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The Agile Product Management Sr.
Advisor serves as the internal voice of the customer.
This individual is responsible for the scope of work that the IFP Agile Release Train (ART) will complete, and the Program Level vision and roadmap for the IFP Agile Release Train (ART).
Must be aware of other work being completed within the Portfolio so that they can help teams proactively manage risks and dependencies.
The incumbent exercises considerable creativity, foresight, and judgment in conceiving, planning, and delivering initiatives.
Uses deep professional knowledge and acumen to advise functional leaders.
Recognized internally as "the go-to person" for complex assignments.
Primary Responsibilities
* Understand key business objectives and strategy of the product(s) they support
* Work with business owners and technical leaders to ensure that they are engaged and supportive of direction
* Work with the engineering leads to decomp and refine technical roadmap strategies and establish business value, make data-driven decisions and prioritize features and requirements
* Collaborate with cross-functional teams including Engineering leads, Architects, Product Managers.
Product Owners and business counterparts to ensure their prioritization is reflected in the team's backlog and aligned with business goals
* Has final decision-making authority on acceptance criteria for product functions
* Maintain and refine the inflow of work to the team (product backlog).
* Assist the team with decomposing features into user stories and acceptance criteria
* Assess business value and prioritizes Program Epics, Features and Stories to ensure work focuses on those with maximum value that align with strategy
* Ensures Program Epics and Features clearly communicate customer/stakeholder needs and works with Product Owners/ Agile team to clarify stories as necessary
* Understand and support inter-team dependencies and escalates prioritization issues when necessary
* Attend team and program ceremonies (e.g.
Daily Stand-up, Iteration Planning, Iteration Review, PI Planning, Demos)
* Work with team members to ensure products are working in production
* Support adoption of the appropriate tooling and best practices that automate our product development lifecycle (ie: Agile, Pathfinder, etc)
Qualifications (i.e., preferred education, experience, attributes)
* Agile certification is a plus (i.e.
SAFe Product Manager / Product Owner)
* Bachelor'sdegree or equivalent of education and work experience
* 5+ years of experience in Agile delivery and experience working in Agile development methodology using tools like JIRA, Rally etc.
* Strong understanding of software development processes and methodologies including programming languages, frameworks and databases
* Excellent analytical and problem-solving skills, with a data-driven approach to decision making
* Exemplifies teamwork and ser...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:33
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We know your type.
You are driven to make an impact on the business and internally motivated to improve how things are done.
You are a quick learner, detail oriented, and can effectively manage multiple priorities with strong outcomes.
You always keep your goals in mind and have an easy time working with all different types of people.
We also know you are looking for an opportunity that challenges your business acumen, and helps your career thrive.Let us tell you a little more.
We're passionate and we care about what we do -being there when our customers, colleagues, partners, and communities need us most.
We are a company that supports whole-person health, provides career advancement opportunities, and offers a rich benefit package.
What you will do:
* Deliver basic technical, administrative, or operative General Administration tasks
* Maintain files and records; obtain/verify routine information from hard copy, microfiche or automated source documents; retrieve, receive, read to identify, sort files and/or deliver documents
* Ensure outgoing mail is prepared every day for established deadline
* Process mail accurately and efficiently every day
* Update contact information on Excel spreadsheets
* Maintain daily logs; makes photocopies
* Fax mail, forms, requests
* Type & input basic data from forms
* Perform General Clerk duties
* Maintain office supplies for staff and office
* Communicate opportunities for best practices based on issues identified
* Work is allocated on a day-to-day or task-by-task basis with clear instructions
* Attend monthly admin meetings
What you need to do the job:
* Ability to work Monday - Friday 8am to 5pm EST or 8am to 4:30pm EST
* High School Diploma or GED is required
* Associates degree or equivalent work experience strongly preferred
* Accounts receivable background preferred
* Proficient in Microsoft Office with working knowledge of Microsoft Excel
* Self-motivated and goal-oriented
* Problem-solving skills
* Solid written and verbal communication skills
* Strong research and analytical skills
* Team player with a positive attitude
* Detail oriented
* Solid organizational 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.
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives.
At The Cigna Group, we're dedicated to improving the health and vitality of those we serve.
Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients.
Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex,...
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Type: Permanent Location: Warrendale, US-PA
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:32
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As an Agile Product Owner, Advisor you will be responsible for directing and managing a technical team to fulfill the needs of the business.
This is a great opportunity for someone with strong business acumen, technical skills, and a thorough understanding of Enrollment Operations to help set the direction and ensure the success of the product line they own.
Primary Functions:
* Working with multiple Kanban teams and/or Scrum Teams in an Agile Team Structure environment.
* Understanding and managing team capacity & optimizing performance, building trusted relationshipswith engineering
* Understanding dependencies & broad knowledge of product/service offerings
* Identifying and engaging necessary stakeholders, technology, and expertise to drive alignment within projects or programs
* Being a passionate advocate, with the ability to identify, champion customer needs, and improve with agile principles in mind
* Team leader of indirect reports and initiatives
* Own the product development lifecycle of assigned product or capability areas, including status reports
* Understand technology systems and customer journeys impacted by product/capability area
* Understand trends and metrics associated with product/capability area
* Translate complex business objectives into effective requirements and agile implementations
* Work collaboratively with cross-functional partners to deliver the business case via intake(s), prioritization, estimate exercises, journey mapping, capability build, adoption, production roll-out, and metric tracking / feeding of the backlog
* Resolve issues and determine contingency plans and triggers for risks.
As needed, escalate issues to appropriate audiences including key business leaders and team members
* Communicate effectively with individuals in various functional areas and at all levels of management
Specific areas of responsibility:
* Manages capacity and work for multiple Kanban and/or Scrum teams in the Medicare Advantage Domain.
Responsible for communicating vision, goals and business value.
Prepares, executes and incorporates feedback from customers.
Change Agent - ability to analyze processes and determine improvements by suggesting optimization of workflows
* Backlog Grooming - In charge of backlog management, looking for value - adding additional user stories based on project/sponsor need and assessing the prioritization of existing work to ensure there is proper sequencing,
* Ability to plan, direct, coordinate work activities of others
* Build and maintain relationships with other teams in the wider IT organization
Qualifications:
* High School Diploma or GED required, advanced degree or certification preferred
* 5+ years of healthcare industry experience
* 3 + years relevant experience in product management, operational effectiveness
* Medicare related Knowledge preference
* Excellent time and priorit...
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Type: Permanent Location: Scottsdale, US-AZ
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:32
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Are you ready to step into a position that combines your organizational skills, ability to multitask, and unrelenting drive to help others? We're looking for certified pharmacy technicians to join our fast-paced, customer-focused pharmacy teams across the Phoenix Valley.
If you've always wanted to work in pharmacy operations and enjoy a friendly work environment...
well, we're pretty sure you'll love this position.
Work hours: Typically, Monday-Friday 8 a.m.-5 p.m.
Before we move on, let us tell you a little more about us.
We're a global health service company dedicated to helping people improve their health, well-being and sense of security.
But we don't just care about your well-being, we care about your career health too.
That's why when you work with us, have the opportunity to train, grow, and develop a career you will be proud of.
What you'll do:
* Ensure day-to-day operations run like a well-oiled machine: Use your supernatural organizational powers to help manage pharmaceutical stock, ensure a safe and clean pharmacy by following policies and procedures, prepare reports, and maintain records of physician orders and prescriptions.
* Get hands-on: Calculate needed quantities; prepare labels; and organize and assemble medications for the lead pharmacist to dispense...and check, double check, and then check again for accuracy.
* Be a superstar in the eyes of providers and patients alike: Help answer questions and requests, both in person and by phone, and handle all the transaction-related steps of any purchases made.
This job is for you if you:
* Have both a Pharmacy Technician Certification (CPhT) and an Arizona Board of Pharmacy Certified Technician License.
* Are a graduate of a Pharmacy Technician Academic Program, or minimum of one year job experience.
* Have excellent customer skills, and care deeply about providing empathetic, quality care to customers.
* Have spent time in a retail environment.
* Know your way around a computer.
Bonus points for:
* 2+ years of clinical pharmacy experience in a retail environment
* Bilingual (English/Spanish) skills
Why join us?
