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Express Scripts is looking for Pharmacy Technician Associates to work onsite at our St.
Louis Fulfillment Center!
What we Offer:
* Health coverage effective day 1 (including medical, dental, vision).
* 401(k) plan with company match.
* Holiday Pay and Paid Time Off.
* Education/Certification Program (Grow to Thrive).
* Career Growth and Advancement opportunities.
Responsibilities:
* Accurately and responsibly operates production equipment to include but not limited to:
* Changing prescription labels
* Cleaning printers
* Monitoring production equipment
* Repacking and restocking medications/materials
* Preparation of drugs for dispensing
* Collaborate with pharmacists and production clerks to ensure that medications are adequately filled and packed
* Clean and help maintain equipment and work area
* Assigned additional tasks as required
Qualifications/Requirements:
* HS diploma or GED required
* Pharmacy Technician license/certification preferred
* Knowledge of standard concepts, practices, and procedures within dispensing pharmacy, strong attention to detail with good organizational skills, good verbal and written communication skills, ability to adapt in a dynamic work environment, learn quickly, solve problems, and make decisions.
Ability and desire to assist team members
* PC knowledge, including Microsoft Office suite
* Effective written and oral communication skills
Physical Requirements:
* Sit and/or stand for lengthy periods
* Lift up to 50 lbs.
occasionally and 20 lbs.
frequently
* Perform repetitive motion with fingers, hands, and arms.
* Work may be in confined areas close to machinery
* Work may be performed in an environment with varying levels of noise
Work Schedule:
* 4 day shift/40 hours per week
* Wed-Sat 5am-3:30pm or
* Sun-Wed 5am-3:30pm
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 employ...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:53
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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 if 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 withou...
....Read more...
Type: Permanent Location: Dorchester, US-MA
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:52
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Job Description
The Cigna Medicare Strategic Analytics Team (MSAT) offers solutions which provide actionable insights to internal and external business partners and customers to help reduce health costs, improve outcomes, provide financial security and measure and forecast business performance.
This position is a hands-on role responsible for providing requirements to develop business reporting objects and for validating of the accuracy of those objects.
The team member will use professional knowledge and acumen to determine needs, facilitate requirements, design data layers, and design and develop reports to support decision making and execution within supported functional areas.
Duties and responsibilities
* Exercises considerable creativity, foresight, and judgement in conceiving, planning, and delivering initiatives
* Elicits business requirements and specifications from operations and other partners
* Utilizes a consultative approach with stakeholders, fostering clear and effective communication to ensure mutual understanding and alignment of goals
* Collects and organizes data and information from a variety of sources and has a deep understanding of data normalization and creating reporting layers
* Extracts and writes queries to underlying Microsoft SQL, Teradata SQL, and PostgreSQL servers and databases
* Designs, develops and deploys dynamic & interactive dashboards, operational scorecards, ad hoc and canned reports based on requirements and using Business Intelligence tools and solutions
* Maintain responsibility for the accuracy, quality, and integrity of data in all produced reports
Qualifications
* 3+ years' experience using SQL, Tableau, and/or similar tools/languages recommended
* Intermediate proficiency with SQL is required
* Experience in Tableau design and development is a plus
* Experience with DBT, AtScale, and/or Databricks is a plus
* Familiarity of standard concepts, best practices, and procedures within a data warehousing and business intelligence environment
* Ability to establish and maintain strong working relationships across the organization
* Ability to communicate the results of the analysis to non-technical and technical audiences
* Ability to quickly learn and apply domain expertise across business operations (i.e.
Claim Ops, Enrollment, Provider Ops, Finance, etc.)
* Must be strong at problem solving and demonstrate an analytical mindset
* Strong written, verbal communication and presentation skills.
Must be able to convey information in a clear, focused, and concise manner
* Ability to convey complex data via visual techniques to succinctly communicate for decision-making and storytelling
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 Th...
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Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:51
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The Federal Government Affairs Legislative Assistant is a key contributor to the Cigna Government Affairs Advocacy and Public Affairs team.
You will join a team of advocacy professionals to support the execution of sophisticated federal government affairs capabilities, including developing materials to support successful advocacy campaigns; legislative tracking, research, analysis, and issue spotting; monitoring hearings and driving outreach opportunities; and assisting with casework, executive briefing memos, and written responses to congressional requests.
The role also advises and assists with the management of consultant resources, trade association relations, coalition participation, and advocacy strategy development.
What you'll do:
* Join the Government Affairs team responsible for official corporate responses from Congressional Committees and Members of Congress on requests for information, official inquiries, hearing questions, and related projects.
* Create and expand upon advocacy materials, such as branded PowerPoint presentations, issue briefs, talking points, and by identifying information from government, peer-reviewed, or other credible sources to educate on trending issues of importance to Capitol Hill audience.
* Contribute to and develop timely content to support executive briefing materials, executive updates, and internal newsletters.
* Support the advocacy team across all operations by participation in and reporting on various internal and external meetings, as well as monitoring active legislative and regulatory proceedings.
* Drive targeted external consultants' activities and engagement initiatives.
* Coordinate closely with advocacy, public affairs, and policy partners to align initiatives to government affairs objectives and advocacy campaigns.
* Support efforts to design and implement internal reporting processes and standards for legislative tracking and advocacy operations.
* Support annual team planning and goal setting process.
Qualifications:
* 3+ years of experience working in Congress, the Executive Branch, government relations, public policy, advocacy, government affairs, campaigns, or other related experience.
* Understanding of health care public policy issues, federal legislative processes, media monitoring, political action committees, and interest in following stakeholder activities in health care and technology sectors.
* Bachelor's Degree required.
Master of Public Policy or Master of Public Health degree a plus.
