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This role is responsible for building a number of tableau dashboards utilizing a number of data sources e.g.
Jira, Pathfinder, ServiceNow, Workday etc.
They will also be responsible to implement a number of project management steps including process flow, documentation, QA and collaboration activities across multiple teams within and outside of the immediate team group.
They will be sharing the dashboards as well as any related data analysis with the stakeholder from Management and leadership teams.
Responsibilities
* Tableau dashboards development utilizing various data sources.
* Complete process of requirements, analysis, design, build and testing of the dashboards.
* Manage a number of best practices for the whole team, for their implementations and monitoring to adhere to the standard processes and continuous improvements.
* Partner with other Tech Metrics & Reporting team members and leads, be a voice for best reporting practices.
* Provide ad-hoc data analysis to support leadership decisions.
* Accountable for continuous process optimization and automation, as well as documentation.
* Socialize & demonstrate scorecards and improvement findings with various partners including management and leadership teams.
Qualifications
* Bachelor's Degree in Computer Science, Information Systems, or other related field or previous work experience.
* 5 to 10 years of work experience related to metrics.
* Advanced skills in Tableau and SQL Server.
* Keen focus on data and data analytics.
* Proficient in Microsoft office tools, with focus on Microsoft Excel and its analytical capabilities.
* Knowledge of various data system, queries and database connections capabilities required.
* Proficiency in use of and manipulation of data extracts and reporting techniques.
* Have excellent problem-solving and critical-thinking skills.
* Be able to handle multiple ongoing projects simultaneously and manage priorities ensuring delivery timelines.
* Team player with proven ability to manage strong working relationships within a matrix organization.
* Comfortable with working with cross functional IT orgs at all levels including senior management.
* Be able to propose, develop and deliver creative solutions/alternate approaches as necessary.
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 applic...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:45
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Summary:
The Infrastructure Engineer Senior Advisor serves in providing advanced/escalated technical support for critical infrastructure services and components across the enterprise.
This includes Product and Application knowledge of troubleshooting, performance analysis, maintenance, monitoring and continuous improvement.
Essential Duties and Responsibilities:
* Provide Advanced knowledge of Data Movement process and procedures
* Serve as initial escalation point for internal Data Movement matters including but not limited to: setup, troubleshooting, and process advisement
* Provide technical training and knowledge transfer via workshops, training sessions, and lunch-and-learn sessions
* Responsible for escalated set up, execution, and troubleshooting of Trading Partner/client infrastructure components including accounts, scripts, settings, notifications, builds, etc.
* Serve as the advanced/escalated IT/technical point of contact for the client, or the client's vendor and Cigna personnel in all Data Movement matters
* Manage and maintain the creation and testing of new and existing enterprise data transfers, including but not limited to use of standard file formats {i.e.
834, 837, 4010, & 5010}, proprietary eligibility, and auto-registration file formats
* Good organizational, time management, customer service skills; with the ability to work accurately and meet deadlines with frequent interruptions
* Close interaction with Application areas, CIP, Change Management, OCC, Data Storage Management, Server Support, Database Support, and Project teams
* Maintain and adhere to EDI and file transfer security compliance standards; including but not limited to: HIPAA, PII, PCI, etc.
* Troubleshooting of incidents/issues caused by performance, application, infrastructure and database code issues
* Address, manage, and/or troubleshoot customer/client reported escalated issues, service requests, and/or changes
* Provide timely completion and/or resolution to requests and technical support issues; providing Root Cause Analysis where applicable
* Provide planning and implementation of product and service installs, updates, and checkouts when applicable
* Provide 24X7 on-call support for all production environments; rotational pre-scheduled basis
* Off Shift Work: rotational on-call responsibilities all initiated through the EOCC for any relevant Managed Incidents; production change/task implementations
* Maintain on-call scheduling and resource assignment with Management assistance/approval
* Provide service reports and service audits upon request
* Identify, develop, and implement continual process improvement opportunities and automation development
* Performs other related duties as assigned
Core Competencies:
* Experience in one or more of the following technologies:
+ File Transfer Protocols: HTTPS, FTP, SSH/SFTP, AS2, AS3
+ Co...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:45
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Position Summary:
As a federal government contractor, it is critical to the overall success of our business to remain in compliance with various contract requirements and regulations.
The Director of Contract Compliance will establish, maintain, and continuously evolve an overarching compliance management plan and strategy for a portfolio of federal contracts.
We are looking for an energetic and self-motivated Compliance professional with experience in Federal Government Contracting.
The successful candidate will lead a team of contract compliance professionals who coordinate and facilitate compliance activities across a number of federal contracts while working collaboratively with a cross functional team including Account Management, Legal, Quality, Contracting, IT, and Operations.
Responsibilities:
* Lead a team of contract compliance professionals, including daily management and oversight of compliance related projects and initiatives
* Enable and foster a culture of compliance for federal contracts
* Develop, maintain, continuously evolve, and execute the overarching compliance management plan(s) and strategy from acquisition phase, through implementation phase, through execution phase
* Ensure Express Scripts has robust processes and procedures in place to ensure compliance with all contractual elements for multiple federal government contracts, including ensuring accurate reporting to clients, and compliance with all Business Systems (Accounting System, Purchasing System, Estimating System)
* Establish tools and techniques to prevent compliance issues from happening, and for quickly resolving them when they do happen
* Maintain a tracker of open compliance items and associated action plans for all federal contracts
* Develop and execute a robust supplier compliance oversight model
* Oversight, management, and mitigation of potential conflicts of interest (OCI mitigation plan management)
* Collaborate with other functional areas, such as Legal or Contracts Administration, while supporting Federal Contracts to determine compliance status and assisting with process improvements when needed
* When compliance concerns arise, coordinate with business partners to quickly resolve the open issue and establish process changes to prevent reoccurrence
* Support the drafting of Correction Action Plans (CAPs) and ensure execution of the CAPs
* Support Compliance Governance activities including facilitating Governance Committee meetings and completing contract mappings and related documents
* Perform annual updates to trainings specific to Federal Contracting and verify assignment lists
* Partner collaboratively with Corporate Compliance to ensure compliance with all regulatory compliance requirements
* Manage ongoing listing of team Standard Operating Procedures (SOPs) including assisting business owners as they write new SOPs and regularly validating existing SOPs to keep ...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:44
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Remote, work from home - Phoenix, AZ (must be located in/or near area)
* First things first.
We're a global health service company dedicated to helping people improve their health, well-being and sense of security.
But we don't just care about your well-being, we care about your career health too.
That's why when you work with us, you can count on a different kind of career - you'll make a difference, learn a ton, and share in changing the way people think about healthcare.