* Health coverage effective day 1 (including medical, dental, vision)
* Holiday, PTO and OT pay
* 401K with company match
* Tuition reimbursement
* Fun, friendly and unique culture
* Growth and advancement potential
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.
...
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Type: Permanent Location: Chandler, US-AZ
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:31
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Home Infusion Nurse (RN):
Primary location : Duluth, MN
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 state of Minnesota, and that should be 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
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.
Qual...
....Read more...
Type: Permanent Location: Duluth, US-MN
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:30
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Do you crave an intellectually stimulating job that allows you to leverage your clinical expertise while developing new skills and improving the lives of others? Then look no further! As a Medical Oncology Medical Director at eviCore, part of Evernorth Health Services, a division of The Cigna Group, you'll use your clinical know-how to provide evidence-based medical reviews for patient care.
Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases.
This role offers you the opportunity to build new skills while enhancing the health and vitality of others.
We're seeking a detail-oriented individual with good communication, technology, and typing skills, as well as strong clinical judgment.
Drive growth in your career with our innovative team.
How you'll make a difference:
* You'll start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success.
* Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on eviCore's case management software.
* Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence-based medical necessity and appropriateness of the requested service or treatment.
* Leverage your clinical expertise to recommend alternative services or treatments as necessary.
* Work collaboratively with over 500 eviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making.
What you'll enjoy about working here:
* Benefits start on day one
* Predictable work schedules
* 100% work from home
* 8 Paid Holidays + 23 PTO Days
* 401(K) with company match
* Reimbursement for continuing medical education
* Career growth opportunities across the enterprise
* Networking with peers across multiple medical specialties
Requirements:
* M.D.
or D.O.
with a current, active, U.S.
state medical license and board certified in Medical Oncology , recognized by the American Board of Medical Specialties, or American Osteopathic Association
* Eligible to acquire additional state licensureas required
* 5 years of relevant clinical experience post residency/fellowship
* Knowledge of applicable state federal laws
* Utilization Review Accreditation Commission and National Committee for Quality Assurance standards is a plus
* Ability to commit to a set, weekly work schedule (Monday through Friday)
* Strong computer skills: ability to work autonomouslywith automated processes, computer applications, and systems
* Meet physical demands of the role including, but not limited to, typing, speaking, and listening 100% of time
* In accordance with our HITECH Security Accreditation, company provided encrypted-workstation is required to be hard-wire connected to a modem or router.
Wireless connection is...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:30
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Registered Dietitian - Onsite Health Coach - Evernorth - Falls Church VA
Hybrid - work on site in Falls Church VA / Fairfax County VA and part time work from home
Our Custom Coaching program connects employees with a highly skilled wellness coach for face-to-face sessions.
Coaches take a holistic approach to help employees set and accomplish goals, manage chronic conditions and encourage healthy behaviors.
Here's more on how you'll make a difference :
• Provide onsite face-to-face customer coaching and support, with a focus on stress, anxiety, depression and other challenges.
• Identify customer health education needs through targeted health assessment activities.
• Collaborate with customers to establish health improvement plans, set personalized evidence-based goals, and support customers in achieving those goals.
• Empower customers to become an active participant in their own health outcomes.
• Assist Customer in overcoming barriers to better health
• Lead and support a variety of Health and wellness promotional activities, such as group coaching, wellness challenges and Health related seminars.
• May perform biometric screenings , including finger sticks, blood pressure, body composition, etc.
• Utilize biometric values and motivational interviewing techniques to collaborate with customer to drive to improve clinical outcomes.
• Provide support for health-related site events, which include open enrollment, wellness committee facilitation, flu shot events, health fairs, etc.
What we expect from you :
• Strong Clinical skills with at least 3 or more years of experience health coaching , health education and health promotion
• Bachelor's degree in a health-related field.
Master's degree preferred.
• Registered Dietitian with license in respective state
• CDCES/CDE strongly preferred
• Diabetes coaching/program execution experience
• Current ACLS/BLS/CPR/ AED Certification
• Must have high energy level, with dynamic group presentation skills
• Positive role model in demonstrating healthy behaviors
• Ability to proactively collaborate professionally with the client and other matrix partners.
