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Are you looking to make a connection to your career? Come to Molex where we create connections for life.
We use innovation, engineering excellence, commitment to quality and reliability, and superior customer experience to improve communication, elevate experiences, and engage and inspire people everywhere.
Molex's Copper Solutions Business Unit (CSBU) is a global team that works together to deliver exceptional products to worldwide telecommunication and data center customers.
CSBU is one of the most highly technically advanced business units within Molex.
Our engineering teams are designing cutting edge solutions for high-speed, high-density products that maximize speed, signal integrity and efficiency.
The Technical Project Manager (TPM) will be leading a highly motivated, world-wide, cross functional team through the New Product Development Process from project initiation approval through production.
This person will lead projects with global cross functional teams, working directly with customers, mentoring team members, solving problems, and making/being accountable for project-level decisions.
You have strong project management experience in "technical" business environments.
The Project Manager will thrive on moving the needle to achieve business objectives that will take Molex and our customers to the next level.
What You Will Do
* Partner to Product Manager: Ensure Molex key technology projects seamlessly support our customer's finished good project deliverables through close collaboration and effective communication with our customer.
* Project Team Leader: Simultaneously lead multiple New Product Development projects for customer specific and general market projects.
* Develop internal & external facing Project Charters that clearly articulate project strategy, scope, financials, and schedule.
* Own Project Reporting communication to both Management and Customers.
* Perform the Project Management function: Manage Project Change Control and Decision Documentation.
* Lead Project Plan development, management, and closure (transfer to production owner).
* Own and develop Macro Project Schedules and understand and hold accountable Functional Team Members supporting Micro Schedules.
* Lead and mentor team members in project management principles, PDP processes, risk management, issue resolution, decision making, etc.
* Proactively identify, document, and execute risk reduction activities to minimize Project Risks associated with Cost, Quality, and/or Timing that could negatively affect Project Plan achievement.
* Work with Suppliers: Ensure that they meet Molex's expectation for timing, cost and quality in support of the Project Plan
Who You Are (Basic Qualifications)
* Bachelor's degree in engineering, finance, business, supply management or related field
* Experience leading projects with Product Development
* At least 4 years of Project Management experience
*...
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Type: Permanent Location: Conway, US-AR
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:28
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JOB DESCRIPTION: Quality Control Technician
Burlington, MA, USA
Poly6 is enabling production of complex turbine engine designs by combining additive manufacturing with advanced materials.
Our technology is uniquely suited to increase the efficiency of complex manufacturing processes as well as advance engineering design capabilities.
Long-term benefits of Poly6's products include reduced greenhouse gas emissions for the aviation sector.
You will have the opportunity to work alongside a highly talented team to solve problems in one of the world's most complex engineering sectors: aviation.
JOB SUMMARY
As part of ceramics process operations, the Quality Control Technician is responsible for inspecting parts within the process flow of ceramics-based finished goods.
The technician will use visual magnification techniques and equipment and machines to assist in the validation of Quality production.
Responsibilities
* Inspect highly intricate and delicate ceramic parts for defects (visual and feature), recording the defects into an MES system for high data integrity.
* Perform ceramic core and inspection processes in accordance with customer and regulatory requirements.
* Read, comprehend, and adhere to work instructions and standard operating procedures with emphasis on quality.
* Achieve team production and efficiency goals by meeting operational and quality standards.
* Work directly and cooperatively with cross-functional team members to troubleshoot issues and ensure emphasis on quality.
* Maintain a safe and clean work environment by meeting and exceeding established 6S standards.
* Perform all other duties assigned by supervisor or manager.
QUALIFICATIONS
* High school, GED, or 2+ years' work experience in a visual inspection role in a production environment
* Experience working under microscope or magnification on highly detailed parts or assemblies
* High level of dexterity to work on detailed surfaces that with small hand movements
* Ability to engage closely with engineers to develop and execute experiments
* Attention to visual and written detail
* Flexibility regarding schedule for potential staggered shifts to meet production demand
* Written and spoken fluency in English required
PREFERRED EXPERIENCE
* Minimum of 3 years' experience in pharma, bio, med device, defense, or aerospace manufacturing
* Experience with quality inspection
PHYSICAL REQUIREMENTS
* Ability to work 8 hours under magnification
* Ability to handle, adjust and transport fragile manufactured parts
* Regular movement across a ~6,000 sf production floor
* Ability to stoop, kneel, crouch and/or crawl
* Demonstration of good sight and hearing
This position requires access to information protected under U.S.
export control laws, including the International Traffic in Arms Regulations and/or the Export Administration Regulations.
Please note that any offer for ...
....Read more...
Type: Permanent Location: Burlington, US-MA
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:21
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Manufacturing Manager
If you would love to be part of a company that is poised for substantial growth with opportunities for career advancement, then working for CPP may be the right fit for you! Join a results-oriented workplace that strives for success through innovation, collaboration, and teamwork.
Consolidated Precision Products (CPP) is an investment casting foundry that specializes in complex aerospace & gas turbine components.
With a stable business model and competitive compensation & benefits, CPP is a great option to consider as you look to make your next career move.
Salary DOE 70k+
For more information, please visit https://www.cppcorp.com/
JOB SUMMARY
The primary function of this position is to support team members to meet daily safety, quality, and production requirements.
The following factors serve as expectations, and will be used to measure the relative performance for individuals in the Manufacturing Supervisor role:
* Work with Team members and other leaders to monitor standards of work and process flow within the department or work area to meet production and customer requirements.
* Responsible to execute goals and objectives for the plant.
PRIMARY RESPONSIBILITIES
* Lead the activities of team members of production of quality parts in accordance with work instructions and company policy to ensure a quality product delivered on time.
* Responsible for maintaining safety standards as required by law and company policy.
* Coach and provide technical expertise to resolve issues and create and ensure corrective action(s) are implemented.
* Ensure the appropriate level of accountability for goals and objectives at the team member levels.
* Monitor and take appropriate timely improvement action to meet production quality and quantity.
* Utilize problem solving techniques, teamwork building strategies, process control, and continuous process improvement tools to meet or exceed the operating goals/metrics.
* Facilitate team member workflow management, workforce scheduling and team member placement to ensure the facility and company goals are successfully met or exceeded.
* Maintain adherence to company policies, safety standards and good housekeeping practices.
* Responsible for the completion of Accident Investigation forms in areas of responsibility
* Responsible for implementation of safety countermeasures and doing root cause analysis to determine appropriate safety changes that are needed to improve plant safety.
