The position will support equipment installations, upgrades, or equipment expansions.
Automation engineer also trains, mentors, and supports the development of other team members
This position will be supporting our Express Scripts Speciality Department Services.
Shift schedule: Monday-Friday 2:30 PM -11:00 PM.
Responsibilities
* Performs advanced level maintenance and service on automated equipment by using and understanding electrical, mechanical, and pneumatic drawings and schematics, and using special test equipment and tools.
* Maintains reliability of the pharmacy automation equipment by executing preventive, corrective, and emergency work orders.
* Troubleshoot, service, install and repair automated production equipment, to include equipment modifications, upgrades, and spare parts inventory
* Utilizes knowledge and skill to monitor and improve the Mean Time Between Failures (MTBF) of the electro-mechanical equipment, and supporting application software systems.
* Observe system for degraded performance using routine inspections, maintenance rounds, and diagnostic equipment.
* Use a computerized maintenance management system (MAXIMO) to record labor hours, repair parts, and monitor pharmacy equipment performance.
* Recommend alterations to developers and designers to improve the quality or performance of processes and/or machines.
* Interpret the output of the reporting systems and take appropriate action that will result in the removal of the root cause problem from the system on a permanent basis.
* Document all emergency, corrective, and preventive maintenance work via work orders associated with Computerized Maintenance Management System (CMMS - MAXIMO).
* Operates on-site in an on-call capacity.
Qualifications
* High School diploma; Associates degree preferred.
* 1-2 years of relevant experience with mechanical electrical experience related to automated and/or industrial equipment.
* Experience working in high-volume production or pharmaceutical environment.
* Experience in troubleshooting complex PLC/computer-operated electro-mechanical equipment; PLC's, I/O, and field devices; repairing, setting up, adjusting, and tuning mechanical systems and pneumatic system...
....Read more...
Type: Permanent Location: Newark, US-DE
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:43
-
Onsite Bilingual Health Educator / Health Coach - Evernorth - Bedford Park, IL
Our Custom Coaching program connects employees with a highly skilled wellness coach for face-to-face sessions.
Coaches take a holistic approach to help employees set and accomplish goals, manage chronic conditions and encourage healthy behaviors.
Our experienced Health Coach will:
• Provide onsite face-to-face customer coaching and support
• Identify customer health education needs through targeted health assessment activities.
• Collaborate with customers to establish health improvement plans, set personalized evidence-based goals, and support customers in achieving those goals.
• Empower customers to become an active participant in their own health outcomes.
• Assist Customer in overcoming barriers to better health
• Lead and support a variety of Health and wellness promotional activities, such as group coaching, wellness challenges and Health related seminars.
• May perform biometric screenings, including finger sticks, blood pressure, body composition, etc.
• Utilize biometric values and motivational interviewing techniques to collaborate with customer to drive to improve clinical outcomes.
• Provide support for health-related site events, which include open enrollment, wellness committee facilitation, flu shot events, health fairs, etc.
The Successful Coach Will Possess:
*
*Bilingual in Spanish is a requirement
*
*
• Strong Clinical skills with at least 3 or more years of experience health coaching, health education and health promotion
• Bachelor's degree in a health-related field.
Master's degree preferred.
• Registered Dietitian (preferred) licensed in respective state
• Current ACLS/BLS/CPR/AED Certification
• High energy level, with dynamic presentation skills is required.
• Positive role model in demonstrating healthy behaviors
• Passion for health improvement
• Ability to work independently
• Customer-centric focus
• Ability to proactively collaborate professionally with the client and other matrix partners.
• Understand and own a variety of clinical targets and outcome measurements.
Develop action plans that drive clinical value for the customers and clients.
• Proven administrative abilities, with strong computer and software application skills.
Bonus points for :
• CHES (Certified Health Education Specialist)
• Motivational interviewing training/experience.
• Smoking cessation and diabetes experience.
*
*
*This position is onsite in the Bedford Park location 3 days per week, Elk Grove 1 day per week and one day remote.
*
*
*
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 i...
....Read more...
Type: Permanent Location: Rockford, US-IL
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:42
-
As a Sr.
Strategic Account Executive, you are the face of Cigna to the client.
Your focus is on spending time with clients in person to cultivate the relationship, addressing client issues, selling annual renewal rate increases in addition to new products and services to expand the relationship.
You will be the trusted advisor and go-to partner for your clients, helping them navigate their business challenges and opportunities by offering strategic insights and ensuring an exceptional client and customer experience.
Key Responsibilities:
* Client Partnership: Act as a key influencer and trusted advisor, cultivating strong, personal relationships with decision-makers and other key stakeholders.