Ideal location:Phoenix,AZ (remote, work at home)
Travel - Locally 75% (25% up to 150-mile radius)
+ Reliable transportation, valid driver's license, and insurance required; m ileage reimbursement provided
+ Valid Arizona Department ofInsurance license will be required
Now let's talk about the role:
SUMMARY:
Responsible for the execution of the CignaMedicare strategy for local topline sales agencies, directly contracted agents, and broker down-line sales within their market for the book of business they manage through training, relationship management.
RESPONSIBILITIES:
+ Execute multi-year local broker strategy for book of business
+ Influence brokers to sell more by positioning our product and promoting our brand
+ Execute on national topline strategies with downline sales agencies & local direct agencies to drive profitable growth through down-line sales (e.g.
educate and expand on MA products)
+ Develop & execute direct agent strategies to drive profitable growth
+ Hunts for new local/regional agencies to cultivate and grow
+ Responsible for a territory, manage contacts and exercise long-term vision approach
+ Executes on strategy to expand sales efforts across multiple products as appropriate (e.g.
synergies with MA, PDP, CSB)
+ Execute on market / region sales goals and objectives (sales events, training, etc.)
+ Communicate and monitor downline agency sales goals against production within their book of business
+ Meet or exceed sales objectives through broker channel
+ Conduct advertised sales presentations for prospects and leverage community partnerships to host events
+ Meet with brokers and agencies to build relationships and promote our brand
+ Produce campaign and event tracking reports showing return on investments and key initiatives
+ Carry out appropriate sales activity standards as directed by their manager
+ Responsible for reporting their daily activities to ensure alignment with creating incremental sales consistent with market goals
+ Adheres to and maintains current understanding of compliance requirements and organizational policies & procedures
+ Coordinates effectively with Sales Operations team for lead management and sales functions
+ QUALIFICATIONS:
+ High School Diplo...
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Type: Permanent Location: Tempe, US-AZ
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:44
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Summary
The D&A Strategy Execution's Digital Product Analytics team is seeking an Analyst with proficiency in data analysis, business intelligence, and digital analytics.
The successful candidate will leverage data to create data models and perform analysis to uncover digital customer/client value potential.
Key responsibilities include providing strategic digital, business, and marketing recommendations; advising on the strategic use of customer and client data; promoting data analytics awareness across the client base and enterprise; and ensuring efficient system implementation and integration.
The role requires a blend of technical ability, strategic thinking, and a deep understanding of digital analysis.
This role on our Digital Product Analytics team is an exceptional opportunity to deepen your understanding of digital data and product strategy integration.
The role offers is a stepping stone towards future leadership roles within the digital and analytics landscape through learning to integrate data analysis into product strategy.
Responsibilities
* Independently develop and implement data analytics decision tools and business case models in collaboration with the Digital Website and Apps Analytics team
* Formulate hypotheses, plan tests, and execute A/B testing on product performance, utilizing a strong understanding of experimental approaches in product launch strategies.
Follow up with go-live value measurements to assess strategy effectiveness
* Generate insightful reports and monitor the product performance to identify customer behaviors and trends, providing a deeper understanding of user engagement
* Apply structured problem-solving frameworks to identify key growth and profitability drivers of a regional insurance portfolio, and to highlight business issues or opportunities
* Translate statistical conclusions into business solutions and facilitate successful implementation in a cross-functional and decentralized global business environment
* Proactively provide innovative, customer-focused recommendations to all sales and distribution channels to maintain existing Business Partner relationships and secure business opportunities in an agile environment
* Support the Digital Product team as required, providing analytics expertise where needed
* Develop scalable standard practices for digital analytics and insight generation, ensuring consistency and efficiency across the business
* Collaborate effectively with team members situated across different geographies, fostering a unified and productive working environment
Qualifications
* 2+ years' of strong relevant analytics experience in two or more of the following disciplines - digital analytics, digital product management, data visualization, hypothesis testing, and insight generation
* A high level of skill using SQL and ETL to wrangle and transform data
* Experience with data visualization (Tableau preferred) to creat...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:43
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A re you ready to step into a position that combines your communication skills, attention to detail and ability to multitask? In a climate-controlled facility that delivers to hundreds of thousands of patients each week, an Inventory Representative is responsible for performing tasks related to receiving, stocking, and replenishing product accurately and efficiently.
If you've always wanted to work in pharmacy operations and enjoy a fast- paced and friendly company environment, this is the opportunity for you.
Job Responsibilities:
* Unload trucks and stage product to be received
* Safely unpack and evaluate incoming product for correct count and condition
* Accurately and efficiently pick and place inventory as directed by handheld scanner
* Maintain bin and shelf inventory - including shelf counts and expired product audits
* Safely operate material handling equipment and hand tools such as forklifts, pallet jacks (manual and electric), carts, dollies, box cutters, etc.
* Communicate effectively to team and other departments using a radio
* Accurately enter data using computers and scanners
* General housekeeping of warehouse and workstations
J ob Requirements:
* High School degree or equivalent is required • 0-1 years relevant work experience
* Basic math, organization, and computer skills
* Attention to detail to ensure accuracy
* Ability to read, write, and type English
* Ability to lift up to 50lbs and complete repetitive motions including bending, squatting, standing, walking, pushing, pulling and hand motions
Why join us?
* Health coverage effective day 1 (including medical, dental, & vision)
* Holiday, PTO and OT pay
* Annual bonus potential based on performance
* 401k and education reimbursement
* Opportunity for growth and advancement
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 accomm...
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Type: Permanent Location: Tempe, US-AZ
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:42
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340B Account Manager - Verity Solutions
Job Summary
Responsible for owning the ongoing account relationship and regular communications with a group of Verity Solutions accounts.
Educates, guides and set appropriate expectations with customers on maximizing Verity Solutions products for cost savings and compliance with 340B program guidelines.
Duties and Responsibilities
• Develop ongoing account relationships and serve as the key contact with assigned customers to understand their 340B program, compliance obligations, concerns and other pertinent data to develop clear service solutions.
• Consistently apply the client business review standards and expectations for consistent communication with assigned accounts, including frequency of scheduled contact and topics for review.
• Establish routines to review and analyze key savings metrics and account elements to maintain compliance and visibility to account performance including, but not limited to multipliers, ignores, unknowns, and savings reports.
• Educate and train customers on platform interaction specifics and new features/functions of all Verity products.
• Proactively report on findings for data anomalies to the appropriate team members and advise on next steps for resolution when possible.
• Use primary client management toolset (Salesforce) to manage and document all client interactions and projects as assigned.