* A successful candidate will be detail-oriented and organized; have advanced writing and research ability; exercise good judgement and ability to manage competing priorities in both collaborative and independent work; at ease developing presentation slides, issue briefs, and various advocacy materials; enjoy being part of a team; and demonstrate a willingness to accept growth opportunities that develop multiple and transferrable s...
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Type: Permanent Location: Washington, US-DC
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:50
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Home Infusion Nurse (RN):
This position is anticipated to need around 12 hours per week.
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 Field Infusion Registered Nurse at Accredo, you'll travel to patients' homes to provide critical infusion medications.
However, this job is about more than just administering meds; it's about building relationships with patients and seeing the positive impact of your care.
You'll work independently, making decisions that lead to the best outcomes for your patients.
You'll drive growth in your career by challenging yourself to use your nursing skills, confidence, and positive attitude to handle even the toughest situations, with the support from your team.
For more than 30 years, Accredo by Evernorth® has delivered dedicated, first-class care and services for patients.
We partner closely with prescribers, payers, and specialty manufacturers.
Bring your drive and passion for purpose.
You'll get the opportunity to make a lasting impact on the lives of others.
How you'll make a difference and improve lives:
* Empower Patients:Focus on the overall well-being of your patients.
Work with pharmacists and therapeutic resource centers to ensure that patients' needs are met and to help them achieve their best health.
* Administer Medications:Take full responsibility for administering IV infusion medications in patients' homes.
* Provide follow-up care and manage responses to ensure their well-being.
* Stay Connected:Be the main point of contact for updates on patient status.
Document all interactions, including assessments, treatments, and progress, to keep track of their journey.
Requirements:
* Active RN license in the state where you'll be working and living
* 2+ years of RN experience
* 1+ year of experience in critical care, acute care, or home healthcare
* Strong skills in IV insertion
* Valid driver's license
* Willingness to travel within a designated area
* Ability to do patient visits 2-3 days per week (mostly on weekdays, but may require some evening or weekend visits)
* Flexibility to work different shifts on short notice
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality.
We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people.
Join us in driving growth and improving lives.
Qualified applicants will...
....Read more...
Type: Permanent Location: Portland, US-OR
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:49
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Are you passionate about working for a company on a mission to make medicine safer, more affordable, and accessible for millions of Americans? Evernorth Health Services, a division of the Cigna Group is looking for high-energy, positive individuals to join our pharmacy technician team at Accredo specialty pharmacy.
Members of this team are tasked with ensuring prescriptions are processed and shipped appropriately so they can arrive in the hands of the 100 million patients whose health depends on their delivery.
Join us in our mission to change lives!
Onsite Pharmacy Technician Shift
Sunday-Wednesday 7:00 pm-5:30 am
What you'll do:
* Fill new and refill prescriptions
* Select and retrieve appropriate medications
* Verify quantities and prepare labels for bottles
* Send orders to pharmacy staff for completion and verification of prescription based programs
* Select appropriate packing materials and prepare packages for shipment
* Enclose client specified materials to orders
* Affix shipping labels on packages and sort by carrier
* Clean equipment and replenish workstation supplies like pill bottles, caps, safety seals, and paper
* Other duties as assigned
* Restock inventory through out the day
What you need to do the job:
* High School diploma or GED required
* A pharmacy technician license/certification/registration is required based on your state's laws.
* Basic math skills and general PC knowledge (i.e.
Microsoft Office, Internet, and Email)
* Strong verbal and written communication skills
* Strong attention to detail, accuracy, and quality
* Ability to work in a fast-paced production environment
* Willingness to work a flexible schedule to accommodate peak volume times
* Willingness and ability to learn internal systems/processes 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 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 accommodat...
....Read more...
Type: Permanent Location: Orlando, US-FL
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:49
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Do you want to Drive Growth and Change Lives? EviCore, a line of business within The Cigna Group, is hiring a Claims System Configuration Lead Analyst.
This highly technical systems role acts as the Subject Matter Expert (SME) for the Configuration of the eviCore Claims Systems and the suite of eviCore Claim Products.
You'll be the primary contact for vendors and clients for production issue triage, new product configuration design, and process-improvement initiatives.
You'll be the subject matter expert to the business and IT for eviCore claims product setups/processes, the eviCore claim system and related job processes.
What you'll do to make a difference:
* Be the Subject Matter Expert for the eviCore claim systems, related job processes and provide SME support to Claims Systems Analysts and other internal departments, and external clients and vendors
* Collaborate with associates, senior analysts, team leads and supervisors to identify solutions for procedural gap to support business needs
* Support and lead client implementations and internal integration/migration efforts, and change requests, design documentation creation and/or approval
* Resolves escalated systems issues from leadership, business, clients and junior team members
* Analyze existing setups and system processes for opportunities to continually improve adjudication automation and accuracy, and update support documentation as necessary
* Communicates concepts and insights to business leaders and partners in a relevant and actionable manner
* Collaborate with technology and analytics teams to develop new data sources for reporting
* Act as liaison between business and technology to execute project initiatives, and resolve issues - research and respond to questions in relation to process, requirements and testing
* Responsible for new product and complex (multi-product and/or multi-state) eviCore claims systems client implementations and internal integration/migration efforts
* Responsible for leading discussions with cross-functional teams, to understand, and evaluate processes, procedures (standard operating procedures, job aids, and work instructions)
* Define business, technical and claim data exchange requirements, instruct on data file mapping (such as provider, member, auths, claims, etc.)
* Design solutions for billing rule, benefits and provider configuration
* Creating test/use cases, SI testing, and providing support for associated UA testing, as related to their SME role, to ensure proper interaction for current and future claims product use
What you need to succeed:
* High School Diploma, required, bachelor's degree preferred
* 3+ years of experience as a subject matter expert for claims system configuration, processing, reporting, issue triage and testing - REQUIRED
* Project Management Experience - REQUIRED
* Six Sigma Certification - REQUIRED
* Experience in creation of...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:48
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As an enabler of Enterprise Strategic Priority for Medicare Advantage Growth, the DMOM program will drive a competitive administrative cost structure while delivering consistent, compliant operational performance.