* Industry Expertise: Deeply understand your clients' businesses, their industries, and their unique challenges.
Continuously learn and adapt, offering tailored recommendations that address both their immediate needs and long-term goals.
* Relationship Building: Engage at all levels with both decision-makers and those who influence the decision-making process, ensuring Cigna's voice is heard and valued.
* Market Insights: Keep clients informed about the latest industry trends, helping them stay ahead of the curve and leveraging Cigna's solutions to meet their evolving needs.
* Financial & Underwriting Expertise: Strengthen your understanding of financials and underwriting to guide clients in managing their costs.
Demonstrate the value of Cigna's solutions, including specialty products, and offer creative, proactive solutions to meet their needs.
* Portfolio Management: Drive growth, earnings and retention across your client portfolio, meeting targets for both new business and renewals.
Work to expand Cigna's relationships through cross-selling additional products and services.
* Collaboration: Work closely with underwriting teams to ensure alignment, build trust, and ensure clients receive tailored, strategic solutions.
* Client Experience: Oversee client service requests, ensuring seamless execution and swift resolution by directing them to the right team for problem-solving.
* Channel Management: Manage key partner relationships to ensure client budgets align with reality, holding internal partners accountable and leveraging resources as needed to maintain success.
What You Bring:
* Strong relationship-building skills and a passion for developing deep client connections
* Expertise in financials, underwriting, and providing strategic solutions
* A collaborative mindset with the ability to work effectively across teams
* Proactive, creative thinking to develop tailored solutions for each client
* A desire to grow with a company that's committed to delivering innovative solutions in an ever-changing industry
At Cigna, we value people who bring both strategic insight and a hands-on approach to client management.
If you're driven by client success and want to work for an organization ...
....Read more...
Type: Permanent Location: New York, US-NY
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:41
-
Incumbent will be responsible for providing regulatory legal support to enterprise entities offering health care services directly to patients.
Legal support includes reviewing, analyzing and preparing summaries for new and existing state and federal provider laws, responding to regulatory inquiries, and reviewing external communications.
This position requires a general working knowledge of laws affecting health care providers, such as provider enterprises, corporate practice of medicine, fee splitting, compensation, licensing, Medicare enrollment, anti-kickback/FWA, privacy, friendly PC model, scopes of practice, physician dispensing, hazardous waste handling and disposal, disease reporting, clinical lab waivers, radiology exposure limits, and consent.
Among the topics listed above, expert-level knowledge and working experience in counseling on virtual health services is required.
ESSENTIAL FUNCTIONS:
* Review, communicate and advise on new and existing state and federal laws that impact provider organizations.
* Serve as a regulatory liaison for new law implementation working groups.
* Provide routine guidance to business units in response to internal (e.g., business or compliance) and external (e.g., government or client) inquiries regarding relevant law.
* Review member-facing communications.
* Provide support to other legal team members, such as business counsel, as needed to manage complex issues involving a regulatory component.
QUALIFICATIONS:
* J.D.
from an ABA accredited law school/Bar membership required.
* At least 5 years' experience at a reputable law firm, large health care corporation or relevant government agency.
Expert experience in telehealth needed to be considered for this role.
* Excellent written and oral communication skills, with the ability to distill complex regulatory issues into practical, actionable legal advice.
* Demonstrated contributor with an execution mindset, project-management skills, strong analytical skills and intellectual rigor, collaboration mindset, high personal integrity, and commitment to providing the highest level of service to internal and external clients.
* Ability to reassess priorities in real-time to ensure internal and external expectations are met.
* Strong listening, influencing and interpersonal skills with senior attorneys and enterprise colleagues to foster collaboration and function to drive results.
* Strong ability to maneuver through regulatory and business barriers to facilitate solutions.
* Strategic and pragmatic legal and business advisor.
* Open to remote location or Hybrid
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 152,500 - 254,100 USD / yearly, depending on rel...
....Read more...
Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:40
-
The job profile for this position is Business Analytics Senior Advisor, which is a Band 4 Contributor Career Track Role with Cigna-Evernorth Services Inc.
Responsibilities-
* Partner with the data engineering and data quality teams to develop a data environment to ensure the availability, accessibility, consistency and reliability for all data required to perform reporting and analytics from descriptive through predictive/prescriptive, including marketing efforts.
* Partner with key stakeholders to extract insights on digital campaigns.
* Lead the development of marketing analytics strategy and roadmaps, collaborate with digital campaign leaders to identify analytic challenges, and develop solutions.
* Facilitate the measurement and optimization of customer campaigns focused on digital registration and engagement.