• Respond timely and completely to customer cases as assigned, ensuring our service level standards are achieved.
• Support and promote the Verity Solutions performance standards and values through positive interactions with both internal and external stakeholders on a regular basis.
• Support occasional after-hours/weekend on-call support expectations
• Attend to other initiatives and goals as assigned
Experience, Skills and Qualifications
• BA or BS in Business or related field or equivalent work experience.
• 3+ years in a customer support, technical support or SaaS account management position.
• Strong written business communication skills, including proven ability to deal with competing goals, ability to lead difficult conversations, and the ability to achieve compromise outcomes.
• Aptitude to analyze data issues and troubleshoot problems with customer data.
• Strong experience and comfort level with MS office products, especially Excel.
• Experience using a CRM toolset, preferably SalesForce.com
• Ability to professionally and calmly communicate in both written and verbal forms with all levels of customer staff and management.
• Ability to be a self-starter, including strong multi-tasking capability, track record of managing multiple client accounts with shifting priorities and details in a fast-paced environment.
• Passion for working with customers, proactive problem-solving, and embodying a culture to exceed expectations.
• Experience working in a goal oriented, delivery focused, and dynamic environment....
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:41
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The Sr.
Contract Specialist role will reside on the Contract Administration team within Express Scripts' Military and Veteran Division focusing on contract administration for Federal contracts.
This role will support multiple client contracts.
Duties include but are not limited to advising the organization on matters of moderate to significant contractual complexity, providing guidance to less experienced contracting professionals regarding the administering of federal contracts, participating in the development and negotiation of Statements of Work, developing and overseeing small business plans and Organizational Conflict of Interest mitigation plans, SCA contract administration, ensuring contract deliverables are delivered on time and with high quality, leading the Contractor Performance Assessment Report (CPAR) process, conducting FAR/DFAR/VAAR compliance reviews pending the client, drafting and submitting proposals, leading discussions and negotiations with clients, financial oversight, and other ad hoc projects as assigned.
This role will also be responsible for drafting internal and client-facing communications on complex topics that may require extensive amounts of research.
Lastly, this position will seek to implement process improvements, mitigate contractual and financial risks while creating efficiencies.
The qualified candidate must be able to demonstrate they are able to work independently and perform their work with minimal oversight.
This employee will have access to advice from more experienced team members and peer reviews.
Tasks involve a degree of forward planning and anticipation of needs/issues.
This role will also work closely with cross-functional partners including the Law Department, Audit, Finance, and the Account Team regarding the requirements of the contracts.
QUALIFICATIONS
* Bachelor's degree in business, contracting, legal, communications, or related field with 7 yrs.
or more experience.
* Experience working in the Government Contracting field is desired but not required.
* National Contract Management Agency (NCMA) or Defense Acquisition University (DAU) certificates are also beneficial but not required.
* A proven track record of being a high performer with strong initiative and desire to excel is a must.
* Candidate should be detailed oriented with strong analytical skills.
* Candidate must have exceptional interpersonal and communication skills to work internally and externally.
* The ability to work independently on a multitude of projects with minimal supervision is necessary.
* This role will require some work to be performed at home and in the office at a Cigna location or client location.
* There may be some travel associated with this role.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps up...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:41
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Account Coordinator - Middle Market
SUMMARY:
The Account Coordinator (AC) plays a crucial role in maintaining client satisfaction and supporting the US Employer Sales Team.
Key responsibilities include participating in new business case discovery and implementation calls, collaborating with cross-functional partners to manage the book of business, providing routine communications, and updating client information and benefit intent.
Additionally, the AC coordinates third-party vendors, completes product incentive forms, and works closely with the Sales Team to ensure client needs are met and potential issues are proactively addressed.
The AC role benefits from face-to-face collaboration with peers and the Sales Team and will be expected to be in their local Cigna office every Tuesday and Wednesday as well as a third floating day per week.
Cigna Competencies: Cigna's competencies identify behaviors required for success at all levels of the organization.
Align
* Builds Networks: Effectively building formal and informal relationship networks inside and outside the organization.
* Manages Complexity: Making sense of complex, high quantity, and sometimes contradictory information to effectively solve problems.
Inspire
* Instills Trust: Gaining the confidence and trust of others through honesty, integrity and authenticity.
Develop
* Nimble Learning: Actively learning through experimentation when tackling new problems, using both successes and failures as learning fodder.
Deliver
* Ensures Accountability: Holding self and others accountable to meet commitments.
* Action Oriented: Taking on new opportunities and though challenges with a sense of urgency, high energy, and enthusiasm .
DUTIES AND RESPONSIBILITIES:
* Collaborate with Sales, Service Operations, and other applicable partners to manage book of business, address issues, and identify process improvements.
* Provide routine communications on behalf of Sales, including eKits and product materials, to clients and internal teams.
* Intake requests and submit forms to appropriate partners (OS, reporting, BOR/BAFb, OLAM).
* Update Salesforce information (e.g., contacts, MLS status, PG activity, benefit summaries) for sold and renewing cases.
* Complete product incentive forms to ensure accurate and timely processing.
* Coordinate and manage set-up of third-party vendors.
* Actively participate in new and existing business discovery and implementation calls.
* Liaise with Sales to meet client needs and proactively address potential problems.
* Keep Sales informed of account status and engage in role-related workgroups, special projects, and best practice sharing initiatives.
* Own creation of BNCA (Business Notification Case Alert) and handoff to Client Implementation.
* Managing PBAB (Product Benefit & Advisory Board) on renewals.
* Provide load balancing support to other ACs if capacity allows.
* ...
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Type: Permanent Location: Scottsdale, US-AZ
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:40
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Evernorth exists to elevate health for all, because we believe health is the starting point for human potential and progress.
As champions for affordable, predictable, and simple health care,
we solve the problems others don't, won't or can't.
Our innovation hub in India will allow us to work with the right talent, expand our global footprint, improve our competitive stance, and better deliver on our promises to stakeholders.
We are passionate about making healthcare better by delivering world-class solutions that make a real difference.
We are always looking upward.
And that starts with finding the right talent to help us get there.
Position Overview:
Join us! We are looking fora talentedIT professional with hands-on experience working in a production support environment, leading a small team to drive positive outcomes.
This position is responsible for managing day to day production tickets, perform thorough analysis and engage in solutioning with business and development teams.
As an experienced professional, they have proven ability to align technology efforts with business expectations.
Key Responsibilities:
* Performs trouble shooting and root cause analysis of production issues and user related defects, on a day-to-day basis ensuring they are reviewed and triaged properly.