* Responsible to adhere to all site safety policies and procedures.
* Coach and model safe behaviors, respect for environment and 6S behaviors.
* Champion safety practices at the site.
QUALIFICATIONS
* Education: High School Diploma or General Education Degree (GED)
* Experience: Manufacturing experience required.
* Other Required Knowledge, Skills & Abilities:
+ LANGUAGE SKILLS - Ability to read, understand a...
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Type: Permanent Location: Chittenango, US-NY
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:19
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JOB DESCRIPTION: Patch & Inspection Technician
Burlington, MA, USA
Poly6 is enabling production of complex turbine engine designs by combining additive manufacturing with advanced materials.
Our technology is uniquely suited to increase the efficiency of complex manufacturing processes as well as advance engineering design capabilities.
Long term benefits of Poly6's products include reduced greenhouse gas emissions for the aviation sector.
You will have the opportunity to work alongside a highly talented team to solve problems in one of the world's most complex engineering sectors: aviation.
JOB SUMMARY
As part of ceramics process operations, the Quality Control Technician is responsible for inspecting ceramic parts at 0x, 4x and 7x magnification for visual defects, feature defects and working with engineering team to improve our process.
Responsibilities
* Inspect highly intricate and delicate ceramic parts for defects (visual and feature), recording the defects into an MES system for high data integrity
* Perform ceramic core and inspection processes in accordance with AS9100 requirements
* Read, comprehend, and adhere to work instructions and standard operating procedures with emphasis on quality
* Achieve team production and efficiency goals by meeting operational and quality standards
* Work directly and cooperatively with cross-functional team members to troubleshoot issues and ensure emphasis on quality
* Maintain a safe and clean work environment by meeting and exceeding established 6S standards
* Perform all other duties assigned by supervisor or manager
QUALIFICATIONS
* High school, GED, or 2+ years' work experience in a visual inspection role in a production environment
* Experience working under microscope or magnification on highly detailed parts or assemblies
* High level of dexterity to work on detailed surfaces that with small hand movements
* Ability to engage closely with engineers to develop and execute experiments
* Attention to visual and written detail
* Flexibility regarding schedule for potential staggered shifts to meet production demand
* Written and spoken fluency in English required
PREFERRED EXPERIENCE
* Minimum of 3 years' experience in pharma, bio, med device, defense, or aerospace manufacturing
* Experience with quality inspection
PHYSICAL REQUIREMENTS
* Ability to work 8 hours under magnification
* Ability to handle, adjust and transport fragile manufactured parts
* Regular movement across a ~6,000 sf production floor
* Ability to stoop, kneel, crouch and/or crawl
* Demonstration of good sight and hearing
This position requires access to information protected under U.S.
export control laws, including the International Traffic in Arms Regulations and/or the Export Administration Regulations.
Please note that any offer for employment may be conditioned on authorization to receive software or technology...
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Type: Permanent Location: Burlington, US-MA
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:18
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Consolidated Precision Products (CPP) in City of Industry is currently looking for General Labor workers to join our team! This role will be reporting to our Operations Supervisor on 2nd Shift (3:30 pm - 12:00 am) at our Aerospace Manufactory in City of Industry, CA.
This is a great opportunity to join a growing company that has been in business for over 30 years! CPP offers a competitive compensation with heavy overtime opportunities, comprehensive benefits package which includes a quarterly bonus program, medical/dental/vision/life insurance, and 401k with employer match, paid vacation, sick time, and holidays.
ESSENTIAL JOB FUNCTIONS/DUTIES
* Examines and feels surface of workplace for defects.
* Starts grinder and moves surface of workplace over to remove imperfections and excess material.
* Operate a stand grinder to remove gates, risers, rough spots and other excess metals from a variety of castings in accordance with specifications.
* The operator works with medium to large size castings.
* Work is subject to inspection and check, with instructions given on new work or variations in requirements.
* The work includes grinding to maintain contours, present smooth surfaces, etc.
* The operator sorts, stacks and moves castings as directed.
* Acquire additional certifications and credentials as required for work or career development
* Work on/participate in special projects as needed or assigned by Management
QUALIFICATIONS
* Education: High school diploma or equivalent preferred
* Experience: On the job training
Hourly Rate: $19 - $21 DOE + $1 Shift Differential
Consolidated Precision Products (CPP) is an industry-leading manufacturer of highly engineered components and sub-assemblies, supplying the commercial aerospace, military and industrial markets with small-to-large "function critical" products.
CPP provides its customers with a "total solution" source, taking them from concept to finished product with one of the broadest and most diverse product offerings in the industry.
More information about our company can be found at: http://www.cppcorp.com/
This position requires use of information or access to hardware which is subject to the International Traffic in Arms Regulations (ITAR).
All applicants must be U.S.
persons within the meaning of ITAR.
ITAR defines a U.S.
person as a U.S.
Citizen, U.S.
Permanent Resident (i.e.
'Green Card Holder'), Political Asylee, or Refugee.
It is the policy of CPP Corporation to cooperate to the fullest extent with the applicable regulations of the Civil Rights Act and any legislation on Equal Employment Opportunity.
CPP Corporation is an Equal Opportunity Employer that recruits, hires, trains, and promotes employees in all job classifications without regard to race, color, religion, age, sex, sexual orientation, gender identity, marital status, national origin, disability, veteran's status, or other legally protected status.
EOE/M/F/DISABLED...
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Type: Permanent Location: City of Industry, US-CA
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:17
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Join Our Growing Team at Superior Metals Manufacturing!
Are you looking to be part of a dynamic company that's on the fast track to growth? Superior Metal Manufacturing is excited to offer you the opportunity to join our team and make an impact in a state-of-the-art facility!
Why You'll Love Working With Us:
* Attractive Benefits Package: Enjoy a quarterly bonus, comprehensive medical, dental, and vision coverage, a 401(k) plan, company-paid life insurance, and more!
* Competitive Pay: Starting at $22.54+ per hour, with potential to make more based on your role, shift, and experience.
We also have available overtime.
* New Facility: Work in our brand-new, cutting-edge manufacturing environment.
* Shifts: We currently have both 12 hr.
and 8 hr.
day and night shifts.
Some include weekend work.
* Sign-On Bonus: Receive a $1000 sign-on bonus when you join our team!
Position Overview:
We are actively seeking entry-level Operations Associates for our Chittenango, NY facility.