* Manage the development of predictive models, segmentation, audience selection, experimentation, and statistical analysis to improve the performance of marketing efforts.
* Build fully automated dashboards for customer data platform campaigns to measure results and report insights/performance to senior leadership.
* Create hypothesis formulations, test designs, perform A/B and multivariate testing, develop scalable standard practices for process automation and insight generation, provide recommendations to key stakeholders, and develop data-driven insights.
* Turn insights into actions in an iterative cycle to improve key metrics.
* Oversee creation of insightful data visualizations, charts, maps, graphics, etc.
Identify high impact opportunities focused on engagement and containment goals by synthesizing &
* analyzing existing call center data.
* Provide analytics consulting and support for digital campaigns for various digital products.
Partial virtual/work from home benefit available.
Qualifications-
Position requires a master's degree or foreign equivalent in Business Analytics and Project Management, Data Science, or related plus two years of experience in business analytics or a bachelor's degree or foreign equivalent in Business Analytics and Project Management, Data Science or related plus five years of experience in business analytics.
Must have experience in the healthcare domain and experience with data extraction, manipulation, and warehousing tools, including SQL, SAS, and Tableau.
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 dr...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:40
-
Role Summary
The National Account Manager (NAM) will have responsibility of overall operational performance strategy and execution for Cigna clients with 3,000+ employee lives.
Primary responsibilities include development and execution of broad service strategy in support of large client global benefit programs, wellness, and employee relation goals, as well as Cigna persistency, membership growth, and earnings targets.
The NAM effectively manages business relationships, collaborates, and communicates across all product/operational lines to ensure that systems and processes are in place to meet client/customer needs, and drive efficiency for the organization, segment, and team.
Role Components
* Support clients in the Northeast region of the US.
* Support the organization to achieve net medical membership growth, profitability and persistency objectives through effective service oversight, account retention and management strategies
* Effectively collaborates with Advocacy partners on benefit, service, and relational strategies targeting enhanced customer and client experience
* Maintains market/competitive knowledge on service trends and differentiators - can "sell" Cigna service & tools in a retail setting and/or client discussion
* Effectively collaborates with National Account Executive (NAE) on broad account retention, growth, and satisfaction strategies(multi-product/operationalcollaboration for operations, network, marketing, product, Health Care Reform etc.) drives inclusion of case installation, product and service partners where appropriate
* Collaborates with National Account Executive on renewal activities, to include RFP involvement, geo access reporting/analysis, etc.
* Develop/maintain "trusted advisor" relationships with clients and consultants; by proactively engaging in needs and goals discussions, and then leverages Cigna's capabilities and services to differentiate Cigna from the competition
* Maintain in-depth knowledge of Cigna products/services across all product lines (HealthCare, Dental, Behavioral, Cigna Group Insurance, Pharmacy, Medical and Condition/Disease Management, Lifestyle Management Programs, Incentive Programs, Cigna Global, etc.)
* Maintains current knowledge of Health Care Reform(legislation/compliancerules) and can confidently and effectively articulate impacts for the client, and Cigna
* Lead in managing dental reporting requests to include analytics and presentation
* Develop/implement consumerism strategies for target accounts to drive enrollment growth and facilitate meaningful customer behavior change and through health advocacy& cost transparency.
Includes detailed communication campaigns and event participation as applicable
* Maintains basic understanding and conceptual application of underwriting principals
* Effectively leverages resources to fulfill client onsite needs, offers creative and effective solutions to drive optimal c...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:39
-
Candidates who reside within 50 miles of the following locations may be asked to work in person: Bloomfield, CT, Chattanooga, TN, Denver, CO, St Louis, MO, and Scottsdale, AZ.
Reporting to the Customer Operations Enablement Senior Director, the Individual Family Plans (IFP) and MD Live Operations Enablement (OE) Senior Manager will oversee the development and execution of all operational enablement functions to support the needs of the IFP and MD Live Operations including instructional design, training delivery, knowledge management, and operational performance improvement.
This forward thinking leader will work closely with OE and Operations leadership to align business strategies with operational goals, manage the execution of strategic initiatives, and oversee day to day enablement operations for IFP and MD Live, ensuring the organization operates efficiently and effectively to meet monthly performance metrics.
Key responsibilities:
* Aligns the vision and strategy of the IFP and MD Live Operations Enablement team to key business priorities and initiatives, taking into account the strategy & vision of the broader Customer Operations Enablement organization.
* Serves as a trusted partner to our IFP and MD Live Operations internal stakeholders in understanding the business needs and translating that into an effective support model
* Ensures the IFP and MD Live Operations Enablement team is deployed to the highest value creation opportunities, maximizing cost savings and realized efficiencies to contribute and support future growth opportunities in support of the enterprise strategy.