* Acts as the first line of contact for production monitoring, research, and analysis.
* Communicates with stakeholders, clients, external vendors, and development team members.
* Ensures that production issues and backlogs are prioritized accordingly.
Required Experience / Qualifications:
* Bachelor's degree in information technology or computer science or engineering or related course work
* 7+ years of experience working in various application components - UI, API and DBs
* Knowledge of databases like SQL, Oracle, MongoDB
* Experience with cloud infrastructure (AWS, Google App Engine, or Heroku)
* Experience with Application Monitoring Tools (Splunk, Cloudwatch, Dynatrace etc)
* Experience working in Agile/Scrum environment.
* Solid understanding of Software Development Lifecyle.
Desired Experience / Qualifications:
* Healthcare domain knowledge
* Web and Mobile application project experience
* Hands on experience with these technologies: React / React Native / Angular and Java / Node JS
* Excellent written and verbal communication skills
* Solid analytical skills, highly organized, self-motivated and a quick learner
* Flexible and willing to accept change in priorities as necessary.
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 a...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:39
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POSITION SUMMARY
This position will be responsible for interpreting client contracts to identify and set up Pharmacy Management Funds.
In addition, this position will assist in reconciliation, reporting, and processing reimbursement requests, which includes gathering proper documentation and preparing payment files for accounts payable processing.
The position requires regular communication with cross-functional areas in order to meet deadlines, including Client Pricing, Account Teams, IT, Audit, etc.
The ability to communicate requests, results, and issues effectively with team members, management and cross-functional areas is essential.
The successful candidate will also be expected to proactively contribute to driving and developing best practices across the Financial Client Operations team.
SCOPE OF JOB
Position will support over 3,000 active clients, establishing their Pharmacy Management Funds, gathering and analyzing documentation to ensure requirements for reimbursement are met, tracking client's balances, and preparing payment files.
ESSENTIAL FUNCTIONS
* Works under minimal supervision, through established procedures, to ensure appropriate assessment of the Pharmacy Management Fund.
* Recommends resolution of identified issues during assessment as well as efficient process improvements.
* Work cross-functionally with business partners to research and analyze the Pharmacy Management Fund.
QUALIFICATIONS
* Bachelor's Degree in Accounting/Business/Finance or related field.
* 1+ years of relevant experience.
* Related work experience in PBM, Pharmaceutical, or Healthcare industry preferred.
* Excellent PC skills including Microsoft Office (Excel and Access).
* Experience with PostgreSQL, SQL Servers, Excel VBA and accounting systems helpful.
* Strong analytical, planning, problem identification and resolution skills required.
* Effective communication with internal and external individuals in various functional areas and at all levels of management.
* Demonstrate initiative with commitment and ability to work under pressure, with high quality and meet tight deadlines.
* Proven ability to plan for, and integrate, multiple tasks concurrently, as well as work independently.
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 re...
....Read more...
Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:38
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Must reside within 50 mile radius of 401 Chestnut St.
Chattanooga, TN 37402
Must successfully complete 10 weeks of onsite training at 401 Chestnut St.
Chattanooga, TN 37402
Position Summary
Utilize Implementation materials to load client specific benefits in the Proclaim claim engine, using macro/BOT technology and manual system entry to support new and existing business.
The PAA will also ensure that account benefits are in compliance with State and Federal legislation.
Responsibilities
Utilize Implementation materials to load client specific benefits in the Proclaim claim engine to support new and existing business.
Review and analyze various documents; such as, contract language, ePro, benefit summaries, and state mandates to ensure the claim engine is in compliance with client intent and benefit standards.
May be involved in benefit review discussions with Proclaim subject matter experts (SMEs) to provide technical insight as requested from internal matrix partners.
Prevent access to care (ATC) issues and resolve member impacting benefit disjoints by updating the claim engine timely based on updated source documents and/or benefit load clarifications
Internally communicates workflow and quality improvement processes when identified.
Qualifications
High School Diploma or GED required, advanced degree preferred
3+ years of experience in the Healthcare Industry, Pharmacy, or PBM highly preferred; or related experience
Intermediate knowledge of MS Office products, specifically MS Excel required
Excellent written communication skills; inclusive of accurately documenting system updates made
Strong verbal communication, analytical and problem-solving skills
Strong organizational, time and inventory management skills
Ability to "learn on the fly" and function in a fast paced and changing environment
Ability to interpret, process, and implement complex information
Ability to accurately self-audit completed system updates
Ability to prioritize and meet deliverables within expected timing
Experience working independently
Knowledge of matrix partner functions and how they interact; preferred
Actively participate in stretch assignments and remediation initiatives
Appropriately use MOS tools including DPL (inventory tracking system)
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...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:38
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The Infrastructure & Automation engineering team is focused on in the infrastructure operations for the applications within Provider Reimbursement Solutions.
The engineer will also be responsible for improving the stages within the Software Development Life Cycle so a product can be delivered to market faster, safer, and reliably.
The Infrastructure & Devops engineer will focus on work to cultivate DevOps practices and implement automation tools.
The engineer will work closely with other delivery, engineering, and operational teams throughout the iterative development cycle.
High level responsibilities.
* Support Production Operational teams for infrastructure level 1 through level 3 issues.
* Support non-production and production infrastructure requests for program delivery initiatives.
* Building and maintaining automation/deployment tools using industry standard technology.
* Building and maintaining infrastructure for many assets across different coding languages.
* Establish and promote Scaled Agile Framework (SAFe) DevOps Engineering best practices
* Actively troubleshoot any issues that arise during testing while catching and solving issues before launch.
* Support code and database deployments for all SDLC environments.
* Specifying, documenting and developing new product features, and writing automation scripts so that others may learn and utilize the functionality.
* Work with open-source technologies as needed.
* Work with CI and CD tools, and source control such as Ansible, Jenkins, Udeploy, and GIT.
* Participate in Agile ceremonies across the Agile release train to produce results conducive to company interests.
* Offer good technical support where needed.
* Stay current with industry trends and source new ways for our business to improve.
* Work with an Agile framework, and attend the Scrum/Kanban ceremonies like Sprint Planning, Daily Stand up, Sprint review and retrospective etc.
Qualifications:
* Bachelor's degree preferred with 5+ years of relevant work experience in software development or software engineering.
* Experience working within Scaled Agile Framework DevOps principles.
* Ansible and Python development experience is highly preferred.
* Hands-on programming experience using relevant languages.
Pega and Java recommended.
* Hands-on experience with supporting core infrastructure technology like RHEL operating systems, Java containers (EAP/JWS), and databases (Oracle/PostgreSQL).