This will be accomplished through the implementation of a new operating model - transformation across people, process, and technology.
The Business Acceptance Testing (BAT and UAT) tester is responsible for developing and executing testing to ensure results align to expectations.
This individual will report to the BAT Lead.
This individual will collaborate and communicate frequently with other BAT Testers or members of the technical and solution teams.
This individual must possess an understanding of business processes and capabilities.
This position supports the Provider Reimbursement/Claims Pricing, Capitation and Claims Intake team
Primary Responsibilities
• Prepare and create test scenarios that match real life claims processing.
• Participate in analysis of business processes to drive test workflows.
• Create and execute the testing of business process scenarios for all aspects of Medicare business including provider matching, provider fallout, member validation, enrollment, disenrollment, MOOP/OOP, benefit terms, Rules and Rates, procedure codes, appeals.
• Assist in preparation of compliance testcases reviewing compliance controls using samples from previous audit findings, CMS program audit, HIPPA guidelines, CMS reports etc.
Ensure the business scenarios are executed on the system to support high quality and compliant solution.
• Create configuration testcases for product and benefit setup, COB, CMS mandates, EGWP, Service and procedure codes, Accumulators etc.
• Coordinate with Business SME and Business process optimization to understand various aspects of business needs
•Work with Test data and Test environment teams on deployment schedule for BAT environment readiness for testing
• Coordinate necessary access on tools/platforms to enable BAT testing
•Gain a deep working knowledge of Medicare business, IT landscape, and coordinate collaboration across BAT team
•Drive automation where possible for all BAT testing in collaboration with BAT Automation Engineers
•Identify and document defects, issues, risks and dependencies
•Develop and execute test scripts, test conditions, input test data, and expected results for Business Acceptance Testing/ User Acceptance Testing
•Prepare Production checkout plan, data and scenarios working with business SME and end users
•Coordinate with Product Owner, Technical Leads, Product Managers and QA on readiness for release and timeline
•Measure and report test coverage across all applicable coverage dimensions
•Ensure appropriate testing tasks are scheduled during release, iteration planning
•Participate proactively in daily standup meetings, story grooming sessions, team retrospectives and suggest improvements
•Establish standard proce...
....Read more...
Type: Permanent Location: Tampa, US-FL
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:47
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Home Infusion Nurse (RN):
This position is for WEEKENDS + 3 Weekdays for a total of 40hrs/week (every weekend unless taking PTO).
Take your nursing skills to the next level by helping to improve lives with Accredo, the specialty pharmacy division of Evernorth Health Services.
We are looking for dedicated registered nurses like you to administer intravenous medications to patients in their homes.
As a Home Infusion Registered Nurse at Accredo, you'll travel to patients' homes to provide critical infusion medications.
However, this job is about more than just administering meds; it's about building relationships with patients and seeing the positive impact of your care.
You'll work independently, making decisions that lead to the best outcomes for your patients.
You'll drive growth in your career by challenging yourself to use your nursing skills, confidence, and positive attitude to handle even the toughest situations, with the support from your team.
For more than 30 years, Accredo by Evernorth® has delivered dedicated, first-class care and services for patients.
We partner closely with prescribers, payers, and specialty manufacturers.
Bring your drive and passion for purpose.
You'll get the opportunity to make a lasting impact on the lives of others.
How you'll make a difference and improve lives:
* Empower Patients:Focus on the overall well-being of your patients.
Work with pharmacists and therapeutic resource centers to ensure that patients' needs are met and to help them achieve their best health.
* Administer Medications:Take full responsibility for administering IV infusion medications in patients' homes.
* Provide follow-up care and manage responses to ensure their well-being.
* Stay Connected:Be the main point of contact for updates on patient status.
Document all interactions, including assessments, treatments, and progress, to keep track of their journey.
Requirements:
* Active RN license in the state where you'll be working and living
* 2+ years of RN experience
* 1+ year of experience in critical care, acute care, or home healthcare
* Strong skills in IV insertion
* Valid driver's license
* Willingness to travel to patients' homes within a large geographic region
* Ability to work 40 hours a week (Saturday and Sunday, plus 3 weekdays.) May include days, evenings, and weekends, per business need.
* Flexibility to work different shifts on short notice and be available for on-call visits as needed
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality.
We relentlessly innovate to make the prediction, prevention and treatment of ...
....Read more...
Type: Permanent Location: Fort Lauderdale, US-FL
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:46
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Role Summary
Responsible for client retention, focusing on expanding and exceeding earnings and persistency targets through innovative negotiation sales tactics and effective portfolio management.
Develops and implements comprehensive strategies related to account management.
Cultivates strong relationships with key clients and producers to foster collaboration and client loyalty.
Responsibilities
* Overall account management responsibility for Cigna assigned clients in the South Texas/Louisiana geographical area including responsibility for persistency results, membership and revenue growth, and the cultivation of customer and producer/broker relationships.
* Creates and executes portfolio strategies that positively impacts financial results.
* Ensures exceptional service and growth through the development of strong client and broker relationships.
* Oversees and guides team members to ensure an optimal client experience.
* Qualifications
* College Degree or equivalent related experience
* Minimum 3 years' experience in health benefits
* Excellent communication/customer service skills/sales negotiation skills
* Sales/marketing/underwriting or operations
* Financial Savvy; ability to grow book of business
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.
This role is also anticipated to be eligible to participate in an incentive compensation plan.
We want you to be healthy, balanced, and feel secure.
That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health.
Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
For more details on our employee benefits programs, visit Life at Cigna Group .
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life.
We guide our customers through the health care system, empowering them with the information and 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 app...
....Read more...