* Acts as a strategist for future instructional design, knowledge, and training delivery needs to support the evolution of our business and workforce.
* Drives efficiency through the implementation of enhanced technology and leverages data insights to drive decisions.
* Owns identification and execution of process improvement initiatives within the operations necessary to continuously drive our Operations Enablement readiness and learning strategies.
Drives strategic deliverables for initiatives/projects to support strategic roadmaps, objectives and opportunity analysis.
* Establishes and drives the key partnerships and global service partner relationships to deliver on the broader Customer Operations Enablement strategy.
* Collaborates with cross functional matrix partners, operations, and human resources teams to ensure planning, execution, adoption, and reporting strategies for related areas of responsibility
* Ensures effective communication with key stakeholders and internal management
* Effectively manages teams through instilling a healthy culture and driving results
* Fosters a connection and a sense of personal purpose to our Operations Enablement and Enterprise vision
Qualifications and Competencies:
* High School Diploma or G.E.D.
required
* Bachelor's or advanced degree preferred
...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:38
-
Account Management (Non-IC) Lead Associate
The Account Manager is responsible for ensuring Accredo's customers, inclusive of payers, prescribers and patients, receive superior service.
Responsible for the overall satisfaction and retention of assigned book of businesses.
Manages the day-to-day customer relationships and r esolves customer complaints by investigating problems, developing solutions, preparing reports and making recommendations to management.
Accountable for core service delivery for customers working cross-functionally with all operational teams.
The Account Manager proactively reviews performance metrics to promote client satisfaction, manage contractual requirements, profitability, accounts receivables and retention.
Utilizes technology, tools, processes and resources to anticipate and exceed client's needs and expectations.
Collaborates with other team members on customers' activity, expectations, and service needs.
Responsible for increasing the visibility and awareness of our organization's service offerings and maximize sales growth.
ESSENTIAL FUNCTIONS and Expectations
* Align with Corporate values and create and maintain an environment based on such values
* Manages day to day customer relationships through comprehensive knowledge of customer's benefit plan and Accredo's product offerings.
* Daily interaction with customers, providing preventative consultation, analysis and issue resolution associated with Accredo's core services.
* Responsible for timely and accurate management and execution of all client benefit requests, contract requirements, including benefit changes, product upsells, new groups, terminations and escalated issues.
* Accountable for new group and specific product implementations; including establishing and leading internal meetings to ensure collaboration and attention to detail throughout the process in order to meet expected timelines and quality standards.
* Manage and lead customer centric team meetings to review Accredo's operational performance against client's expectations and needs.
* Presentation of Accredo's services and operational performance metrics to customers on a monthly and/or quarterly basis to show specific performance measures in comparison with Accredo's book of business to promote client satisfaction, client retention and upsell opportunities.
* Serve as a single point of contact for customers and referral sources and respond to general inquiries, urgent requests and escalated issues in a timely fashion.
* Provide collaborative prior authorization assistance.
* Align and work with manager on the management and strategic direction of sales and account management
* Build positive trust relationships with new and existing customers and referral sources to influence targeted group(s) in the decision making process
* Liaise with and persuade targeted doctors to prescribe our products utilizing effective selling skills to...
....Read more...
Type: Permanent Location: Honolulu, US-HI
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:38
-
Role Summary:
The Engagement Consultant works with employers and brokers to develop and execute health engagement strategies based on client-specific needs.
The Engagement Consultant coordinates awareness and education activities geared towards helping clients and customers become better consumers of healthcare and maximize the value of the solutions they purchase from Cigna Healthcare.
Essential Functions & Scope of Role:
* Partner with Client Manager or Client Service Consultant to understand client needs and objectives and deliver on client strategy.
* Consult with Client on effective wellness program framework- virtually or in-person based on client needs/preferences.
* Maintain in-depth knowledge of Cigna products/solutions/services across all product lines (including but not limited to Medical, Pharmacy, Dental, Behavioral, Clinical, inclusive of Well-being incentives).
* Advise on Client Wellness Funds utilization for assigned book of business and facilitate payments through the funds.
* Participate in finalist, midyear, cross-sell, broker and analytics opportunities to provide insights on Cigna's health and well-being capabilities.
* Supports Healthy Workforce Designation opportunities for clients.
• Present Cigna employee benefits for new or renewing clients.
* Effectively leverages Expert Advisors (e.g.
Client Service Consultants, Platinum or Gold Service team, Implementation Managers, Well-Being Strategists, and others) to deliver on client expectations.