• Understand and own a variety of clinical targets and outcome measurements.
Develop action plans that drive clinical value for the customers and clients.
• Proven administrative abilities, with strong computer and software application skills.
• Must reside local to Falls Church VA.
This position will be a hybrid role.
Part of the week will be work from home and part of the week will be on site at various locations across Falls Church VA.
The schedule is Monday - Friday and hours TBD.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Gr...
....Read more...
Type: Permanent Location: Falls Church, US-VA
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:29
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* Job Description Summary
Guides the company on strategic Utilization Review decisions and provides medical advice that has a significant impact on strategic planning and patient treatment.
Widely recognized Medical Direction expert and thought leader by both internal and external community.
Provides professional guidance and assistance in the evaluation of medical factors of proposed risks.
Establishes research parameters and maintains a system/process that evaluates the quality and medical utilization of members.
May prescribe procedures and provide interpretations of laboratory, EKG, and X-ray results involved in risk appraisal.
Establishes and implements policies and standards, evaluate new treatments, and conduct medical research to ensure the quality of the medical care provided to patients.
Implements utilization and financial initiatives.
Responsible for program execution and drives utilization review medical program management for specific clinical programs.
Develops and manages efforts to improve and maintain cost and utilization trends.
Requires an MD, DO or DC.
Hiring Requirements
Job Details
* Do you crave an intellectually stimulating job that allows you to leverage your clinical expertise while developing new skills and improving the lives of others? Then look no further! As a Radiation Oncology Medical Director at eviCore, part of Evernorth Health Services, a division of The Cigna Group, you'll use your clinical know-how to provide evidence-based medical reviews for patient care.
Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases.
This role offers you the opportunity to build new skills while enhancing the health and vitality of others.
We're seeking a detail-oriented individual with good communication, technology, and typing skills, as well as strong clinical judgment.
Drive growth in your career with our innovative team.
* How you'll make a difference:
+ You'll start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success.
+ Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on eviCore's case management software.
+ Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence-based medical necessity and appropriateness of the requested service or treatment.
+ Leverage your clinical expertise to recommend alternative services or treatments as necessary.
+ Work collaboratively with over 500 eviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making.
What you'll enjoy about working here:
+ Benefits start on day one
+ Predictable work schedules
+ 100% work from home
+ 8 Paid Holidays + 23 PTO Days
+ 401(K) with company ...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:29
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The job profile for this position is Software Engineering Senior Advisor, which is a Band 4 Senior Contributor Career Track Role with Cigna-Evernorth Services, Inc.
* Develops Teradata SQL procedures and jobs to build extract, transform, and load ("ETL") solutions.
Works on designing the ETL for project requirements.
* Provides technical assistance for resolution of application issues.
* Creates mapping documents and develops ETL Logic to integrate GBS data to Operations Support Systems.
* Performs analysis on program changes and documents logical processes.
Position requires quarterly travel to Nashville, Tennessee for onsite meetings and planning activities.
* Virtual/work from home benefit available.
Qualifications
* Requires a Master's degree in Computer Science or a closely related field and 3 years of IT experience (or a Bachelor's Degree in Computer Science or a closely related field and 5 years of IT experience).
* Must have experience with healthcare domain experience; processing and analyzing facets including membership, accumulators, billing, claims, broker commission, and provider data; software development using Oracle (PL/SQL); issue tracking systems such as Jira and Service Desk; and code repositories such as Bitbucket and SVN.
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 123,400 - 205,600 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure.
That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health.
Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
For more details on our employee benefits programs, visit Life at Cigna Group .
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives.
At The Cigna Group, we're dedicated to improving the health and vitality of those we serve.
Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients.
Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expres...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:28
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The job profile for this position is Software Engineering Lead Analyst which is a Band 3 Senior Contributor Career Track Role with Cigna-Evernorth Services, Inc.
* Design, code, and deliver Pega solutions.
Identify tasks and responsibilities for Pega implementation.
* Create and extend Pega applications.
* Manage rules and rulesets.
Leverage Enterprise Class Structure (ECS) to promote rule reuse between case types and applications.
* Configure roles, access groups, and privileges.
* Manage data access within an application.
* Create wizards to configure a sequence of assignments.