Type: Permanent Location: Seattle, US-WA
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:46
-
Business Analysis Advisor -Medicare- DMOM
Location: Remote-Work at Home
Primary Responsibilities
• Prepare and create test scenarios that match real life claims processing.
• Participate in analysis of business processes to drive test workflows.
• Create and execute the testing of business process scenarios for all aspects of Medicare business including provider matching, provider fallout, member validation, MOOP/OOP, benefit terms, Rules and Rates, procedure codes, appeals.
• Prepare compliance testcases reviewing compliance controls using samples from previous audit findings, CMS program audit, HIPPA guidelines, CMS reports etc.
Ensure the business scenarios are executed on the system to support high quality and compliant solution.
• Create configuration testcases for product and benefit setup, COB, CMS mandates, EGWP, Service and procedure codes, Accumulators etc.
• Coordinate with Business SME and Business process optimization to understand various aspects of business needs
•Work with Test data and Test environment teams on deployment schedule for BAT environment readiness for testing
• Coordinate necessary access on tools/platforms to enable BAT testing
•Gain a deep working knowledge of Medicare business, IT landscape, and coordinate collaboration across BAT team
•Drive automation where possible for all BAT testing in collaboration with BAT Automation Engineers
•Identify and document defects, issues, risks and dependencies
•Develop and execute test scripts, test conditions, input test data, and expected results for Business Acceptance Testing/ User Acceptance Testing
•Prepare Production checkout plan, data and scenarios working with business SME and end users
•Coordinate with Product Owner, Technical Leads, Product Managers and QA on readiness for release and timeline
•Measure and report test coverage across all applicable coverage dimensions
•Ensure appropriate testing tasks are scheduled during release, iteration planning
•Participate proactively in daily standup meetings, story grooming sessions, team retrospectives and suggest improvements
•Establish standard processes for managing end user feedback, triaging issues and routing to and from product and engineering.
•Provide recommendations for Go/ No Go release decisions
Minimum Qualifications
• Bachelor's degree or equivalent experience required; HS Diploma required
• Five or more years of experience in Testing and Quality Engineering
•Two or more years of related business or healthcare experience.
• Candidate should have strong claim processing understanding, and advanced knowledge of health care coding, fee schedules and reimbursement methodologies
• Knowledgeable with high complexity, high volume transaction healthcare claim environment
• Experience in Quality Engineering and/or Business Acceptance Testing
• Knowledge of data model/database design concepts and working knowledge of SQL
• Experience i...
....Read more...
Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:45
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If you're lo okin g to add value, make an impact, and use strong analytical and math skills in a fast-paced environment, starting your career within the Risk Management & Underwriting Leadership Development Program (RULDP) will allow you to do all this and more.Underwriters evaluate the risk of insuring a potential customer and use that information to set premium rates for insurance coverage.
As part of our Underwriting team, you will directly impact our business on a daily basis by protectingthe company's sound financial position and enabling us to meet our financial commitments to our clients.
RULDP associates begin to shape their careers with program support and discussions with direct managers, mentors, RULDP peers, trainers, andprogram managers.RULDP offers structured technical training (ULTRA - Underwriting Leadership Training & Risk Assessment) and non-technical training (competency-basedworkshops), networking opportunities, formal mentoring, and exposure to a breadth ofunderwritingroles across multiple product lines.This multi-year development program consists of 2 rotations each typically lasting 2.5 years.
In addition torotations,you willgaininsight into other roles within the Risk Management & Underwriting organization through formalized job shadows and project work.Throughout the program, you will develop the skills and competenciesnecessaryto become a successful Risk Manager/Underwriter and future leader within our organization.
RULDP Evolve is an extensive learning opportunity that guides your experience through the early stages of your Risk Management & Underwriting career.
The program includes a mixture of instructor-led classroom training, self-study, and on-the-job experiences.
Most associates will start their first rotation supporting our health care side of the business and will have an opportunity to take on new responsibilities and experiences within their second rotation.
These new experiences could include the following:
* New Market (different geographies)
* New Buyer Group (employer size)
* New Product (ex.
Supplemental Health, Pharmacy, Dental, etc.)
* New Responsibilities within the same team (ex.
project work, mentor opportunities, increased exposure to brokers/clients, book of business management, etc.)
What you'll do:
Upon starting in RULDP's EVOLVE, you will complete training through our Underwriting Leadership Training and Risk Assessment (ULTRA) curriculum.
This multi-faceted program is designed to be one year in length, starting with 11 weeks of technical classroom training.
This curriculum provides associates with the knowledge, skills and competencies necessary to meet the performance objectives of the Risk Management & Underwriting position, including in-depth training on our products & services, insurance basics, risk analysis & rate projection, negotiation skills, systems & tools, and contract language & terminology.
Immediately following the initial training, you, with Mentor su...
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Type: Permanent Location: Franklin, US-TN
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:44
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We are seeking an experienced AWS Data Engineer (Software Engineering Sr.
Advisor) to join our dynamic team.
The ideal candidate will have a strong background in data engineering and extensive experience with AWS services.
This role involves designing, developing, and maintaining scalable data pipelines and infrastructure to support various data-driven projects.
Responsibilities:
* Design and hands-on development of robust solutions to hard problems considering scale, security, reliability, performance, operational excellence, and cost.
* Supports other product delivery partners in the successful build, test, and release of solutions.
* Works with distributed requirements and technical stakeholders to complete shared design and development.
* Supports the full software lifecycle of design, development, testing, and support for technical delivery.
* Actively participate in agile ceremonies
* Work with the team to understand the business value and break down the feature as stories
* Reviews user story/requirements to identify ambiguities
* Communicate clearly, concisely, and effectively for your audience.