Qualification
* Bachelor's degree (preferred) or equivalent experience in health-related industry Experience in corporate health promotion program design is preferred
* Excellent oral and written communication skills
* Experience in developing and managing key relationships (internally and externally)
* Team player with proven ability to prioritize and manage multiple tasks simultaneously and meet timelines within a fast-paced environment
* Strong skills in Outlook, Webex, CRM (Salesforce), and other Microsoft 365 suite of programs.
* Must be willing to travel to local and remote clients/customers and trainings/meetings as needed (30-35%); overnight travel may be required; markets may vary
* Must reside in local market with ability to commute to local Cigna office and meet in-person commitments 2-3 days per week (either in-office or in-market with clients/customers)
* If working in WVA, FL, TX: Ability to obtain Health & Life Insurance license
Competencies
* Plans and Aligns - Planning and prioritizing work to meet commitments aligned with organizational goals.
* Balances Stakeholders - Anticipating the needs of multiple stakeholders.
* Communicates Effectively - Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences.
* Interpersonal Savvy - Relating openly and comfortably with diverse groups of people.
*...
....Read more...
Type: Permanent Location: McLean, US-VA
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:37
-
The job profile for this position is Software Engineering Senior Advisor, which is a Band 4 Contributor Career Track Role with eviCore healthcare MSI, Inc.
Responsiblities-
* Build Extract, Transform, and Load (ETL) processes to allow data to flow seamlessly from source to target.
* Load and enhance dimensional data models, perform code reviews, and participate in sprint ceremonies.
* Leverage code to apply business rules to ensure data is clean and is interpreted correctly by all business stakeholders.
* Analyze reports using various tools.
* Provide support to offshore operations teams, train operations teams on ETL processes, and support user questions on data management processes and results.
Troubleshoot and address issues with data or ETL process.
* Fine tune existing code to make processes more efficient.
* Maintain and create documentation to describe data management processes.
Hybrid work schedule.
Qualifications-
Bachelor's or foreign equivalent degree in computers or engineering plus five years of experience as a solution architect or closely related position.
Must have experience with: Java/J2EE, Scala, Python, JavaScript; Spring 3.X, Hibernate 3.X, JSP, Servlet, EJB, JPA, Web Services; Hadoop, HDFS, Map Reduce, HDFS, HBase, Hive, Oozie Job, Sqoop, Spark, Kafka, NIFI; Hortonworks Data Platform, Azure HDInsight, Azure cloud, Amazon EMR, Data bricks; Azure Data Factory, ADLS Gen2, Azure data bricks, Key Vault, Azure Table Storage, AZ copy, SQL Warehouse, Synapse, Azure Search; Oracle, MySQL, SQL Server, PostgreSQL; Spring-XD, HAWQ, Redshift; JIRA, Git, Mercurial, SVN, Maven, Azure DevOps, Terraform.
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 resum...
....Read more...
Type: Permanent Location: Franklin, US-TN
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:36
-
The job profile for this position is Software Engineering Advisors, which is a Band 4 Contributor Career Track Role with Cigna-Evernorth Services Inc.
Responsibilities-
• Provide expert professional leadership on complex engineering and information technology assignments and projects;
• Participate in all aspects of the Software Development Life Cycle, from requirements gathering to design and implementation, to ensuring business needs are being addressed;
• Work with senior staff to define standards, patterns, and frameworks to deliver the initiatives;
• Provide thought leadership within Information Management while working on broader projects that require understanding of wider business;
• Participate in process improvement and cross-departmental IT initiatives;
• Participate in the delivery of definitive enterprise information environment that enable strategic decision-making capabilities across enterprise via analytics and reporting;
• Exercise considerable creativity, foresight, and judgment in conceiving, planning, and delivering initiatives; and
• Support production research and resolution recommendations;
• Partial work from home benefit available.
• ~15% domestic travel to other company sites required.
Qualifications-
• Bachelor's degree or foreign equivalent in computers or engineering;
• 5 years of experience in a related occupation;
• Experience using Front-end languages and libraries (HTML/CSS, JavaScript, XML, JQuery);
• Experience in database, web servers and UI/UX design;
• Experience with Docker;
• Experience with CI/CD, Azure DevOps, GitHub, TFS;
• Experience with Architectural Patterns and Development Best Practices;
• Experience with Unit Testing, Test Driven Development and use of mocking frameworks;
• Experience with Angular 5+, .net Core;
• Experience building in Event Driven Architecture; and
• Experience working in Agile SDLC.
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 ...
....Read more...
Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:36
-
Production Clerk
Work Hours: 2nd shift 2:30pm - 11pm est.
Location: On-site
Are you ready for a new job that allows you to make an impact and improve the lives of others? Express Scripts by Evernorth Health Services, a division of The Cigna Group, is hiring production clerks like you to stock, pick, and pack pharmacy prescriptions.
Using a high level of attention to detail, as well as your organization, time management, and problem-solving skills, you'll help ensure the accuracy of each prescription order for each patient we serve.
Express Scripts by Evernorth is committed to making pharmacy simpler and better - from our industry-leading supply chain team to our specialized clinical experts, we're focused on making sure patients get and can stay on the medications they need at prices they can afford.
Bring your drive and passion for purpose.
You'll get the opportunity to make a lasting impact on patient's lives.
This Pharmacy Production Clerk job is located at our on-site office in Fairfield, OH.
How you'll improve the lives of others:
* Dispense and pack prescriptions in preparation for shipment
* Process prescriptions
* Follow-up with patient issues
* Data entry and reference database as needed
Requirements:
* Basic math skills.
* General computer skills.
* General computer program knowledge including Microsoft Office and use of the internet and email.
* Flexibility to adapt to a dynamic work environment; willingness to work a flexible schedule when needed.
* Effective communication skills both written and verbal.
Why Choose Us?
* Comprehensive Health Coverage from Day One (including medical, dental, vision).
* Competitive Holiday, Paid Time Off (PTO), and Overtime Compensation.
* Robust 401K Plan with Company Match.
Join us in shaping the future of pharmacy operations while enjoying a supportive and enriching work environment that fosters professional growth and fulfillment.
Apply now to embark on a rewarding career journey with us!
Address: 4865 Dixie Hwy, Fairfield, OH 45014
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 fami...
....Read more...
Type: Permanent Location: Fairfield, US-OH
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:35
-
The Cigna Group is seeking an experienced communications professional to join the Evernorth Health Services Communications Team supporting Pharmacy and Care Delivery as a Communications Senior Advisor.
In this role, you will lead and execute the communications strategy for critical programs and leaders across Evernorth Health Services.
Success comes from taking a collaborative, proactive, enterprise approach that drives impact and promotes key business and reputational efforts.
Responsibilities:
* Create and execute internal and external communications strategies to drive key business efforts for our Pharmacy and Care Delivery businesses including but not limited to Accredo, CuraScript SD, and Express Scripts Pharmacy.
* Develop internal and external communications plan(s) and materials aligned to business priorities; supporting product launches, client communications, press releases, social media, newsroom story development, agency management, etc., as well as content and measurement to support these plans.
* Provide counsel and advice - and take lead on the development of work product (e.g., communications materials) - on significant business communications matters, often requiring cross-organization coordination and collaboration across a highly matrixed environment.
* Drive communications efforts for key executives, including internal communications support (e.g., Town Halls, org announcements), social media support (i.e., LinkedIn) and event support (e.g., speechwriting/presentation development, external event coordination, etc.).
* Support issues management work across business as needed.
Qualifications:
* At least 10 years of communications experience.
* Bachelor's or Master's degree in communications, journalism, creative writing, marketing or similar field preferred.
* Health care experience required, experience in benefits management, pharmacy, provider and/or care delivery a plus.
* Proactive mindset; curiosity; passion for learning.
* Strong project and stakeholder management skills.
* Excellent writing skills and ability to flex to a range of executive styles.
* Experience in corporate storytelling, media relations, social media, internal communications, issues and crisis management.
* Experience in public affairs communications a plus.
* Adept at planning, managing, and prioritizing work to meet tight deadlines.
* Strong collaboration and interpersonal skills, highly motivated, creative self-starter who is eager to take on projects, learn new concepts, and dive into new territories.
* Results-oriented, with a proven track record of executing strategic communications programming, preferably in a large matrixed organization.
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 th...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:34
-
Accredo Tennessee is looking for a Nationally Certified Pharmacy Technician to "Work at Home".
If you are NOT a Nationally Certified Pharmacy Technician , with a NHA and/or PTCB and do not have a Tennessee Pharmacy Technician license , unfortunately you will NOT be considered.
This is noted under the requirements.
Are you ready to step into a position that combines your communication skills, attention to detail, ability to multitask, and unrelenting drive to patients?
We're looking for certified pharmacy technicians to join our pharmacy team.
If you've worked in Pharmacy Operations before, this role is different - you'll take your knowledge and expand it beyond your belief.
Take a break from a retail environment, enjoy a set schedule, and come enjoy the satisfaction of helping others! Prepare prescriptions on a large scale while working closely with our team of Pharmacists as need.