* Design applications for multiple device types and screen sizes, including mobile devices, and manage integration settings.
* Provide expertise, tools, and assistance to operations, development, and support teams for critical production issues and maintenance.
* Troubleshoot production issues, diagnose the problem, and implement a solution.
Work cross-functionally with the support team, development team, and business team to address user issues.
* Support, maintain, and participate in development of state-of-the-art software technology platforms.
Part-time telecommuting permitted.
Qualifications
* Bachelor's or foreign equivalent degree in computers or engineering plus two years of experience in software development.
* Must have knowledge of or experience with: Pega PRPC; full PRPC implementation cycle, including Enterprise Class Structure (ECS) design and rulesets design; designing and developing process-based solutions or BPM (business process management); rules and features such as Flows, Activities, User Interface, Flow Actions, Agents, SLA, Correspondence, Single-Sign-On, External Authentication, PRPC Security, Reports, Listeners (File, MQ), Connectors, or SOAP Services; best practices in PEGA architecture, design, and coding; SQL, Postman, Java, HTML5 and REST API's; web technologies, including Ajax and JavaScript.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives.
At The Cigna Group, we're dedicated to improving the health and vitality of those we serve.
Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients.
Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with rega...
....Read more...
Type: Permanent Location: Austin, US-TX
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:27
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The job profile for this position is Software Engineering Advisor, which is a Band 4 Senior Contributor Career Track Role with Cigna-Evernorth Services, Inc.
* Design and implement robust backend solutions to business requirements following established designs using Go and MongoDB technologies.
* Help develop plans and estimates for deliverables.
* Collaborate with Product Management in clarifying business and product requirements, and apply technical approaches to satisfying requirements.
* Collaborate with development team members on design, task sharing and problem solving.
* Prioritize quality and collaborate with the software testing team to ensure prospective functionality is mutually understood.
* Collaborate with DevOps team members to help define effective system monitoring in computing environments and software deployment requirements.
Contribute to improving software development processes (e.g.
sprints, version control, unit testing, build/release).
* Develop software engineering and security best practices.
* Protect the confidentiality of sensitive and/or proprietary company and customer information, including patient health data.
* Partial virtual / work from home benefit available.
Qualifications
* Requires a Master's degree in Computer Science or a related field.
Will also accept a BS in Computer Science or a related field with 2 years of IT experience.
* Must have experience of or knowledge with: developing software applications in an object-oriented language; modern APIs; multi-threaded development; integration testing and unit testing; transforming large datasets into readable datasets; MySQL; Jira; and, developing UIs using HTML and MVC.
* Qualifying knowledge or experience may be acquired during graduate-level academic studies in Computer Science or a related field.
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 105,800 - 176,300 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure.
That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health.
Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
For more details on our employee benefits programs, visit Life at Cigna Group .
About Evernorth Health Services
Evernorth Health Services, a di...
....Read more...
Type: Permanent Location: San Francisco, US-CA
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:27
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As a Sr.
Delivery Manager Brian will oversee highly complex Technology initiatives that will deliver a successful business outcome
that is measurable.
He will be responsible for all aspects of the development and implementation of assigned initiatives and provides a
single point of contact to the business product owner and other initiative sponsors.
His primary reasonability is in the deliver phase; to monitor, track, and
coordinate strategic initiatives at a holistic view and communicates progress.
He will support the Regulated Markets portfolio across multiple
initiatives; analyzing reports, collaborating with cross-functional teams, monitoring process, facilitating initiative 'scrum of scrum' / Program Epic level meetings.
Job Expectations / Essential Functions:
* Project planning
* Maintaining schedule and dependencies
* Managing issues and risks
* Facilitating status and escalation meetings
* Coordinating cross functional delivery and testing
Relevant Experience / Qualifications:
* Bachelor's degree
* 8 - 15 years of project management
* Project Management Professional (PMP) certification preferred
* Demonstrated management and analytical skills
* Advanced written and verbal communication skills
* Experience with JIRA, Clarity, Tableau, Microsoft Office Products
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives.
At The Cigna Group, we're dedicated to improving the health and vitality of those we serve.
Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients.
Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support.
Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible.