In this role, you'll be a vital part of our production team, responsible for ensuring that your specific job process is completed so manufacturing deadlines are met on-time.
We will teach you all you need to know - all we ask is that you come with a team player spirt and willingness to lean.
Eventually, you'll use your skills and experience to tackle challenges, achieve objectives, mentor other associates, and contribute to both short-term and long-term business success.
What You'll Be Doing:
* You could be inspecting, cleaning, sorting, resizing, and weighing virgin and recycled metals "revert" to prepare for the melting process.
* You could be building and deconstructing crucibles.
Crucibles are containers used to melt metals in a furnace, which are usually made of ceramic materials.
* You could be inspecting and preparing molds for the melted alloys to be poured into.
* You could be using state of the art technology to take ingots (metal bars) out of molds and inspect/prepare them for shipping per the specifications of our customers.
* Throughout our process you could use various equipment, such as computers, robots, metal shear, wheelbrator, hydraulic press, plasma torch, grinders, cut-off saw, cranes and forklifts.
* You will also be in a team environment so collaboration, multitasking, and providing guidance to colleagues at times will be required.
* Most importantly you will need to adhere to all safety policies and procedures.
Qualifications:
* Education: High school diploma or GED.
* Experience: No prior experience required as we provide training, but prior manufacturing or mechanical experience is a plus!
* Computer skills: Basic computer skills are needed
* Certifications/Licenses: Forklift license is a plus, but not required
* Language skills : Ability to read, understand, and comprehend documents.
Ability to speak effectively and interact with other team members, engineers, an...
....Read more...
Type: Permanent Location: Chittenango, US-NY
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:17
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Consolidated Precision Products (CPP) in Rancho Cucamonga is currently looking for General Labor workers to join our team! This role will be reporting to our Operations Supervisor on 2nd Shift (1:30 PM - 10:00 PM) at our Aerospace Manufactory in Rancho Cucamonga, CA.
This is a great opportunity to join a growing company that has been in business for over 30 years! CPP offers a competitive compensation with heavy overtime opportunities, comprehensive benefits package which includes a quarterly bonus program, medical/dental/vision/life insurance, and 401k with employer match, paid vacation, sick time, and holidays.
ESSENTIAL JOB FUNCTIONS/DUTIES
* Examines and feels surface of workplace for defects.
* Starts grinder and moves surface of workplace over to remove imperfections and excess material.
* Operate a stand grinder to remove gates, risers, rough spots and other excess metals from a variety of castings in accordance with specifications.
* The operator works with medium to large size castings.
* Work is subject to inspection and check, with instructions given on new work or variations in requirements.
* The work includes grinding to maintain contours, present smooth surfaces, etc.
* The operator sorts, stacks and moves castings as directed.
* Acquire additional certifications and credentials as required for work or career development
* Work on/participate in special projects as needed or assigned by Management
QUALIFICATIONS
* Education: High school diploma or equivalent preferred
* Experience: On the job training
Hourly Rate: $17 - $19 DOE + $1 Shift Differential
Consolidated Precision Products (CPP) is an industry-leading manufacturer of highly engineered components and sub-assemblies, supplying the commercial aerospace, military and industrial markets with small-to-large "function critical" products.
CPP provides its customers with a "total solution" source, taking them from concept to finished product with one of the broadest and most diverse product offerings in the industry.
More information about our company can be found at: http://www.cppcorp.com/
This position requires use of information or access to hardware which is subject to the International Traffic in Arms Regulations (ITAR).
All applicants must be U.S.
persons within the meaning of ITAR.
ITAR defines a U.S.
person as a U.S.
Citizen, U.S.
Permanent Resident (i.e.
'Green Card Holder'), Political Asylee, or Refugee.
It is the policy of CPP Corporation to cooperate to the fullest extent with the applicable regulations of the Civil Rights Act and any legislation on Equal Employment Opportunity.
CPP Corporation is an Equal Opportunity Employer that recruits, hires, trains, and promotes employees in all job classifications without regard to race, color, religion, age, sex, sexual orientation, gender identity, marital status, national origin, disability, veteran's status, or other legally protected status.
EOE/M/F/DISABLED...
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Type: Permanent Location: Rancho Cucamonga, US-CA
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:16
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Role Summary:
Help Cigna Healthcare provide high quality affordable coverage to some of our country's most vulnerable citizens while being good stewards of federal tax dollars by becoming a part of a small team that supports Affordable Care Act for the Individual and Family Plan segment.
The ACA Reconciliation Lead Analyst will provide oversight of a third-party administrator that is responsible for enrollment, billing, and data reconciliation with Federal and State Healthcare Marketplaces.
Key responsibilities include researching and resolving individual customer issues, driving improvements through process and technology enhancements, developing key reporting and other activities that ensure Cigna Healthcare executes delegated entity oversight, while compliantly delivering the best quality service for our customers and stakeholders.
Responsibilities:
* Maintain a current knowledge of all federal or state specific regulations and sub-regulatory guidance as it relates to Federally Facilitated or State Based individual insurance exchanges and reconciliation programs.
* Act as a subject matter expert for Affordable Care Act Marketplace Enrollment and Policy Based Payments including federal and state regulations and sub regulatory guidance, transactional processing, and business processes.
* Ensure compliance with all federal and state regulations.
* Research and resolve enrollment or financial reconciliation discrepancies to provide root cause analysis and trending to drive Enrollment Alignment Performance metric attainment, improve first touch resolution rates, decrease time to resolution across the federally facilitated and state-based marketplaces.
* Support oversight of third-party administrator by maintaining complete and accurate reconciliation file inventories and execution status.
* Support oversight of third-party administrator by identifying and auditing statistically valid discrepancy resolution actions and providing results and trending.
* Partner with enrollment and billing vendor, Cigna Group matrix partners and Federal/State marketplace representatives to analyze and resolve enrollment and financial discrepancies uncovered during the monthly reconciliation process between the Healthcare Marketplace and Cigna Healthcare
* Support the development and maintenance of critical documents including policies, standard operating procedures, business rules, and technical specifications.
* Support and deliver accurate and timely weekly and monthly reporting including but not limited to various reconciliation metric scorecards and progress reports.
* Communicate the status of reconciliation efforts, including all remediation, efforts to cross functional matrix partners and leadership.
* Use data-based analysis to prioritize and drive decreased disjoint metrics and increased operational efficiency.
* Partners with operational and information technology teams to influence, develop an...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:13
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Summary
The Provider Data Quality & Accuracy (PDQA) team is seeking a highly skilled and detail-oriented Data Analyst to join our team.