* Solid understanding of object orientated languages such as JAVA, C++, and Python.
* Experience using web services and APIs.
* Experience with CI/CD pipelines via projects such as Jenkins, Teraform, Gitflow, CI, ect...
* Strong organizational and multi-tasking skills, as well as attention to detail.
* Strong written and verbal communication and interpersonal skills.
* Must be able to "know your audience" and communic...
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Type: Permanent Location: Raleigh, US-NC
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:37
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Remote - Work from home - United States
Summary
We are seeking a seasoned professional for the role of Business Analytics Advisor within the Medicare Growth Analytics Team to assist our self-service analytics strategy.
Reporting to the Growth Analytics Sr.
Manager, this role will work with a team of professionals on setting and executing the vision for how our Medicare Growth team can lead Cigna to achieving its goals.
This role involves data integration, modeling, and analytics efforts.
You will play a pivotal role in shaping our data strategy and delivering advanced solutions for key growth reports and strategic analyses.
This position will blend creativity, analytical, and technical competencies, relentless problem solving, and business acumen to deliver solutions to our business partners.
This position requires expertise, vision, and a track record of success in supporting data-driven initiatives.
While this role is posted as a WFH position, strong preference will be given to candidates near our Medicare Hubs (Nashville, TN; Bloomfield, CT; Philadelphia, PA; Phoenix, AZ)
Responsibilities
* Provides expert content and professional leadership on complex analytics assignments/projects.
* Exercises considerable creativity, foresight, and judgement in conceiving and delivering initiatives.
* Takes projects from beginning to end by managing variable tasks, stakeholder engagement and data review with limited supervision to meet targeted timelines.
* Analyzes results and presents data in a consumable method using high-level overviews, major takeaways, critical questions, and next steps.
* Partners with other analytics and growth team members to make executive-level recommendations and align on strategy and plan.
* Partners with other analytics team members as well as growth team members to continuously improve department procedures.
* Partners with data engineering to ensure environment stability.
* Act as a liaison - bridging the gap between end-users (business) and engineering teams - responsible for translating the business needs into technical requirements, ensuring clear communication, and understanding between both groups.
* Troubleshoots logic and data flow issues on Tableau self-service reports, including upstream data and logic integrity.
* Performs data validation analysis, including high level data quality/audit checks, process/logic/assumption documentation and ongoing monitoring and maintenance of solutions.
* Maintains analytics skillset through an understanding of new technologies, automation techniques, and the ability to execute and apply new skills to day-to-day work.
* Identify and specify additional data necessary to execute innovative metrics required to understand underlying performance of annual initiatives.
* Compiles, prepares, and presents to stakeholders and leadership analytical results with identification, quantification, and prioritization of opport...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:37
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Founded in 1973, Freedom Fertility Pharmacy was one of the first pharmacies to focus exclusively on the needs of fertility patients.
Today, Freedom is America's leading fertility pharmacy.
Our teams at Freedom specialize in the unique needs of fertility patients by providing medication compounding, expedited delivery, superior customer service and comprehensive patient support.
As aPharmacy Technicianwith Freedom Fertility, you will be assisting patients in receiving needed medications to help achieve their dreams of building a family.
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 your day working on our computer system, answering incoming calls and making outbound calls to patients to review benefit coverage.
Work Schedule:Rotating schedule that consists of 3 days working 9:00 AM EST - 5:30 PM EST and 2 days 12:30 PM EST - 9:00 PM EST; approximately every 6 weeks there will be a weekend day scheduled.
Here's a little more on how you'll make a difference:
* Associate prescription images to patient profiles and create patient profiles in system if needed.
* Prepare prescriptions for processing, including assessing validity of prescription.
* Manually route orders to appropriate stage for processing, validation or clarity from Doctors' offices, insurances and/or patients.
* Accurately enter prescriptions into our system, run test claims, run test claims, and support patients with their medication orders.
Use the knowledge you gain from training, your problem-solving skills and support from your team to accurately process prescription claims so they will be dispensed accurately.
* Associate and add insurance/discount program information to patients or specific medication, including setting up coordination of benefits.
* Resolve rejections and update patient on all delays in processing accordingly.
* Interact directly with healthcare providers and insurance companies.
Research issues with pharmacists and doctors' offices and provide guidance to our patients about medication coverage.
* Respond to incoming calls from patients with questions about their prescriptions, prescription coverage including copays, as well as setting up patient-driven medication refills.
* Complete multiple tasks without sacrificing attention to detail or customer service.
You will be busy handling multiple requests at any given time as well as documenting information in our system.
What we offer:
* $2,500 Sign on Bonus (50% payable after 90 days of employment, 50% after 180 days of employment).
* Health coverage effective day 1 (including medical, dental, vision).
* 401(k) plan with company match.
* Holiday Pay and Paid Time Off.
* Competitive Benefit package (including tuition reimbursement).
* Growth and Advancement opportunities.
* Fun, ...
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Type: Permanent Location: Byfield, US-MA
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:35
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The Operations Senior Supervisor is responsible for day-to-day operations of a team of technicians.
Manages and improves productivity and performance standards, plans and directs workflow and project assignments.
Responsible for attaining or exceeding production goals for their respective area daily.
Conducts hiring, training, and evaluation of front-line team members.
Responsible for team's adherence to employment policies and corporate values.
Works with the Pharmacy senior leadership team to establish team and site standards and expectations, operational processes and procedures, and the business work plan for the team.Recognizes and recommends operational improvements.
Work Schedule: Monday through Thursday 3:30 PM to 2 AM
Location: 4600 North Hanley Road; St.
Louis, MO 63134
What you will do:
* Develop, track and monitor employee's safety, compliance to quality, service and production standards.
* Monitor prescription turnaround time so that internal standards and client performance guarantees are met.
* Assist Pharmacy senior leadership team in monitoring costs to ensure compliance with cost to fill goals.
* Address staff concerns and day to day operational, system, customer service, quality, and professional issues.
* Work in production as needed.
* Implement programs and process improvements to enhance the level of internal and external customer service provided.
* Work with Pharmacy senior leadership team to analyze operations and overall efficiencies of the pharmacy.
* Serve as a point of escalation for issues requiring a higher degree of expertise or discretion to resolve.
* Represents pharmacy operations in cross-functional meetings and projects.
* Other special projects and tasks as assigned.
What you will need:
* High school diploma or GED
* BA/BS degree preferred.
* Relevantoperations experience (i.e., pharmacy, warehouse, distribution, production, manufacturing, or engineering)
* Must be eligible to maintain a pharmacy technician license issued through the Missouri State Board of Pharmacy throughout time in position.