Candidates in such states who use tobacco/nicotine will not be considered for employment unless they...
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Type: Permanent Location: Bloomington, US-MN
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:26
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After completion of application, be sure to complete the required assessment to continue in the hiring process.
If you like to make a difference and help people, have great communication skills and are able to problem -solve with a cool head, eviCore Healthcare, a subsidiary of The Cigna Group , want s you to join our team! In joinin g our non-Clinical team, you will help manage the benefit needs of inbound callers from start to finish, while delivering excellent patient-provider care.
RESPONSIBILITIES
* Accept a daily average of 100-125 inbound calls from Health Plan clients, providers , and imaging cent ers seeking pre-authorization
* Properly handle and verify patient records under HIPPA and PHI, and secure confidentiality for each call
* Accept multiple b ack-to back calls utilizing various applications on multi ple screens, and properly enter all patient, prov ider, and imaging center data
* Follow the complete formal script pathway with each caller, identifying and transferring any calls that cannot be resolved via the formal script to the appropriate person or department
* Remain client - focused at all times, with the ability to independently re solve customer inquiries and compl aints with one-call resolution.
* A ttend 100% of 8 week training, which will include live-call participation training
* Meet or exceed all performance metrics through accurate call handling and high-quality calls .
QUALIFICATIONS
* High School diploma or equivalent required
* Prior customer service background strongly preferred
* Intermediate profi ciency in Microsoft Outlook; s trong written, organizational, and verbal communication skills
* Excellent c ustomer focus orientation with ability to diffuse difficult callers constructively
* Takes accountability and ownership to efficiently solve problems
* Engaged, coachable, upbeat attitude, with a willingness to be a positive role model for your peers
* T eam player who e xchanges personal knowledge , offers, and accepts support
* Flexible , open-minded, and able to adapt positively to business changes or needs
* Self-confident and empowered to use good judgement to do what is right and keep all promises.
Training:
Will begin on 10/28/2024
Post Training:
You will be expected to work a shift with a start time between 8am - 11:30am EST, Mon - Fri.
Our Company and What We Offer
eviCore healthcare is committed to making a positive impact on healthcare, and also making a positive impact on our employees.
eviCore offers a variety of perks and benefits including, but not limited to:
NOTE: We are currently training in a work at home environment, and you will be required to have reliable internet connectivity provided through a wired connection.
A mobile or hot spot environment is not acceptable and you may need to purchase an Ethernet cord depending on your current set up
If you will be working at home occasionally or permanen...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:25
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The primary function of this role is to support our clinical telephonic nurse team by connecting calls to ensure we deliver upon our commitment and promises.
HOURS will be M-F 10:30-7pm EST.
Responsibilities
* Adhering to quality and production standards while complying with all applicable company, state and federal safety and environmental programs and procedures.
* Additional duties as assigned
* Following up on the individual workload and taking appropriate action when agreed targets are not met
* Works within a fast-paced environment
* Take initiative for problem solving with ability to multitask effectively and use critical thinking when working different task with the team
* Team-player enjoys working as part of a team.
* Actively working to maintain a co-operative and friendly working environment
* Taking ownership of difficult task work.
* Responding via the most efficient channel (e.g.
phone, e-mail, letter, etc.)
* Demonstrate exemplary customer service skills
* Effectively manages timetocomplete job responsibilities and tasks.
* Prioritize work by knowing the most effective and efficient processes toaccomplishtasks, with a focus on continuous improvement
Qualifications:
* Must have a private dedicated workspace that is free of distractions
* High school diploma or GED
* 1 year of experience in call center preferred
* Ability to work in collaboration with a team
* Proficient in Typing
* Knowledge of MS Suite (Microsoft Excel, Microsoft Word, PowerPoint) 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 at least 10Mbps download/5Mbps upload.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality.
We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people.
Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support.
Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
Qualified applicants with criminal histories ...
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Type: Permanent Location: Orlando, US-FL
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:25
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Category Management Lead Analyst: Aviation/ Overpayment Recovery Operations
Reports To
Category Director, Pharmacy & Enterprise Operations
Role Summary
Works as part of the team accountable for sourcing activities and associated strategies across the Aviation and Overpayment Identification and Recovery Operations ("OR") Commodities as it relates to the identification, negotiation and procurement of the various products and functions associated with Aviation and OR services.