This role will help us to ensure the reliability, accuracy and integrity of our data assets and that we meet specific goals and metrics, as defined by business and regulatory requirements.
Essential Functions and Responsibilities
* Perform thorough data analysis to detect anomalies, inconsistencies, and inaccuracies.
* Collaborate with data engineers and analysts to validate data sources and ensure data integrity.
* Design and develop data cleansing algorithms and processes.
* Communicate data quality findings and recommendations to both technical and non-technical audiences.
Qualifications
Candidates should model our team's core values - Communicate Effectively and Instills Trust .
They should also have the following skillset and characteristics.
Preferred Qualifications:
* Bachelor's or Master's degree in Computer Science , Data Science, Statistics, or a related field.
* At least 5 years of proven experience as a Data Scientist or in a similar role focused on data quality and accuracy .
* Strong proficiency in data analysis tools and programming languages such as Python, R, Spark and SQL.
* Experience with data quality tools and platforms ( e.g.
Informatica, Talend, Trifacta) .
* Excellent analytical and problem-solving skills with a keen attention to detail.
* Strong communication and collaboration skills, with the ability to work effectively in a team-oriented environment.
* Knowledge of data governance and data management principles is a plus.
* Willingness to share opinions and take risks.
* Creative thinker with ability to think outside the box & translate strategies into actions .
* Must possess strong organizational skills with ability to manage multiple priorities simultaneously.
* Strong, clear, concise, and analytical written and oral communication skills
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an annual salary of 109,100 - 181,800 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure.
That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health.
Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holida...
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Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:12
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Job Details
Sr.
Customer Service Representative (Remote)
SUMMARY
The Cigna Group is a global health Service Company dedicated to helping people improve their health, well-being, and sense of security.
We seek dedicated, compassionate, and empathetic Customer Service Representatives to join our Medicare team who are genuinely interested in helping people at some critical points of their lives.
The Medicare Call Center Customer Service Representative represents the company, and our people make all the difference in our success.
RESPONSIBILITIES
• Answer inbound calls from members and customers regarding their Medicare insurance benefits.
• An average of 30-40 calls are expected daily.
• You are expected to take calls back-to-back while toggling through several applications on multiple screens.
• Availability to attend 100% training and the first 90 days of employment.
• Resolve customer complaints through independent problem-solving skills and one-call resolution.
• Understanding and striving to meet or exceed call center metrics while providing excellent consistent customer service.
• Enjoy a work-from-home lifestyle where you can virtually connect with coworkers and customers.
QUALIFICATIONS
• High School diploma or equivalent.
• 2 years of relevant call center experience is required.
(Healthcare experience a plus)
• Must have a minimum internet speed of 10 Mbps download and 5mbps upload (No satellite internet is allowed).
• A dedicated workspace with no distractions is required.
• Intermediate proficiency in Microsoft Outlook.
• Strong organization skills, written, and verbal communication skills.
• Ability to remain calm and helpful even when dealing with difficult situations.
• Foster teamwork and partnership with cross-functional departments to resolve issues and improve customer experience
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 - 25 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 The Cigna Group
Doing something meaningful starts with a simple decision,...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:11
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JOB PURPOSE
The account consultant will provide support to their aligned sales executive within their assigned market/partner relationships.
The account consultant will provide broker and group support, triage requests, assist in the renewal process and support operational needs.
RESPONSIBILITIES AND DUTIES
* Manage the renewal process including the preparation, and communication to brokers within an assigned territory.
* Provide summary of plans and options, service area information, and other specific deliverables to broker partners to support their clients.
* Maintains ownership for assigned service/operational deliverables.
* Assist with monitoring and identifying service trends as requested, to allowing for immediate resolution of any service issues.
* Collaborate and take immediate action to resolveoperational/service-relatedissues; escalate issues when appropriate and drive recovery efforts.
* Coordinates deliverables with internal operational departments to ensure broker satisfaction and loyalty.
* Acts as an intermediary between distribution organizations and members for customer service issues.
* Build strong effective relationships with all our matrix partners.
Demonstrates approachability and openness to delivering consistent customer service.
* Analyze and document product/plan gaps and risks.
* Coordinates structured meetings for complex cases.
* System analysis competencies and able to consider the business implications of the technology to current business setup.
KNOWLEDGE, SKILLS AND EXPERIENCE
* Bachelor's degree in related field or 2-4 years of relevant experience; preferably in the small group health insurance space
* Strong PC skills including Microsoft Office products, e-mail and the Internet.
* Excellent verbal and written communication and presentation skills.
* Strong analytical and problem solving skills.
* Responsiveness, relationship building and Accountability
* Knowledge of the healthcare or insurance industry preferred.
* Demonstrated ability managing projects, utilizing proven project management processes.
* Ability to work cross-functionally to proactively communicate and to resolve issues with the highest sense of urgency.
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 24 - 36 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-re...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:11
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Home Infusion Registered Nurse - Accredo
Take your nursing skills to the next level by helping to improve lives with Accredo, the specialty pharmacy division of Evernorth Health Services.
We are looking for dedicated registered nurses like you to administer intravenous medications to patients in their homes.
As a Home Infusion Registered Nurse at Accredo, you'll travel to patients' homes to provide critical infusion medications.
However, this job is about more than just administering meds; it's about building relationships with patients and seeing the positive impact of your care.
You'll work independently, making decisions that lead to the best outcomes for your patients.
You'll drive growth in your career by challenging yourself to use your nursing skills, confidence, and positive attitude to handle even the toughest situations, with the support from your team.
For more than 30 years, Accredo by Evernorth® has delivered dedicated, first-class care and services for patients.
We partner closely with prescribers, payers, and specialty manufacturers.
Bring your drive and passion for purpose.
You'll get the opportunity to make a lasting impact on the lives of others.
How you'll make a difference and improve lives:
* Empower Patients:Focus on the overall well-being of your patients.
Work with pharmacists and therapeutic resource centers to ensure that patients' needs are met and to help them achieve their best health.
* Administer Medications:Take full responsibility for administering IV infusion medications in patients' homes.
* Provide follow-up care and manage responses to ensure their well-being.
* Stay Connected:Be the main point of contact for updates on patient status.
Document all interactions, including assessments, treatments, and progress, to keep track of their journey.