* Demonstrated leadership skills and the ability to effectively develop, train and coach less experienced team members; supervisory experience preferred.
* Knowledge of lean or process improvement methodologies
* Excellent oral and written communication skills
* Ability to adapt in a dynamic work environment, make independent decisions.
* Advanced problem-solving skills and the ability to work collaboratively with other departments to resolve complex issues with innovative solutions.
* Willingness to work a flexible schedule for peak times.
* Monitors daily operations of a unit and actively assists or provides direction to subordinates as required.
* May perform, especially in staff or professional groups ongoing operational tasks of organization units (typically not more than 40% of time performing the...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:35
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Role Summary
The Provider Contracting Senior Manager will have oversight of a region of facility networks and will be responsible for its contract performance.
This Senior Manager will be responsible for directing a team of negotiators to manage all rate renewals and contract maintenance activities.
This Senior Manager will collaborate with the other Regional Senior Managers to develop facility affordability action plans, align with medical contracting as well as partner with large regional and select national systems.
In addition, the Senior Manager will contribute to the overall Network Strategy by delivering strategic projects related but not limited to implementation of strategic initiatives regarding Network Solutions and Innovative Contracting to enhance provider supply and demand as well as the evolution of our reimbursement models.
Role and Responsibilities
* Oversee system contract performance teams to rate renewal targets, unit cost and overall claim trend targets are met.
* Utilize internal data such as claims, completed negotiations and network composition along complete and external benchmarking to develop a comprehensive reimbursement strategy that drives affordability while improving access and quality of care.
* Coordinate with Network Informatics, Finance, and other Network Managers to develop and monitor the facility budget for new and existing regional facility systems as well as develop a competitive intel process leveraging transparency data as well as Medicare and Medicaid pricing.
* Collaborate with Network Directors, Medical Directors, and product leadership to create new coverage policies for innovative reimbursement structures and new product designs as well as implement product specific networks curated to drive quality and affordability.
* Execute partnership plans with facility systems as well as construct a united negotiation strategy with our Medical Commercial and Medicare contracting and Network Strategy Leadership.
* Design innovative contract solutions such as measurement-based care, case rates or preferred provider networks, performance guarantees, as well product specific networks and rates.
* Enhance the Facility Center of Excellence Program along with with Network Medical Director and Clinical Operations which include but not limited to developing a performance meeting process which will increase the utilization and expand the number of Facility Center of Excellences.
* Work with other Contract Managers to build a contract management system and oversee contract governance for facility contracting templates and protocols.
* Increase provider satisfaction through provider experience improvement initiatives such as decreasing turnaround times and streamlining facility onboarding and contract maintenance.
* Set facility targets and oversee Team Monthly Operating Reports (MOR) and assist in maintaining Department MOR to identify trends and highlight successes...
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Type: Permanent Location: Baltimore, US-MD
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:34
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*
*MUST RESIDE within a 50-mile radius of:
- Warrendale, PA
- Orlando, FL
- Memphis, TN
Transform healthcare and contribute to our industry-leading organization as a Customer Service Representative.Our Customer Service Representatives are dedicated team members who excel at customer service, helping us elevate our Patient Care to new heights.
In this crucial role, you are on the front lines with patients, responding to phone inquiries and addressing each with care, detail, and most importantly, empathy.
Here's a little more on how you'll make a difference:
* Help patients understand their pharmacy benefits better.
Use the knowledge you gain from training, your problem-solving skills and support from your team answer patient calls effectively.
* Help us keep track of our patient interactions.
While on calls, use your expert listening skills to get to the heart of a patient's question quickly and document all interactions in real-time.
* Ensure patients are equipped with the best advice.
Identify and empathetically address patient concerns and, if necessary, escalate appropriately.
What You Should Have:
* High School Diploma / GED required
* 1 year of relevant experience
* General PC knowledge including Microsoft Office
* Excellent communication skills (verbal and written)
What you'll love about working here:
* Fun, friendly, and unique culture - Bring your whole self to work every day!
* Medical Dental & Vision start 1st day
* 18 days Paid Time Off & 8 Paid Holidays
* Employer Contributions for HRA and HSA accounts
* 401K with Company Match
* Tuition Assistance
NOTE : 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.
For positions that are Flex/WAH:
This role is WAH/Flex which allows most work to be performed at home.
Employees must be fully vaccinated if they choose to come onsite.
ABOUT ACCREDO
Through our range of health care products and services offered, Accredo team members provide in-depth care for patients with chronic health conditions like hemophilia, oncology, rheumatoid arthritis and growth hormone deficiency.
In addition to health care products, we provide comprehensive management services - including outcomes measurement, counseling, clinical care management programs, social services and reimbursement services.
By performing in these very high-touch roles, employees have a daily opportunity to make a positive impact on their patients' lives.
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 ben...
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Type: Permanent Location: Philadelphia, US-PA
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:34
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The Provider Performance External Representative is a key member of the market that assists in the growth and development of the provider network.
The External Representative is the primary conduit to the providers and the individual that represents Cigna MA.
The Provider Performance External Representative's responsibilities include:
* Most likely to have responsibility for non-centralized provider groups requiring 1:1 intervention to improve and/or maintain performance.
* Creates engagement with provider group and leads discussion or organizes PPE partners for effective meetings.
* Develops and executes provider group improvement plans autonomously, with expert-level technical support from manager.
* Knowledge of quality and affordability metrics and tools; effective communication to inform external partners.
* Supporting the development, management and oversight of the physician/ provider network in his/her assigned Mid-Atlantic (MD, DC & VA) region.
* Establishing and managing strong, solid relationships with assigned provider groups and their staff (e.g.
physicians, practice managers, care coordination teams), as well as executing with provider group on initiatives that benefit the customer, provider, and health plan.
* Educating providers on the performance requirements associated with value-based contracts.
* Conducting regular provider visits to educate providers and office staff on topics including, but not limited to: preventative and quality outcome metrics, risk adjustment, medical cost management, etc.
* Schedules, prepares for and participates in meetings with providers, provider staff, and/or physician leadership including creating and delivering presentations.
* Collaborating with Provider Performance Senior Manager/Manager on strategic plans on growth, development, and vision for assigned territory.
Participating with the Senior Manager/Manager in monthly financial review.
* Assisting in initiatives and performing special projects and other duties as assigned by leadership
* Developing time and cost effective territory management in compliance with department and enterprise goals.
* Understanding, developing, tracking, monitoring and reporting on key program performance metrics, such as utilization, coding, and Stars/quality performance.