* Collaborate across teams and departments to help to create best practices
* Identify risks and help mitigate
* Ability to design with ambiguous requirements
* Guide and mentor team members on all aspects of software engineering
* Ability to drive innovation in the organization
* Ability to make presentations on software technologies, frameworks, and patterns to the organization
Skills:
* AWS Services: S3, Glue, Lambda, Step Functions, API Gateway
* Experience with developing complex ETL jobs using PySpark
* Programming experience with Python & Node.js
* Strong Knowledge on SQL
* Experience working with various database engines - MSSQL, PostgreSQL, DynamoDB
* Strong experience in developing and integrating RESTful web-services
* Experience with build and deployment tools, e.g., Git, Jenkins etc
* in depth Terraform knowledge
* Experience with EKS and ECS is a plus
* Healthcare experience and Facets knowledge preferred
* Attention to details
* Quick Learner
* Excellent Communication
* Automation driven Mindset to improve maintainability and testability
* Document design and solution to provide clarity.
* Certification desired: AWS certified Developer Associate, AWS certified Data Engineer Associate, Databricks Spark certification.
Education:
* College or University degree in Computer Science or a related discipline preferred
* 10+ years of work experience in software engineering.
* 3+ years of experience in AWS
* Strong desire to learn
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, ...
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Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:43
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Do you want to Drive Growth and Change Lives? EviCore, a line of business within The Cigna Group is hiring a Claims Systems Configuration Quality Review Senior Analyst.
For this highly technical senior configuration role, you'll review our claims system to ensure all configurations were input correctly per the specifications of the provider.
The Claims Configuration Quality Review Senior Analyst will have in depth knowledge of the eviCore claims systems and products.
As the Subject matter expert (SME), you'll partner with claims configuration Associates, senior analysts, internal departments, external clients and vendors to ensure system configurations have met client requirements and quality standards.
What you'll do to make a difference:
* Resolve non-routine issues escalated from leadership, business, clients and junior team members and act as a subject matter expert (SME) to business and IT for eviCore claims product setups/processes
* Collaborate with internal and external clients to understand, and evaluate processes, procedures, job aids and identify solutions for procedural gaps
* Analyze business and user requirements to design solutions and system configurations, specifications, create test plans/use cases perform SI testing, end to end testing and continuously improve adjudication automation and accuracy.
* Partner with technology and analytics teams to develop new data sources for reporting and act
* as liaison between business and technology to execute project initiatives, and resolve issues
What you'll need to succeed:
* High School Diploma or GED required
* Strong analytical skills
* The ability to work independently and as a team
* Strong communication skills
* 5+ years of healthcare claims lifecycle; configuration design, editing, claims system requirements, and analysis required
* 3+ years of experience in Microsoft ACCESS and EXCEL required
* 3+ years of experience with SQL querying, database management systems, creating test plans/use cases, and SDLC models required
* 3+ years of experience with AS400, MC400, McNet and RC3 systems required
* 3+ years of experience with claims adjudication, claims data types and editing rules (ICD, CPT/HCPC, NCCI, MPPR, OPPS, RBRVS, FFS)
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 51,200 - 85,400 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...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:42
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Nurse Practitioner - Evernorth Workplace Care - Plano TX
Evernorth Workplace Care (EWC) offers health care delivery services along with population health and health coaching solutions, conducted in person or virtually.
Our mission is to deliver proactive, personalized and holistic patient care and coaching by acting on health data and insights to improve the overall health and wellness of our clients' employees, and those they care about most, by providing access to high quality, affordable services where they work and live.
Our Evernorth Workplace Care solution isn't a one-size-fits-all model.
Using data-driven insights, we'll customize a solution that addresses your organization's most pressing needs-creating a more affordable, predictable, and simple health care experience.
Evernorth Workplace Care - Personalized Care Where You Are
Sound like you? Great! Here's more on how you'll make a difference :
* Provide Primary Care treatment in a worksite-based setting to include: chronic condition management, appropriate referrals, virtual wellness exams, and ordering labs and imaging in alignment with primary care practices.
* Episodic care (low acuity Urgent Care)
* Extended Episodic Acute Care which can include 4-5 visits for an illness or injury that is limited in its chronicity
* Chronic condition education and co-management with outside primary care if we are not the PCP
* Ability to oversee and perform CLIA waived tests, order Rx medications, and oversee dispensing by the RN where allowed by state law.
* Recommend and order immunizations based on USPSTF preventive services guidelines and ACIP.
* Health Coaching or referral of patients into wellness programs and follow-up on all referrals.
* Excellent interpersonal skills including internal and external customers and group settings
* Ability to partner with local HR/Benefits team to improve employee health.
Minimum Requirements :
* Graduate of Certified NP program
* Meet the requirements to practice within the designated state(s) with an active and unrestricted NP license and practice independently where allowed.
* Active, unrestrictive NP license in Texas
* Minimum ofat least 3or more years of NP experience, working independentlyin an internal medicine, family practice setting or onsite health center.
* DEA licensure and prescriptive authority
* Electronic Health Record experience
* BLS certification
Bonus points for :
* Experience working in an employer-based health center
* Chronic Disease Management experience
* Passionate about overall health and wellness and patient education
* High energy and strong customer-centric focus
This role is based in an employer-based health center in Plano TX.
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 10...
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Type: Permanent Location: Plano, US-TX
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:42
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WORK LOCATION: Hybrid position that will require 3 days (Tues, Wed, + 1 Flex Day) in the office/local travel to Market Providers.
The Manager, Provider Contracting Network Management serves as an integral member of the Provider Contracting Team and reports to the AVP, Provider Contracting.
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.
* 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 healthcare provider 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 will be considered in lieu of a bachelor's degree.
MBA or MHA preferred.
* 3+ years Managed Care contracting and negotiat...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:41
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The IT Strategy Senior Manager will support the Evernorth Consumer Digital organization in delivering innovative digital healthcare technology solutions to our patients, members and customers.
They will courageously push the boundaries of our agile engineering culture.
They will passionately, persistently and productively challenge the status quo.
They will balance a wide-range of initiatives and manage relationships with other leaders to deliver on our strategic priorities.