Requirements:
* Active RN license in the state where you'll be working and living
* 2+ years of RN experience
* 1+ year of experience in critical care, acute care, or home healthcare
* Strong skills in IV insertion
* Valid driver's license
* Willingness to travel within a designated area
* Ability to work Monday-Friday, during the day, with occasional evening or weekend visits as needed
* Flexibility to work different shifts on short notice and be available for on-call visits as needed
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality.
We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people.
Join us in driving growth and improving lives.
Qualified applicants will be considered with...
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Type: Permanent Location: Louisville, US-KY
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:10
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As a Senior Inventory Representative you are responsible for processing supplier delivery receipt information in perpetual inventory system.
Ensure all paperwork is received and filed properly.
Resolve delivery issues between receiving department, purchasing, and suppliers.
SHIFT: Monday-Friday 7am-3:30pm
Job Responsibilities:
* Deliver specific delegated Inventory tasks assigned by Supervisor.
* Conduct daily/weekly cycle counts of inventory
* Complete day to day administrative, facilities/clerical and/or other business support service tasks without immediate supervision but has ready access advice from more experienced team members
* Resolve non-routine issues escalated from more junior team members
* Maintain an accurate physical count of product in dispensing and overstock locations
* Reconcile variances to vendor invoices/packing slips; research and troubleshoot quantity discrepancies
* Organize and maintain dispensing and overstock for efficient dispensing and material storage and handling
* Work with warehouse Associates to maintain accurate labeling of items and locations
* Set up of new items and resources in software as needed
* Continually update Inventory Descriptions in Dispensing software
* Assist Operations Managers/Supervisors with all inventory reports
* Performs related duties as required
* Ensure each package receives the correct paperwork, envelopes, medications, packing and or shipping labels before sealing and sending packages to patients.
* Consistently work on only one order at a time at their work station at all times
* Ensure that the address prints correctly on each package, all bags are correctly sealed and printers are accurately loaded with the correct paper
* Accurately package prescriptions requiring special handling according to specific process and policy requirements
* Work collaboratively with all coworkers to ensure that best-practices are shared while maintaining productivity and quality standards
* Keep work station clean at all times
* Other duties assigned as needed
Job Qualifications:
* High School Diploma or GED required
* 2-3 years relevant experience
* Intermediate computer skills including Microsoft office: Word, Outlook, Excel & Access
* Intermediate office equipment skills
* Ability to understand mathematical conversions
* Working knowledge of inventory control practices
* Must be detail-oriented and pay close attention to accuracy
* Ability to effectively establish rapport; present information and respond to questions related to inventory
* Excellent verbal and written communication skills
* Ability to quickly resolve problems and develop favorable solutions
What we offer:
* An independent work environment, effective communication, positive morale, and manager/mentor coaching to provide successful career pathing.
* Comradery and Engageme...
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Type: Permanent Location: Tempe, US-AZ
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:09
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The experienced MA provides front assistance to the providers in the preparation for, examination and treatment of patients, and is a critical partner in our Health Centers.This MA will be cross trained for the back office for any coverage as needed.
EvernorthDirect Health is an industry leading business providing custom care delivery and wellness services across four key business lines: Wellness Centers, Health Coaching, Wellness Events and COVID 19 solutions.
Evernorth is built on the recognition that health makes progress possible.
Our health services are designed to redefine healthcare as we know it.
But we can't do it alone.
True change takes all of us, united in a shared vision.
Health is what drives us.
But it's just the start.
Together, we can solve the problems others don't, won't or can't.
* Greet and check in patients at the health care centers by verifying coverage and eligibility and completing appropriate paperwork.
* Obtains the patient history, takes vital signs, and assists with coordination of care.
* Administers medications
* Prepares examination room
* Cleans and sterilizes instrument per protocol
* Answer telephone in compliance with departmental procedures.
Ascertain nature of call and route appropriately.
If necessary, take accurate and legible messages.
* Schedule appointments and verify membership according to various benefit coverage
* Reviews preprinted instruction sheets with patients
* Attends department Staff Meetings and In-service programs
* Cross-trains to new procedures and departments.
* Assists in orienting new employees and temporary pool staff to job responsibilities.
This position is with Evernorth, a new business within the Cigna Corporation.
What we expect from you :
* CMA or RMA
* Current BCLS required
* At least 1 or more years of front and back office experience
* Experience answering phones and scheduling patients
* Phlebotomy skills
* Solid Computer skills including Electronic Health Records
* Excellent customer service skills required
* Team oriented
* Strong time management skills
* Responsible and reliable
* Bilingual in Spanish
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 ...
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Type: Permanent Location: Kissimmee, US-FL
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:08
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The Registered Nurse will:
* Perform clinical and operational processes related to transition / coordination of care and utilization / case management of Post-Acute Care services including but not limited to long term acute care, skilled nursing and inpatient rehab facilities, home health care, care management, and utilization review.
* Implement, evaluate and coordinate the plan of care for all assigned patients.
Develop care plan and other case management tools by participating in meetings.
* Identify progress toward desired care outcomes; intervening to overcome deviations in the expected plan of care; reviewing the care plan with patients in conjunction with the direct care providers.
* Monitor delivery and utilization of care by completing patient rounds with Medical Directors.
Minimum Education and Licensure:
* Associates Degree or Bachelor Degree in Nursing
* Current unrestricted Registered Nurse licensure in the state of residence
* Multistate license preferred
Minimum Experience Required (number of years necessary to perform role) :
* 2 years of clinical experience in acute care, managed care, ER, ICU, or clinical utilization management
* Home health, SNF, and/or rehab experience desired
* Medicare/Medicaid managed care programs preferred
Qualifications
* Position is remote
* Position is full-time during core business hours with the ability to work any shift between 7 am and 7 pm CST, plus mandatory on-call responsibility after business hours equivalent to approximately two weekends per year.
May require weekend rotation.
* Ability to sit at a desk 50% of the time and utilize the computer, telephone, and other office equipment, throughout the entire work day; walking and standing
* Dependable and reliable work schedule is essential
Required Skills:
* Time-management : Ability to effectively manage one's time and resources to ensure that work is completed efficiently Excellent organizational skills
* Communication : Ability to provide clear verbal and written information via in-person, email, and phone to customers, co-workers, and leadership
* Critical-Thinking/Decision-making : Ability to choose a course of action or develop appropriate solutions by identifying and understanding issues, problems, and opportunities
* Autonomy : Ability to work independently with little to no supervision
* Proficient in computer literacy skills with the ability to use and troubleshoot Microsoft Word, Excel, Outlook, and PowerPoint with the ability to type 30 wpm preferred
* Experience using videoconferencing systems such as WebEx
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 27 - 41 USD / hourly, depending on relevan...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:08
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The Advocate role is a non-clinical customer service position within an inbound call center that supports Evernorth Behavioral Health.