* Partnering with other internal departments, including but not limited to Health Services, Medical Economics, Sales, and Sales & Risk Adjustment in order to develop solutions for strategic business needs
* May provide guidance to others in the department
Role Components
All market team members contribute to the growth and profitability of the Medicare Advantage business in their market in the following aspects:
* Growing the MA Business: The Provider Performance External Representative is accountable for the growth of the assigned (Mid-Atlantic (MD, DC & VA) region in terms of financial profitability, engageme...
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Type: Permanent Location: Baltimore, US-MD
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:33
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Job Description
Provides counsel and advice to top management on significant Clinical Program Management matters, often requiring coordination between organizations.
Focuses on providing thought leadership and technical expertise across multiple disciplines.
Recognized internally as "the go-to person" for the most complex Clinical Program Management assignments.
Represents company externally and serves as conduit to educate and enable care coordination between stakeholders resulting in an optimal healthcare experience and customer satisfaction.
Serves as clinical advisor to the sales organization, providing ongoing product and industry knowledge/education that positively influence cost, quality and customer satisfaction.
Essential Functions
* Serve as business owner to necessary client work that involves Medicare operational and implementation benefits changes
* Understand client's existing clinical benefit and business philosophy to help avoid unnecessary clarifications
* Accurately capture and document clinical benefit requirements in collaboration with business stakeholders
* Provide excellent customer service and act as a trusted client advisor
* Work with internal partners to ensure all implications of requested clinical benefit requirements are vetted, understood and communicated as necessary
* Provide operational Subject Matter Expertise (SME) to Clinical Account Executives/Implementation Manager (CAE/IPM's), Client Benefit Administrators (CBA), Clinical Application Teams (DCRS, FRS, CRS, Criteria), Product Owners
* Manages and tracks all requests to ensure timelines are met
* Develop a deep understanding of claims adjudication system and associated clinical applications
* Leads the development, preparation, and presentation of project plan including execution and delivery for each client(s) assigned
* Participates and contributes in formal and informal training programs and professional development activities which may include taking, developing, and/or conducting sessions
Skills
* Ability to multi task and communicate effectively
* Microsoft office with a strong understanding of Excel and Access
* Written and verbal communication (listening, feedback; translating complexideas/processes), collaboration, analytical thinking/critical thinking,results-oriented and organizational skills
* Must have the ability to work on multiple tasks, prioritize, resolve complex issues, and have strong project management skills
* Ability to learn multiple internal reporting and analytic tools for client management
* Provide project and administrative support to the team and escalate issues, risks, concerns as needed
* Ability to manage timelines and meet tight client deadlines
* Advanced problem solving skills and the ability to work collaboratively with other departments to create solutions and to resolve issues
* Must be able to work under pressure and per...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:33
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Training Schedule: Monday-Friday 830AM-5PM CST (7 weeks)
Production Schedule: Monday-Friday 1030AM-7PM CST
The Personal Advocate position is responsible for representing Cigna Behavioral Health (CBH) to all inbound callers within a call center environment and assuring caller's contact with CBH is positive.
Advocates are many times the first encounter customers have with Cigna and thus are responsible for giving a positive first impression.
The Advocacy tasks of this position are varied and often complex in nature requiring flexibility and multi-tasking capabilities.
Responsibilities may include but are not limited to: educating customers on benefits, eligibility, referrals, non-clinical resources and assessing for potential risk of harm or substance abuse concerns.
This position services calls in a warm and empathetic manner as many of the calls are sensitive in nature.
Independent problem solving skills are critical to success within the role along with intelligent judgment of assessing the caller's needs.
Based upon the call type and requests advocates should be able to use customer service skills, knowledge of the mental health/substance abuse field and Cigna training to effectively address callers needs in an educational manner.
This position is an entry level role with opportunity for growth within the company.
Incumbents will utilize telephonic communication the majority of the time with some web, and internal CBH materials to achieve first time resolution for callers.
Responsibilities:
The primary responsibility of the Advocate role is answering calls from customers.
The majority of the day will be answering inbound calls from customers looking to access, understand, or utilize services.
Within a call an advocate may:
* Register participants in the intake system and opens case files
* Educate participants on their benefits based upon individual plan design and other clinical or non-clinical resources available
* Conduct an intake as needed to assess for presenting concern and risk of harm or substance abuse concerns
* Provide participants with names and phone numbers of nearest providers
* Multi-task by maneuvering through various computer programs and screens
As needed an advocate may also:
* Write authorizations to ensure claims are paid correctly.
* Provide follow-up calls to participants to ensure correct information is given
* Send eligibility requests to determine effective coverage dates or to verify correct benefits are loaded
* Send complaints to initiate grievance process for customers
On all calls an advocate is responsible for:
* Providing high quality customer service as identified by Advocacy department quality standards
* Using independent problem solving skills to make sound decisions in assessing the needs of the callers by giving accurate information and providing first call resolution
* Understanding the business needs of the role, while balancing the...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:32
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Role Summary
Develops and implements sales strategies for targeted key accounts in a plan, a territory, or a specified geographic area.
Very knowledgeable of complete line of products/services and clients' issues and needs.
Primarily focuses on seeking out new clients.
Typically has at least three years of related sales experience.
Responsibilities
* Obtain new accounts through direct or brokerage channels for sales.
* Meet or exceed annual business plan as measured by new firms, revenue, membership and profitability objectives.
* Maintain prescribed weekly activity levels.
* Manage the sales process for Medical, Dental, Pharmacy, Behavioral products.
* Review and respond to RFP's, manage internal strategy and present quotations.
* Manage database of prospects and assigned producers.
Qualifications
* 3+ years sales experience strongly preferred
* Prior Insurance experience in Underwriting, Operations or Proven sales track record
* 1-2+ years' experience in managed care sales
* Highly motivated with excellent organizational skills
* Self-starter with ability to work independently or as a team to achieve goals and objectives
* Excellent presentation skills, verbal and written communication skills
* Ability to work strategically with matrix partners to design presale strategies and proposals
* Ability to obtain necessary licenses
* Acceptable driving record
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life.
We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality.
Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, 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 ...
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Type: Permanent Location: Houston, US-TX
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:31
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GENERAL PURPOSE
Responsible for coordinating the security administration function for all Treasury Department systems including the Treasury Workstation (Reval), the global payments hub (CEPP/DPAS), the check management platforms (CDDP/BCIP) and the escheat due diligence and unclaimed property reporting tools.
Performs balancing and control procedures for company's electronic funds transfer transmissions to its global banking partners.
Supports the design and implementation of enhancements to assigned Treasury applications.
Supports the Treasury Department's daily production process, including trouble shooting and table maintenance for assigned systems.