We're pretty sure you'll love this position.
How you'll make a difference:
* Be a superstar in the eyes of your team and the end patient: Select and retrieve appropriate quantities of medication and prepare the labels that correspond.
No need to answer any patient questions as those are answered by another skilled team.
* Use your expert problem solving skills to help our patients be at their best every day: Work with a skilled team in a temperature controlled warehouse environment to ensure patients get the medication they need in a timely manner.
* Create new knowledge with our systems and new relationships with your peers: You'll start with training, but you're not doing it alone.
You'll enjoy a supportive environment with your peers and other teams who want you to succeed.
Speaking of supportive environments, did you know we offer 20 days PTO +6 holidays off/year, tuition reimbursement, benefits that start on day one, and 401K match? Well, now you do.
What you should have:
* Valid Pharmacy technician license/certification/registration as required by state laws.
* National Pharmacy Certification under the PTCB and/or NHA
* 1 to 2 years of relevant experience as a Pharmacy Technician
* High School Diploma / GED required, a bachelor's degree is preferred.
* Basic math skills and General PC knowledge including Microsoft Office, use of the internet and email is required
* Excellent verbal and written communication skills
ABOUT EXPRESS SCRIPTS
At Express Scripts, we dare to imagine a better health care system, and we're driven to make it happen.
Where some see obstacles, we see possibilities.
We're challengers, difference-makers and opportunity-seekers, united with our partners in pursuit of a simpler, more sustainable system and better health for all.
We have always acted first to take on the toughest challenges.
We uniquely partner across the health care ecosystem to uncover opportunities, take action, advance health care and deliver better outcomes - like no one else can.
We believe health care can do more.
We ar...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:33
-
Overview
A career within Forsyth Health's Product team will provide you with the opportunity to help Pharma/Life Science organizations uncover patient and market insights.
At Forsyth Health, we focus on a collection of data management, business intelligence and advanced analytics capabilities to support various functions within these organizations to meet their business needs around market access and patient support programs.
How you'll make a difference
The Business Analytics Senior Advisor role is a key role to the enterprise and will be supporting a highly complex and growing area within the health care data and product development space.
As a strong individual contributor, the role will collaborate on analytic and product development efforts and help design Forsyth's data products to enable research within the commercial Pharma Analytics space.
Responsibilities include mining unstructured data, development of healthcare domain-specific ontologies, development of use cases, data curation models and algorithms that help bring "research-ready" datasets to market.
This role will work closely with the internal Technology, Analytics, and Client Services teams to support and showcase Forsyth data capabilities with both existing and potential clients.
Role Summary
The Business Analytics Senior Advisor, RWD Product Development position is an opportunity for a data and analytics professional to meaningfully impact the design and development of the Forsyth Enterprise Data Model.
The job responsibilities include, but are not limited to the following:
* Efficiently query multiple data types (medical and pharmacy claims, EMR, lab, chargemaster) using SQL to gain a deep understanding of patient / clinical activity from Forsyth data and investigate gaps and anomalies both within and longitudinally across patient records.
* Influence the data model to enable expedient and meaningful observational research.
* Work with Analytics team to develop algorithms for derived variables and metrics for inclusion in data product.
* Compile detailed requirements for data model development and work with Data team to implement and test the resulting data sets.
* Develop vocabularies and ontologies towards standardizing data - for granular structured data and for unstructured / free-text data with an eye on automation and scale.
* Collaborate with Data team to create detailed documentation for data product, including ERD's and best practices for onboarding and maintenance of licensed data.
* Assist in providing RWD training, analytic guidance, and use case development and support for clients.
* Continually assess new data sources and work with internal teams to map and incorporate new data into existing model or to expand the model accordingly.
* Project management and prioritization - Advisor role willsupportmultiple projects per Product roadmap and will work with Client Solutions, Data and Analytics teams to manage multi...
....Read more...
Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:33
-
This production role is an entry-level position in the Dental Network Management team.
Role delivers straightforward administrative and/or other basic business services supporting the growth and retention of our provider network to support client strategies and performance guarantees.
Receives requests to review and analyze data, summarize reports, create new records in activity tracking systems and verify data for internal and external reporting.
Role could also include some monitoring of in progress network performance guarantees and escalating to more senior staff when there is a need as well as assisting with provider enrollment when necessary.
R equires knowledge of company/operating processes and procedures; works to clearly defined procedures under close supervision .