They will partner with other leaders within the digital organization to ensure the team is strategically positioned for success.
ESSENTIAL FUNCTIONS:
* Helps drive the strategic planning for several of the largest initiatives in the Digital Engineering Organization
* Partners with core team members and ancillary organization to successfully support all facets of the organization including portfolio delivery, talent management, and financial management
* Facilitates and supports workstream efforts to ensure scope and deliverables progress at necessary rates and align to key timelines and stakeholder commitments
* Effectively communicates across multiple facets of the organization, including senior Technology and Business leadership, stakeholders, and consumers
* Manages relationships with all impacted stakeholders, vendors, and contributors to drive consistent messaging and help establish our team as a premier and trusted partner within Digital Engineering
* Strategically influences positive outcomes in a dynamic environment, including driving prescriptive work efforts as well as pivoting initial approach and plan as needed
* Manages relationships with all impacted stakeholders, vendors, and contributors to drive consistent messaging and help establish our team as a premier and trusted partner within Digital Engineering
* Provides guidance and council to the organization in support of the overall technology strategy
* Support teams in establishing organizational staffing strategy including budget planning, performance management and development of the team
* Apply knowledge of business and the marketplace to advance the organization's goals
QUALIFICATIONS:
* 10+ years of professional experience managing large initiatives in a matrixed environment
* Working knowledge of company operations
* High proficiency with standard Microsoft products
* High attention to detail
* Excellent analytical skills and ability to consume large quantities of information
* Comfortable presenting to senior leaders and facilitating discussions in a dynamic environment
* Demonstrated experience in technology strategy and implementations
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 w...
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Type: Permanent Location: Charlotte, US-NC
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:40
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Public Affairs Program Management Office (PMO), Senior Principal
Description
As a member of the Public Affairs leadership team, this role will report directly to the leadership of the Public Affairs practice and will be responsible for overall business management processes and support the development of business priorities and goals.
Key accountabilities for this role include:
* Serves as a critical advisor working in close partnership with the leadership team and key matrix partners.
* Acts as a connector across the cross functional team and business representatives to ensure key initiatives are prioritized, addressed and escalated appropriately, provide strategic guidance and counsel on organizational imperatives, align the leadership team, and drive the appropriate flow of decisions and information in furtherance of strategy execution.
Represent Public Affairs in any portfolio and prioritization activity.
* Serves as proxy on vital matters and act as a conduit between Public Affairs and various internal stakeholder groups.
* Drives the processes of annual strategic and operating plan, roadmap, project efforts, and major initiatives.
The successful candidate for this role will be a strategically minded, execution-oriented, a collaborative team player, a facilitator, an open-minded innovator, a self-starter, a good listener, a change agent, a fact-based critical thinker and possess strong capabilities to transform various ideas and actions into a synthesized set of business plans and processes for an executive level audience.
Core Responsibilities
Strategic Leadership: Bring a mindset and set of skills that leverage creative problem-solving and strategic vision to help achieve long term goals.
Inspire matrixed leaders from across the enterprise.
Think strategically.
anticipate future consequences and trends and incorporate them into the organizational plan.
Operations Leadership: Work collaboratively across the functions and key leaders across various stakeholder groups to drive execution against Public Affairs goals.
Monitors information flow; sometimes acting as a proxy for leadership on project topics or decision-making process.
* Develop a deep understanding of Public Affairs and the broader ecosystem to inform strategy, actions needed from the team, and highlight/enable engagement efforts for leadership.
* Establish strong working relationships and develop a high level of credibility across the business, including other key leaders, and with matrix partners.
* Lead within a matrix environment, including internal associates and external partners throughout the Cigna enterprise.
Management Process & Operating Model: Owns coordination / curation of management process; responsible for ongoing implementation, adherence, revisions, etc.
Oversees team meetings, strategic areas of focus across the team and governance.
* Facilitate and coordinate identification and fulfillment of key deliverables/obj...
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Type: Permanent Location: New York, US-NY
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:39
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Core Responsibilities:
* Performs monitoring of Cigna Medicare coders & vendors in order to ensure quality metrics are achieved.
* Researches IRR disagreements with the purpose of providing substantive feedback to coders.
* Meets fluctuating production demands in order to reach sampling targets.
* Maintains a high level of quality, as set by internal standards, to ensure continued auditor accuracy.
* Stays up-to-date with current Cigna Medicare coding guidelines.
* Maintains coding credentials & CEUs.
* Proficiently functions in a virtual collaborative environment.
* Participates in regular team and company meetings.
Minimum Qualifications:
* Must possess an active professional coding credential through AHIMA or AAPC (required).
* Minimum 2-5 active years of experience as a medical coder (required).
* Experience with HCC coding (required).
* Extensive knowledge of CMS guidance of Risk Adjustment & ICD-10 CM diagnosis guidelines (required).
* Extensive knowledge of medical terminology, anatomy and physiology (required).
* Knowledge of pathophysiology and pharmacology (preferred).
* Extensive knowledge of Medicare and HIPAA regulations and guidelines (required).
* Excellent written and oral communication skills (required)
* Basic proficiency in Excel (required).
* Knowledge of Microsoft Word & Outlook (required).
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an hourly rate of 21 - 32 USD / hourly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure.
That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health.
Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
For more details on our employee benefits programs, visit Life at Cigna Group .
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life.
We guide our customers through the health care system, empowering them with the information and 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 b...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:37
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Job Summary
The Software Engineer Advisor provides expert content/professional leadership on complex Engineering assignments/projects.
Designs and develops a consolidated, conformed enterprise data warehouse and data lake which store all critical data across Customer, Provider, Claims, Client and Benefits data.
Designs, develops and implements methods, processes, tools and analyses to sift through large amounts of data stored in a data warehouse or data mart to find relationships and patterns.