This role includes leading and facilitating sourcing projects of various sizes and complexities and supporting larger projects.
This role will involve the creation, market analysis, strategic development, negotiation, and maintenance for activities around identifying a supplier, managing the competitive process and recommending a supplier that best meets the business objectives.
This resource must have experience in dealing with dynamic requirements that are tied to strategic level business and claims operations services In order to effectively engage suppliers, this resource must have experience dealing at various management levels to achieve desired outcomes through sourced engagements.
This role will report to the Aviation/ OR Category Manager.
Responsibilities
* Identifies opportunities to improve the sourcing approach and procurement process which could have significant financial impact on the organization.
* Ensures that contracted relationships have enabled supplier performance measurement and reporting function.
* Analyzes overall business requirements, supplier relationship structures and processes to improve performance and overall value.
* Analyzes industries, supply, markets, and sourcing best practices to define alternative supplier relationship structures to meet enterprise-wide requirements, manage costs, and maximize value for dollars spent.
* Manages execution and implementation of sourcing initiatives within assigned commodity.
* Develops timelines and organizes matrix teams to implement sourcing strategies and initiatives.
* Manages day-to-day execution of sourcing and contracts process and facilitates involvement of expert resources.
* Collaborates with business staff and manages development of RFPs and other selection and supplier evaluation tools.
* Works with Category Lead to develop negotiation strategies and conducting 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.
Qualifications
* BA / BS strongly preferred, ideally in Business, Supply Chain, Claim Operations or related field.
* 2-3 years-experience in procurement activities
* Excellent project management skills.
* Prior military and or law enforcement experience is a plus.
* ...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:24
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Reporting to the Risk Adjustment Strategy and Operations Leader, this role serves as leading and managing all activities related to Cigna's Corporate Integrity Agreement (CIA).
Serves as the main point of contact for internal teams to drive performance and deadlines related to deliverables related to Corporate Integrity Agreement as well as key compliance related deliverables.
Identify gaps in operational infrastructure to ensure the delivery within expected timeframes, establish critical measures to track performance to goals, identify additional critical operational metrics to support improved execution and performance, collaborate with vendors and legal and compliance teams to drive execution.
Role Components
* Collaborating with matrix partners to ensure execution of key deliverables
* Engaging and influencing the organization to prioritize around the established CIA deliverables.
* Influencing operational performance and the impact to CIA deliverables, including socializing and communicating the overall requirements, strategy and direction
* Identifying and championing additional opportunities/efficiencies around CIA requirements and other key compliance initiatives, including exploring operational solutions that drive efficiency in process.
* Facilitating and actively participating in monitoring vendor performance related to these initiatives and identifying roadblocks to success
* Monitoring operational proxy metrics, tracking and trending metric performance, and identifying gaps/opportunities to improve
Primary Responsibilities
Lead projects from end to end using best practices and disciplines.
Partner with cross-organizational areas in implementing project initiatives.
Provide leadership and guidance to the project team and across multiple areas.
* Responsible for delivering small to large scale project initiatives.
* Collaborate with leadership teams on all aspects of the day-to-day operations to build and manage a detailed project plan, with key milestones, priorities,dependencies/sequencing,from inception to closure.
Plan will incorporate tasks that represent all work needed for a successful implementation.
* Identify, track, mitigate and escalate (when appropriate) project risks, issues, and decisions.
Develop contingency plans and triggers to invoke.
* Drive to delivery timelines, while also adapting to a dynamic work environment; set priorities to best support organization performance and impact.
* Provide transparent and accurate project status reporting at all times, in alignment with stakeholder and sponsor input.
* Identify and develop relationships with cross-enterprise teams and key stakeholders to establish and monitor progress against goals and objectives, and a clear vision to achieve goals.
* Understand communication dynamics and build/execute a plan to meet stakeholder needs.
* Ensure funding and resources are prioritized and secured to facilitat...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:24
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Customer Service Associate Representative - Hybrid - Honolulu, HI
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Performs Customer Service duties under direct instruction and close supervision.