Advocates are responsible for handling inbound calls from both members and providers or their office support staff regarding mental health or substance use disorder services.
Advocates guide and assist the members and providers to help them work with Cigna/Evernorth more effectively and ensure first-call resolution.
The types of calls an Advocate service may include but are not limited to: triaging and assessing the need for clinical intervention, inquiries about provider referrals and access to care, eligibility, and benefits.
Due to the wide variety of call types, several applications are required to service these inquiries, and multiple applications are often needed within the same call.
Independent problem-solving, multitasking, and technical savvy are essential in order to be able to carry out the responsibilities of this role.
Calls must be serviced helpfully and professionally.
The nature of discussions within the Behavioral Advocate role often delves into personal and sensitive topics with members.
It demands a nuanced understanding of mental health and substance use issues.
This role differs from its medical counterpart in that mental health is a sensitive subject and staff are helping members navigate complex and emotional mental health challenges.
Responsibilities:
The primary responsibility of this role is to answer inbound calls from members and providers.
The work environment is structured, and the majority of the day will be spent answering these calls from a queue.
Occasional outbound calls may be necessary for issues requiring follow-up.
Within a call, an Advocate may:
* Use active listening and empathy skills to triage and assess for risk of harm and substance use concerns
* Coordinate with multiple matrix partners, and facilitate seamless handoffs to clinical partners for timely support
* Communicate eligibility, generate a list of provider referrals, quote benefits, or advise of authorization requirements for services
* Write authorizations to ensure claims are paid correctly
* Provide follow-up on issues by making outbound calls when necessary
* Send resources to members and providers via email
* Submit a complaint on the member's or provider's behalf
* Independently problem-solve to ensure accurate information is given, and exceptional customer service and first-call resolution is achieved
Qualifications
* Bachelor's degree in the mental health field or psychology/social work-related field (family communications, health coaching, community/public health or other related major), is strongly preferred .
Alternatively, a bachelor's degree in another field or equivalent work experience, combined with 2+ years of experience in the behavioral health field will be considered
* Customer Service experience
* Prior experience working in a ...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:07
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LOCATION: HYBRID position aligned to the Glendale, CA market.
Must reside in Los Angeles/Orange County/Glendale, CA
Will require a weekly schedule of several days per week working in Office or Travel out to in-person meetings with Providers AND several days working from Home
The AVP, Provider Contracting Network Management serves as an integral member of the Network Management & Affordability Team and reports to the VP, Network Management.
This role is a key contributor to the development of the strategic direction and is accountable for the management of contracting and network management activities for multiple local geographies.
DUTIES AND RESPONSIBILITIES
* Directly manages a contracting team or geography, providing leadership and mentoring to their direct reports.
* Manages increasingly complex contracts and negotiations for fee for service and sophisticated value-based reimbursements with hospitals and other providers for both Cigna's US Commercial and Medicare product lines (e.g., Hospital systems, Ancillaries, and large physician groups) for one or more geographies.
* Proactively builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
* Initiates, nurtures and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management.
Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service.
* Manages strategic positioning for provider contracting, develops networks and identifies and acts upon opportunities for greater value-orientation and risk arrangements.
* Identifying and implementing alternative network initiatives.
Supports and provides direction to develop network analytics required for the network solution.
* Responsible for meeting unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position.
* Identify and manages initiatives that improve total medical cost and quality.
* Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist with total medical cost initiatives.
* Prepares, analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms.
* Creates and / or oversees the development of "HCP" agreements that meet internal operational standards and external provider expectations.
Ensures the accurate implementation, and administration through matrix partners.
* Assists in resolving elevated and complex provider service complaints.
Research problems and negotiates with internal/external partners/customers to resolve highly complex and/or escalated issues.
* Manages key provider relationships and is accountable for critical interface with providers and business staff.
* Demonstrates comprehensiv...
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Type: Permanent Location: Glendale, US-CA
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:06
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POSITION SUMMARY
The PBM Operations Business Product Owner (BPO) serves as the key interface and liaison between the business sponsor, or client and technology counterparts to advance high ROI/efficiency, division-wide and enterprise-wide initiatives.
This individual would have responsibility for the accuracy and comprehensiveness of business requirements of new and modified business applications and/or products.
The Business Product Owner serves as the interface to the Technical Product Owners (TPO) for business applications, product or client requests to:
* Contribute to business requirements for new and existing systems from ideation through production and project oversight
* Participate heavily in:
+ the extraction of requirements from business sources
+ discussions with technical resources on business intent and requirements
+ skills to discuss, if not influence, technical design of associated applications
+ the ability to guide technical support
Primary Functions
* Participate in defining business requirements with business sponsors, TPO and System Engineering teams for new and modified business applications, product, or client requests
* Apply new technical tools and techniques to support business within the digital and communication BPO space.
* Apply Express Scripts project tools and methodologies to advance business applications, products, or client requests.
* Provide input and insight into technical design of new and existing business applications.
* Owns the creation of epics to support analytic needs
* Participates in essential meetings, ceremonies, and release planning conversations to ensure training or documentation resources support a successful adoption
* Communicate and report on progress regularly with stakeholders
* Prioritize and manage workload and meet project deadlines.
* Business, technical and financial acumen applied to projects and portfolio
Key Qualifications
* High school diploma required
* Bachelor's degree preferred
* 5 years experience with program management or product owner preferred
* Knowledge of agile methodology preferred
* Proficiency in Jira preferred
* Business, technical and financial acumen preferred
* Ability to operate within a fast paced work environment a plus
* Excellent communication (oral and written), facilitation, presentation, and organization skills required
* Excellent organization skills preferred
* Proven ability to manage multiple projects simultaneously required
* Demonstrated problem solving and organization capabilities preferred
* Proven ability to manage multiple project simultaneously and work well within an ambiguous environment preferred
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 a...
....Read more...
Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:03
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This is a HYBRID role with on-site expectations in St.
Louis, MO
POSITION SUMMARY
The Financial Operations Analyst will own the operational invoicing, receipting and reconciliation activities for their select pharma manufacturer rebate contracts.
The Analyst should develop an in-depth knowledge of the contract to serve as the primary point of contact regarding the manufacturer's monthly rebate invoice.