Participates in the delivery of the definitive enterprise information environment that enables strategic decision-making capabilities across enterprise via an analytics and reporting.
Exercises considerable creativity, foresight, and judgment in conceiving, planning, and delivering initiatives.
Uses deep professional knowledge and acumen to advise functional leaders.
Focuses on providing thought leadership within Information Management but works on broader projects, which require understanding of wider business.
Recognized internally as a subject matter expert.
Responsibilities:
* Design and hands-on development of robust solutions to hard problems considering scale, security, reliability, performance, operational excellence, and cost.
* Supports other product delivery partners in the successful build, test, and release of solutions.
* Works with distributed requirements and technical stakeholders to complete shared design and development.
* Supports the full software lifecycle of design, development, testing, and support for technical delivery.
* Actively participate in agile ceremonies
* Work with the team to understand the business value and break down the feature as stories
* Reviews user story/requirements to identify ambiguities
* Communicate clearly, concisely, and effectively for your audience.
* Collaborate across teams and departments to help to create best practices
* Identify risks and help mitigate
* Ability to design with ambiguous requirements
* Guide and mentor team members on all aspects of software engineering
* Ability to drive innovation in the organization.
* Ability to make presentations on software technologies, frameworks, and patterns to the organization.
Skills:
* AWS Services: S3, Glue, Lambda, Step Functions, API Gateway.
* Experience with developing complex ETL jobs using PySpark.
* Programming experience with Python & Node.js
* Strong Knowledge on SQL
* Experience working with various database engines - MSSQL, PostgreSQL, DynamoDB.
* Strong experience in developing and integrating RESTful web-services.
* Experience with build and deployment tools, e.g., Git, Jenkins etc
* in depth Terraform knowledge
* Experience with EKS and ECS is a plus
* Attention to details
* Quick Learner
* Excellent Communication
* Automation driven Mindset to improve maintainability and testability
* Document...
....Read more...
Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:36
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The APM within the Medicare TechOps organization will utilize Agile practices to help a self-organizing, self-managing Scrum Team achieve its deliverables on-time with quality.
The APM will work with the team to establish priorities, continuously plan work efforts, and remove impediments from internal and external forces.
The APM will have direct influence on team deliverables and team culture.
The APM must be well-rounded, highly motivated, self-starter that works best in a collaborative, dynamic, and agile environment.
Excellent communication skills (written and oral) are essential to this position as the APM will interface with on- and off-shore resources, business owners, enterprise architects, security, and infrastructure resources.
An APM needs to have great motivational and time management skills as well.
Responsibilities
* Facilitating Scrum team ceremonies including Story Grooming, Sprint Planning, Release Planning, Sprint Retrospective, Sprint Demo, Product Backlog Review, Scrum of Scrums, and Sprint Demos
* Responsible for Scrum/Kanban team performance including the team's commitments and quality
* Orchestrates all aspects of Sprint delivery, including analysis, design, development, testing, and deployment activities
* Directly drives all committed user stories and defects through completion during the Sprints.
* Drives reprioritization of stories/scope to keep releases on track
* Eliminates team blockers to ensure the team can remain focused on the task at hand and be able to achieve the task successfully in a timely manner
* Monitor internal and external dependencies and work with others to have a strategy around dependencies
* Graphically and through various other communication paths, report current state of the Scrum/Kanban team to all levels within the organization on both the IT and business side.
Also be able to provide plan vs.
actual analysis of the Scrum/Kanban team, creating better insight into the team's status
* Champion process improvements within the Scrum/Kanban teams based on lessons learned and retrospectives
* Coordinate and facilitate external discussions on project work to ensure successful on-time delivery
* Negotiate scope and schedule with business leads and IT leadership
* Ensuring all expected artifacts are completed and maintained
* Have a thorough understanding of the scrum team's build
* Problem solve with team members based on understanding of the build
* Conduct capacity planning
* Have ability to facilitate large planning sessions
Qualifications
* Bachelor's degree in Business/Management Information Systems or a related discipline strongly preferred
* At least two years of work experience as a Scrum Master required OR Scrum Master Certification
* Preferred to have at least an additional two to five years of work experience within IT in application development management and/or project management
* Exp...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:35
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This newly created role will support Dental Economics, focusing on analytics related to network/contracting, trend analysis, large case analytics, plan design/product analytics, and more.
The role will have one direct report and will be instrumental in establishing a governance committee consisting of leaders from the dental Senior Leadership Team (SLT) to manage the inventory of analytical projects.
This position offers the opportunity to work with various matrix partners across the dental organization and influence business decisions and strategies through analytical insights.
Key Functions
* Gain a comprehensive understanding of dental economics, including network/contracting, trend analysis, large case analytics, and plan design/product analytics.
* Design and maintain a comprehensive testing and analytics plan.
Perform and oversee the execution of various analytical elements to ensure accuracy and relevance of results.
* Lead the creation and management of a governance committee with leaders from the dental SLT to oversee the inventory of analytical projects.
* Work closely with underwriting and other relevant teams for user acceptance testing and training.
* Collaborate with matrix partners across the dental organization to manage various workstreams, ensuring that all stakeholders are properly consulted, engaged, and informed.
* Organize and facilitate participation from the dental analytics team.
Ensure thorough documentation of findings and decisions.
* Facilitate the design of the post-launch release management process for analytical tools and projects, including timing, requirement gathering, etc.
* Provide analytical insights to influence business decisions and strategies within the dental organization.
* Supervise and mentor one direct report, providing guidance and support for their professional development.
Qualifications
* Bachelor's degree in Actuarial Science, Finance, Economics, or a related field strongly preferred.
* 5+ years of relevant experience in actuarial analysis or healthcare analytics.
Prior dental or healthcare experience strongly preferred.
* FSA designation preferred.
* Strong analytical skills with the ability to dive into detailed methodological differences.
* Excellent organizational skills with the ability to manage both detailed and big-picture items.