MAJOR DUTIES AND RESPONSIBILITIES
* Controls and balances the daily processing of wire & ACH transaction files transmitted via SWIFT to Cigna's global banks.
Ensures that all transactions have been processed.
Reconciles confirmations received against transmission totals.
Identifies problems and takes corrective actions.
Communicates problems to internal Treasury users and Systems Support.
* Performs all data security administration for the Treasury Workstation (Reval) & global payments hub (Bottomline Technologies) systems (CEPP/DPAS).
Coordinates new ID requests and ID changes with IT.
Monitors ID usage to ensure compliance to corporate security standards.
Researches and resolves issues as necessary.
* Researches, responds and interprets requests for global payments hub enhancements.
Supports the design and implementation.
Provides for the testing and definition of test plans for the new/enhanced functionality.
Coordinates end user testing of all system changes.
* Participates on various Treasury project teams as assigned.
Supports the implementation of new/enhanced treasury systems.
* Performs table maintenance for treasury applications.
* Handles special projects as assigned.
SCOPE AND DIMENSIONS
1.
Reporting Relationship
a.
Reports to: Treasury Analysis Manager
b.
Positions Reporting to this job: none
2.
Magnitude
Responsible for the integrity of bank information utilized to manage all Cigna daily cash and to process accounting entries for all receipts.
Systems process hundreds of thousands of transactions annually, valued at hundreds of billions.
DESIRED QUALIFICATIONS
* B.A.
in financial discipline and 1-2 years of experience in Treasury and/or accounting functions.
* Must have in-depth knowledge of Treasury/Financial concepts.
* Must have proven customer service skills.
* Individual must have excellent analytical abilities and problem solving skills.
* Position requires strong negotiation and interpersonal skills.
* Individual must be able to function effectively in a high pressure, time sensitive 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 downlo...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:31
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The Pharmacy Technician in the Stars Pharmacy Call Center will work within the Part D Medication Adherence area of the Cigna Medicare Stars department.
The Star rating system was developed by the Centers for Medicare & Medicaid Services (CMS) to measure the quality of care delivered by a health plan.
This call center role performs telephonic outreach to Cigna Medicare customers, pharmacies, and providers for the purpose of addressing prescription medication adherence.
You will be responsible for assisting customers to obtain prescribed medications, determine barriers to medication adherence and working to overcome those barriers by working with the clinical pharmacy team, physicians, and resources within the Medicare Health Plan.
Primary Responsibilities include but are not limited to:
* Telephonic outreach to members, pharmacies, and providers.
* Will work in a call queue where productivity and quality are monitored.
* Meet service level goals (call quality, daily/weekly call performance expectations).
* Maintain member privacy by strictly adhering to HIPAA regulations.
* Answer complex telephonic questions from customers while ensuring a high level of customer service and maximizing productivity with minimum downtime.
* Handles customer correspondence, complaints, and inquiries.
* Will keep track of issues and timelines, research and resolve complex issues, and compile required documentation for daily activities.
* Must maintain a professional, customer-centric demeanor at all times.
What's in it for me?
* An ability to make a positive impact in the lives of our customers.
* Great team environment.
We have fun and get our work done too!
* Professional and personal development opportunities.
* A working environment that embraces diversity.
What do I need for this position?
* Pharmacy Technician license, current.
* Minimum of one year of experience in a retail pharmacy, Pharmacy Benefit Management (PBM) or Health Plan setting required.
* Experience in and a passion for delivering excellent customer service.
* Strong computer skills (will be simultaneously talking on the phone, toggling between multiple open Internet windows, software programs, Word, and Excel).
* Self-motivator with strong organizational skills, attention to detail, and exceptional time management skills.
* Superb active listening skills, able to work in a dynamic, fast-paced team environment.
* Effective written and oral communication skills.
What would be nice to have?
* Experience working in a call center.
* 2+ years of experience in a retail pharmacy, Pharmacy Benefit Management (PBM) or Health Plan setting
* Certified Pharmacy Technician (CPhT), national certification from PTCB or NHA.
Work Schedule:
8:00am - 5:00pm CST Monday thru Friday.
No weekends, holidays.
Central Time Zone Remote location preferred
If you will be working at home occasionally or per...
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Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:30
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Job Description
Primary Function:
Coordinate and manage relationships with participating provider practices.
Maintain detailed understanding of HEDIS / STAR/ CAHPS performance measures.
Develop and maintain a process to ensure all customers in participating provider practices meet all quality metrics.
Supports the delivery of cost-effective, quality -based health care services for health plan customers by development and implementation of alternative treatment plans that address individual needs of the customer, their benefit plan, and community resources.
Plans, implements, and evaluates appropriate health care services in conjunction with the physician treatment plan.
Utilizes clinical skills to assess, plan, implement, coordinates, monitor and evaluates options and services in order to facilitate appropriate healthcare outcomes for customers.
Responsibilities:
* Identifies Quality gaps and metrics for customers and communicates to provider
* Review STAR summary gap report (daily) by payor
* Reviews Arcadia polychronic reports
* Clinical review of charts for clinical documentation integrity ( # Charts Reviewed to TBD by polychronic report threshold)
* Query provider based on clinical chart findings
* Follow up and track provider query's (weekly)
* Maintains physical presence in participating provider practices
* Identifies high-risk/high-cost patients for possible case management intervention and refers to appropriate clinical program.
* Interfaces with providers of medical services and equipment to facilitate effective communication, referrals, supports discharge planning, and alternative treatment plan development.
* Identifies customer needs, coordinates and supports planned and unplanned transitions and post discharge follow up calls which may include primary care physician and specialist appointment scheduling
* Nurse notifies PCP daily of admissions and discharges
* Collaborates with the attending physician to achieve identified patient outcomes.
* Tracking of monthly IPM reports by PCP
* Attend and participate in weekly team or provider meetings
* Collaborates with supervisors, team members, and utilizes buddy system for back up coverage
* Performs telephonic outreach as directed
* Communicates with all departments to resolve issues
* Understands and follows administrative guidelines (policy and procedure) of the department
* Attends and actively participates in staff meetings.
* Requires on camera participation
* Attends clinical documentation integrity training
* Provides detailed clinical chart review to verify chronic conditions and related symptoms
* Support Chart reviews and Pulls medical records for HEDIS
* Supports Health Plan with CAHPS and STARS initiatives
* Extract data as needed and document in appropriate system
* Other Duties as assigned.
Supervisory Responsibilities:
* None
Job Rel...
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Type: Permanent Location: Mobile, US-AL
Salary / Rate: Not Specified
Posted: 2024-06-25 08:24:30