ESSENTIAL FUNCTIONS
* Set up pharma manufacturer rebate contracts and amendments within our FRP invoicing system.
* Manufacturer Implementation in invoicing systems.
* Work with Contracting's Account Directors to understand contract intent.
* Communicate setup strategy to the BDRO team to capture enhanced/restricted rebate options.
* Track all setup actions through Polaris system for validation and audit.
* Prepare validation packets to support all setup actions.
* Review manufacturer specific invoicing and datafix results to help ensure invoicing accuracy.
QUALIFICATIONS
* Bachelors degree in business or equivalent work experience.
* 1+ years of experience with degree.
* Excellent customer service and communication skills; Strong Analytical Skills; Detail oriented.
* Excellent PC skills with ability to utilize MS Excel and Access.
* Knowledge of PBM and healthcare industry preferred.
* Ability to organize and plan multiple projects.
* Ability to demonstrate self-initiative, work cross functionally to resolve issues as they occur.
* Proven ability to work under tight deadlines.
ABOUT THE DEPARTMENT
If your niche is in reporting and analysis, underwriting, cash management, audit, or investor relations, our Finance department may be a perfect fit for you.
Our teams within Finance work together to ensure our spending stays on track, and that we remain a profitable industry leader.
We're always on the lookout for innovative people who think outside the box to join our team
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
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 oth...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:02
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As an Eligibility Representative, you will be part of a team passionate about helping our patients maintain access to life saving medications.
This role is on the front lines with patients, making outbound phone inquiries and addressing each with care, detail, and most importantly, empathy.
Responsibilities
* Review patient balances, benefit setup and payment history in order to release shipment
* Make outbound calls to patients in attempt to secure payments prior to shipment
* Complete limited copay assistance processing
* Provide copay assistance program information to patients
* Validate copay assistance information with manufacturer programs and foundations
Qualifications
* Previous Customer Service experience
* Previous healthcare experience/insurance is preferred
* General PC knowledge includingexperience working withMicrosoft Office
* Excellent written and verbal communication skills
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 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.
For this position, we anticipate offering an hourly rate of 17 - 24 USD / hourly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure.
That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health.
Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
For more details on our employee benefits programs, visit Life at Cigna Group .
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality.
We relentlessly innovate to make the prediction, prevention and treatment of ...
....Read more...
Type: Permanent Location: Tempe, US-AZ
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:01
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This is a full-time onsite Staff Pharmacist position at our Honolulu, HI location.
This role is worksite dependent and can only be performed onsite.
The shift for this position is Monday through Friday 6:00 am-3:00 pm, 7:00 am -4:00 pm or 8:00 am - 5:00 pm including a weekend on-call rotation approximately 1-2 times per month.
POSITION SUMMARY
The Staff Pharmacist ("Pharmacist") is responsible for processing, dispensing, verifying and compounding prescriptions in compliance with corporate, legal and regulatory guidelines.
The Pharmacist is responsible for interpreting physicians' prescriptions, and making contact with physicians, their authorized representatives, or patients to verify and/or collect necessary information.
The Pharmacist tracks order status, resolves open issues, conducts telephonic and/or in-person consultation with patients in regards to medication management and use.
The Pharmacist will assist in inventory and patient refill management.
The Pharmacist maintains daily production and quality and service levels, and prioritizes various tasks to meet operational and business goals.
This role is Worksite dependent and can only be performed onsite.
ESSENTIAL FUNCTIONS
* Perform essential duties of a licensed Pharmacist
* Provide oversight and quality control
* Interpret prescribers' prescriptions
* Contact prescribers, prescribers authorized representatives and/or patients to verify prescription information in order to expedite processing of prescriptions
* Contact prescribers or other pharmacies for new, refill and/or transfer prescriptions
* Verify and confirm validity of controlled substances as per federal and state laws and regulations
* Review accuracy of prescription information entered in the system
* Assist prescribers in converting prescriptions to generic or preferred drugs whenever possible
* Assist providers with clinical questions relating to medication management and patient therapies
* Perform inter-department communication to guide orders through the prescription process to ensure timely delivery of medications
* Assist with inventory management, organization and procurement
* Conduct patient consultations regarding the use of medications and potential drug interactions.
* Other duties as assigned
QUALIFICATIONS
* Current resident pharmacist license in good standing.
* Advanced problem solving skills and the ability to work collaboratively with other departments to resolve issues.
* Excellent oral and written communication skills.
* Ability to read and interpret prescriptions.
* Strong focus on customer service, quality and accuracy.
* Ability to manage timelines and meet tight client deadlines.
* Ability to adapt in a changing environment.
* Ability to work a flexible schedule for peak volume times.
If you will be working at home occasionally or permanently, the internet connection must be obtained thro...
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Type: Permanent Location: Honolulu, US-HI
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:01
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Please note: This hybrid role will require the incumbent candidate to come into a local Cigna office 3 days per week.
The Provider Network Contractor serves as an integral member of the Provider Contracting Team and reports to the Provider Contracting Senior Manager.
This role assists in developing the strategic direction and management of the day to day contracting and network management activities for a local given territory.
DUTIES AND RESPONSIBILITIES
* Manages complex contracting and negotiations for fee for service and value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups).
* Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
* Initiates and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management.
Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service.
* Manages strategic positioning for provider contracting, develops networks and identifies opportunities for greater value-orientation and risk arrangements.
* Contributes to the development of alternative network initiatives.
Supports and provides direction to develop network analytics required for the network solution.
* Works to meet unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position.
* Creates and manages initiatives that improve total medical cost and quality.
* Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist with total medical cost initiatives.
* Prepares, analyzes, reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms.
* Creates "HCP" agreements that meet internal operational standards and external provider expectations.
Ensures the accurate implementation, and administration through matrix partners.
* Assists in resolving elevated and complex provider service complaints.
Researches problems and negotiates with internal/external partners/customers to resolve highly complex and/or escalated issues.
* Manages key provider relationships and is accountable for critical interface with providers and business staff.
* Demonstrates knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape.
* Responsible for accurate and timely contract loading and submissions and interface with matrix partners for network implementation and maintenance.
* May provide guidance or expertise to less experienced specialists.
POSITION REQUIREMENTS
* Should possess a Bachelor's Degree; preferably in the areas of Finance, Economics, Healthcare or Business related.