* Great team player and effective communicator.
* Proactive with the initiative and courage to recommend course corrections.
* Experience in leading and mentoring team members.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an annual salary of 126,900 - 211,500 USD / yearly, depending on relevant factors, including experience and geographic location.
This ro...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:34
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Role Summary:
Responsible for growing membership within existing accounts and for directly managing business relationships with client accounts.
Ensures that systems and processes are in place to meet the needs of internal and external clients.
Develops and implements strategies and policies relating to account management.
May provide guidance or expertise to less experienced account managers.
Responsibilities:
* Overall account management responsibility for CIGNA HealthCare assigned customers including responsibility for persistency results, membership and revenue growth, and the cultivation of customer and producer/broker relationships.
* Provides input that positively impacts financial results.
* Ensures exceptional service and growth through the development of a high performing Client Management team.
Qualifications:
* College Degree or equivalent related experience.
* 5+ years' experience in health benefits.
* Travel may be required.
* Excellent communication/customer service skills and sales negotiation skills.
* Sales/marketing/underwriting or operations experience.
* Financial Savvy; ability to grow book of business.
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.
This role is also anticipated to be eligible to participate in an incentive compensation plan.
We want you to be healthy, balanced, and feel secure.
That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health.
Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
For more details on our employee benefits programs, visit Life at Cigna Group .
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life.
We guide our customers through the health care system, empowering them with the information and 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 ...
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Type: Permanent Location: Denver, US-CO
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:34
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Role Summary
The Category Management Lead Analyst is a sourcing professional who is accountable for the assigned sourcing activities for the Business Process Outsourcing (BPO) portfolio across the Enterprise.
This will include leading small and medium sized sourcing projects and supporting larger projects.
This role will involve the creation, market analysis, negotiation, and maintenance for activities around identifying a supplier, managing the competitive process and recommending a supplier that best meets the business objectives.
In order to effective engage these types of suppliers, this resource must have experience dealing at various management levels to achieve desired outcomes through sourced engagements.
Responsibilities
The Category Management Lead Analyst is responsible for sourcing assigned initiatives primarily related to BPO .
These activities are likely to be a mix of routine and non-routine initiatives with impact across the organization.
A partial list of sourcing functions includes but is not limited to:
* Analyzes overall business requirements, supplier relationship structures and processes to improve performance and overall value
* Manages execution and implementation of small to medium sized sourcing initiatives within assigned categories
* Develops timelines and organizes matrix team to implement sourcing strategies and initiatives
* Review, revise and/or draft contracts
* Manages day-to-day execution of sourcing and contracts process and facilitates involvement of expert resources
* Collaborates with business staff and manages development of requests for proposals (RFPs) and other selection and supplier evaluation tools
* Develops negotiation strategy performing and overseeing detailed financial analysis to determine market and world class costs for specified products and services
* Prepares negotiation and facilitates negotiation strategy in conjunction with the Business Staff and Supply Chain Management leadership where appropriate and able to lead negotiations
* Monitors and reports progress against performance objectives and sourcing initiatives
* Analyzes industries, supply, markets, and sourcing best practices to manage costs and maximize value for dollars spent
* As a key contributor, must be willing and able to act as a change agent and demonstrate resiliency as changes occur
* Identifies opportunities to improve specific project or broader procurement process delivering value across the procurement organization
Qualifications
* BA / BS strongly preferred, ideally in Business, Supply Chain, or related field
* T wo to five years of sourcing or related experience within a large, global organization preferred
* Excellent project management skills
* Strong communication, facilitation and leadership skills with a proven ability to lead, influence and motivate others
* Strong time management skills; highly organized and detailed or...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:33
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WORK LOCATION: REMOTE position
POSITION SUMMARY
This high impact Contracting resource has as its main focus increasing the Affordability and competitiveness of Cigna's delivery system with new and existing products.
The position partners closely with Regional and National Leaders in Contracting, Provider Services, Product, Legal, Network Operations, Compliance and Sales Segments to monitor Cigna's provider networks access and availability for Cigna's customers thereby, enhancing our competitive positioning and opportunities for membership growth.
This position has national lead dotted line responsibility for Market Network Advisors, in establishing standard job descriptions, training and in working with matrix partners.
This role will also be responsible for leading medical network adequacy monitoring activities, driving targeted network recruitment efforts, vendor management, network performance guarantee business owner.,
The position will also own termination management and the management of all standard operating procedures related to termination management and the other functions mentioned above.
This individual will manage a national team and assist other personnel in the department related to Product, Unit Cost, Reporting and Competitive Insights.
The position will work closely with Regional Network Access Leads to drive consistency across regions and to share best practices.
This position is responsible for working in a highly matrixed organization in a collaborative manner and exhibiting behaviors, attitudes and actions that demonstrate a high level of teamwork.
DUTIES AND RESPONSIBILITIES
* Champion needed changes nationally with matrix partners to drive changes that will enhance Cigna's competitive access position
* Business owner for national vendor agreements reviewing and reporting on network access and adequacy including Quest and Zelis Analytics.
* Business Owner of Sales performance guarantees related to network.
* Manage the Provider Recruitment process on a national basis driving new sources for provider non-par or adequacy gap closures and coordination with Regional Access Leads and Markets.
* Lead efforts to proactively communicate network adequacy monitoring results to matrix partners
* Partner closely with Sales segments to support termination management, competitive network requests, performance guarantees, and recruitment enhancement or other needs.
* Drive the creation of actionable information from multiple data sources to support internal and external customers
* Effectively manage team of resources to assist in Network Development, Network Adequacy, Termination Management and Reporting activity
* Coordinate activities with personnel who are also involved in delivering critical Network and provider information.
* Manages the process to review, interpret, communicate, and collect key information to and from Contracting, Sales, HealthCare Professional Solutions, Co...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-11-23 07:53:32