Qualifications:
* Minimum of 1 years experience in provider/client/customer service insurance environment
* Role requires 1 + years of experience with dental DHMO and PPO provider negotiations, relations or contracting
* Working knowledge of dental insurance products preferred
* Self-motivated individual with the ability to multi-task, ma n age and resolve issues with a take charge attitude to support operational needs
* Ability to navigate and develop relationships with all internal business partners and contracted providers
* D emonstrate active listening, written, and verbal communication and presentation skills
* Excellent organizational and time management skills with a strong attention to detail
* Effective collaboration and problem-solving skills required
* Strong working knowledge of Microsoft Outlook, Word, Excel, PowerPoint, & Internet Explorer are 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 hourly rate of 21 - 32 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 Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life.
We guide our customers through the health care system, empowering them with the information and insi...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:32
-
As an Eligibility Representative, Patient Access, Accredo , 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...
....Read more...
Type: Permanent Location: Memphis, US-TN
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:31
-
*
*MUST Reside in MA!
Certified Pharmacy Technician preferred
Customer Service Representative - Work from Home MA- Freedom Fertility
Ready for a job encouraging you to use your communication and problem-solving skills? If
so, prepare to use those skills to help your patients' dreams of having a family come true!
As a Customer Service Representative at Freedom Fertility, you'll use your empathy and
listening skills to handle inbound and outbound calls from patients and learn more about their medical history and challenges with fertility.
This is not your average customer service job - you'll work for a company that truly cares about people while helping our patients achieve happiness.
Here's a little more on how you'll make a difference:
* Handle 25-30 calls (IB & OB)
* Ensure process efficiency - Work with patients and physicians to coordinate fertility
* plans and medications.
Own the patient experience by resolving customer issues and ensuring 100% follow-up to customers.
* Pay attention to detail - Accurately obtain and enter patient information, including
* shipping, insurance, and payment information.
Why join us?
* Health coverage effective day 1 (including medical, dental, and vision)
* Holiday, PTO, and OT pay
* 401K with company match
* Tuition reimbursement
* Fun, friendly, and unique culture - bring your whole self to work every day!
What you need to do the job:
* An empathetic and fun-loving personality with a few good jokes on the ready
* High School Diploma or GED required
* Excellent customer service, organization, and time management skills
* PC skills including knowledge of Microsoft Office Suite and Internet
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 - 19 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 predic...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:31
-
Candidates must reside in the states of Ohio, Indiana and Florida.
Are you ready to step into a position that combines your communication skills, attention to detail, ability to multitask, and unrelenting drive to help patients?
We're looking for Registered/Certified Pharmacy Technicians to join our pharmacy team.
If you've worked in Pharmacy Operations before, this role is different - you'll take your knowledge and expand it beyond your belief.
Take a break from a retail environment, enjoy a set schedule, and come enjoy the satisfaction of helping others!
The Front-End Pharmacy Technician could be responsible for taking inbound calls transferred from contact center representatives.
Calls would either be resolved or transferred to a pharmacist as appropriate.
Other Front End Pharmacy Technician functions involve responsibility to perform data entry or other pharmacy queue work, typical of a registered pharmacy technician.
What you'll do:
* Be a superstar in the eyes of providers and patients alike: Take inbound calls from contact center representatives and resolve or transfer to a pharmacist as appropriate.
* Pay attention to detail: Translate prescriptions from the prescriber and enter information in the patient's profile in accordance with state regulations.
* Be a team player: Work with pharmacists per work instructions, policy and procedures, management direction or any national or state regulations.
You'll start with training, but you're not doing it alone.
You'll enjoy a supportive environment with your peers and other teams who want you to succeed.
* You'll ensure quality assurance, report adverse events, and assist with prescriber and patient outreach.
What you need to do the job:
* High School Diploma or GED required
* 1+ year of relevant experience
* Valid Pharmacy Technician license required
* Basic math and computer skills including Windows navigation, Microsoft applications, internet and email required
* Strong verbal and written communications skills
* Ability to learn internal systems, processes and programs as needed
* This role is required to reside in the state of Ohio, Florida, or Indiana
Why you should join our team:
* Benefits that start on day 1
* 18 PTO days + 8 holidays off/year
* Tuition reimbursement
* 401K match
* Consistent 40-hour work week, Monday - Friday
* Voluntary Overtime
* Real clinical focus on pharmacy skills (i.e.
not just using the cash register!)
* Great safety record for our patients
* Career progression opportunities
NOTE: We are currently training in a work at home environment, and you will be required to have reliable internet connectivity provided through a wired connection.
A mobile or hot spot environment is not acceptable, and you may need to purchase an Ethernet cord depending on your current set up.
This role is WAH/Flex which allows most work to be performed at home.
If you will be wo...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-04-23 08:42:30