Significant industry experience ...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-18 08:51:00
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Position scope:
Primarily regional with national level case work for Cigna Healthcare (CHC)
Summary description of position: A Medical Principal performs medical review and case management activities.
The physician provides clinical insight to the organization through peer review, benefit review, consultation, and service to internal and external customers.
He/she will serve as a clinical educator and consultant to utilization management, case management, network, contracting, pharmacy, and service operations (claims).
This is an entry to mid-level position for a physician interested in a career in health care administration.
The Medical Director role is a Medical Principal who also manages 2 or more direct reports.
Major responsibilities and required results:
* Performs benefit-driven medical necessity reviews for coverage, case management, and claims resolution, using benefit plan information, applicable federal and state regulations, clinical guidelines, and best practice principles.
* Works to achieve quality outcomes for customers/members with a focus on service and cost
* Improves clinical outcomes through daily interactions with health care professionals using active listening, education, and excellent communication and negotiation skills.
* Balances customer/member needs with business needs while serving as a customer/member advocate at all times.
* Participates in all levels of the Appeal process as appropriate and allowed by applicable regulatory agencies and accreditation organizations
* Participates in coverage guideline development, development and maintenance of medical management projects, initiatives and committees.
* Participates in quality processes such as audits, inter-rater reliability clinical reviews, and quality projects
* Serves as a mentor or coach to other Medical Directors and other colleagues in quality and performance improvement processes.
* Improves health care professional relations through direct communication, knowledge of appropriate evidence-based clinical information, and the fostering of positive collegial relationships.
* Addresses customer service issues with mentoring and support from leadership staff.
* Investigates and responds to client and/or regulatory questions to assist in resolving issues or clarifying questions with mentoring and support from leadership staff.
* Achieves internal customer satisfaction and regulatory/accreditation agency compliance goals by assuring both timely turn-around of coverage reviews and quality outcomes based on those review decisions.
* Provides clinical insight and management support to other functional areas and matrix partners as needed or directed.
Minimum Requirements:
* Current unrestricted medical license in a US state or territory
* Current board certification Pediatrics (lifetime certification or certification maintained by MOC or other applicable program) in an ABMS or AOA recogn...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-18 08:50:59
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Job Posting Title: Digital Operations - Embedded Digital Ops Lead - Operating Effectiveness Sr Advisor
Job Description
As a member of the Digital team, you will join a team transforming health care and health services for over 170M people worldwide.
Our team is constantly innovating and expanding into new verticals and capabilities, while building and maintaining some of the best-in-class healthcare brands and products on the market.
The primary objective of the Digital Product Operations Lead for Customer Engagement role is to own adoption and execution of strategic operational processes at a localized Digital Consumer level.
This dedicated position will bridge the gap between centralized strategic process definition and operational execution enabling the ability for customization of processes where appropriate to meet varying needs and focus of our teams.
With this hub and spoke process model, you will help the Digital organization foster a more consistent, Agile, and efficient way of working.
This position will report to the Digital Customer Engagement Managing Director for the Customer Engagement Horizontal.
You will be responsible for partnering with the centralized Digital Operations leadership team on process development, ensuring that the nuances of our different ways of working are accounted for and then executing locally withing your team.
Examples of operational processes you will directly support include but are not limited to financial management, intake workflows, executive status reporting, strategic meeting administration, onboarding operations and other critical enablement activities.
Working under the leadership of the Digital Customer Engagement Horizontal, you will become deeply familiar with the products, marketing, and services your team provides.
This role requires you to be fluent in some of the critical technologies and Agile delivery practices with proficiency in others and have a hunger to learn on the job and add value.
We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions.
If you think the open position, you see is right for you, we encourage you to apply! Our people make all the difference in our success.
Primary Responsibilities:
* Strategic Process Liaison: Works with the centralized Digital Product and Marketing Operations team to drive localized adoption of our operations strategy and process activation within your local team
* Change Management & Governance: Ensures that the proper operational controls, communications, governance, and engagement actions are in place to effectively meet expectations with a feedback loop for evolution and refinement.
* Financial Management: Manages financial operations for the sub-organization in alignment with Enterprise and Digital expectations including forecasting, run/burn rates, resource allocations etc.
for both baseline and portfolio funding ...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-18 08:50:58
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Director, Product Management - Digital Benefits Platform
As a Product Director in Evernorth's Digital team, you will be responsible for helping to build the strategy, define requirements, and drive execution for the platform capabilities that power an integrated benefits experience across multiple different products and capabilities.
This role will report into the Product Strategy Senior Director and will be responsible for innovating, identifying opportunities and executing strategies to enhance specific platform capabilities including: developing intuitive plan benefits insights, implementing accessible cost of care estimation tools, streamlining claims and Explanation of Benefits (EOBs)/Explanation of Payments (EOPs), simplifying authorization processes & digital payments, and the digitization of ID cards.
These focused efforts will advance the company's transition to a platform centric model, ensuring a robust, user-friendly platform that aligns with the broader goal of creating a modular, reusable architecture.
This includes managing all aspects of product management including strategy & roadmap development, research & analysis, and platform execution.
You'll build, mentor, and work with a team of talented product managers whose mission is to redefine health care as we know it.
The right person for this role can solve complex problems, communicate solutions concisely and articulate clear vision to technical and non-technical groups.
A successful Product Director will help our organization deliver end-to-end experiences that connect health consumers with the guidance, support, and transparency they need to improve their health, well-being and sense of security.
This individual will work closely with Product & Technology leadership, Research, Analytics, Clinical, and Development/Delivery teams, as well as key stakeholders in senior leadership to develop and deliver solutions that will differentiate Evernorth as a market leader.
In support of strategic efforts, this individual will understand the strategy of all stakeholders and will partner with business leads and functional owners to accomplish core responsibilities.
Ultimately, this individual will not only help translate business objectives into a clear product roadmap and requirements, but also help define them and identify opportunities for Evernorth Digital.
How you'll make a difference:
* Set the pace for our future: Manage the development and maintenance of the product roadmap, defining new products and initiatives and communicating product strategy to key stakeholders.
* Get in the trenches with your team: Define requirements and work with Design, Development, and QA teams to ensure rapid and iterative product development.
* Collaborate with all areas of our business: Engage executive business stakeholders as well as various internal and external groups to communicate new features and changes and incorporate feedback.
* Build a superior product: Ensure ongo...
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Type: Permanent Location: Santa Monica, US-CA
Salary / Rate: Not Specified
Posted: 2024-09-18 08:50:58