Work is allocated on a day-to-day or task-by-task basis with clear instructions.
Entry point into professional roles.
Main job functions include:
* Helping patients understand their pharmacy benefits better by using knowledge gained from training, problem-solving skills and added support from your team to answer patient calls effectively.
* While on calls, you will use expert listening skills to address patient questions and concerns empathetically and document all interactions.
* Assisting patients with prescription refills, scheduling shipments and addressing billing questions.
What You Should Have:
* High School Diploma / GED required
* 1 year of relevant call center experience preferred
* 1 year Previous medical insurance or pharmacy experience preferred
* General PC knowledge including Microsoft Office and outlook
* Excellent communication skills (verbal and written)
* Empathetic and genuine customer service skills
What you'll love about working here:
* Fun, friendly, and unique culture
* Choice of three 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
Our Patient Care Advocates are dedicated team members who excel at customer service, helping us elevate our patient care to new heights.
In this crucial role, you are on the front lines with patients, responding to phone inquiries and addressing each with care, detail, and most importantly, empathy.
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 - 18 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 soluti...
....Read more...
Type: Permanent Location: Honolulu, US-HI
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:23
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Are you a caring, curious, dedicated, and compassionate person that wants to make an impact on the lives of others? If so, Cigna Healthcare, a division of The Cigna Group, is hiring customer service representatives like you to join our US Medical team.
Use your problem-solving and listening skills to answer questions from Cigna Healthcare customers.
As a trusted customer service representative, you'll help answer questions about benefits, eligibility, prior authorizations, and claims.
You'll also suggest other programs that could help the customers overall wellbeing.
We'll prepare you for success with 11-12 weeks of required training during your first 90 days.
This training will give you everything you need to provide excellent service to our customers.
An added benefit is that this position is work at home.
So, you get to enjoy helping people from the comfort of your own home.
How you'll make a difference:
* Answer 40+ calls per day on average from customers and help with their questions.
* Use several computer programs at the same time for each call.
* Solve problems on your own and try to fix issues in one call.
* Meet call center goals and provide accurate information politely and professionally.
* Listen carefully to understand what customers need and use your knowledge to respond effectively and guide them on what to do next.
* Adapt to changes in procedures or guidelines and stay professional and focused while working from home.
* Work with other teams to resolve issues and improve service.
Requirements:
* High School diploma or equivalent
* 2+ years of customer service experience
* A quiet, distraction-free workspace at home
* Clear and effective communication skills
* Comfortable using a computer
* Good organizational skills
* Strong written and verbal communication
* Ability to stay calm and helpful, even in tough situations
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 - 23 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 ...
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Type: Permanent Location: Plano, US-TX
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:22
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Help us design our future.
Get ready for a job that encourages you to think strategically yet stay connected with your teams.
Do you have development and integration experience? If so, prepare to innovate, create, and inspire.
The Boomi Developer (Application Development Senior Advisor) will be responsible for designing, developing, and maintaining integration processes usingBoomiAtomSphere.
This role requires strong technical expertise inBoomi and a deep understanding of identity, provisioning, integration patterns, and best practices.
Responsibilities
* Design, develop, and maintain integration solutions usingBoomiAtomSphere.
* Collaborate with business analysts and stakeholders to gather integration requirements.
* Create and manageBoomiintegration processes, including data mapping, transformation, and orchestration.
* Monitor and optimizeBoomiintegrations to ensure performance, scalability, and reliability.
* Troubleshoot and resolve integration issues in a timely manner.
* Document integration processes and maintain comprehensive technical documentation.
* Ensure compliance with best practices for integration architecture and data security.
* Stay updated with the latestBoomifeatures and integration technologies.
* Provide technical support and guidance to junior developers and other team members.
Qualifications:
* High School diploma; GED or equivalent.
* Bachelor's degree in Computer Science, Information Technology, or a related field preferred.
* Proven experience as aBoomiDeveloper or similar role.
* Strong knowledge ofBoomiAtomSphere, including Process Builder, Atom Management, and API Management.
* Proficiency in data integration, ETL processes, and web services (REST).
* Familiarity with SQL, XML, JSON, and other data formats.
* Experience with cloud platforms (e.g., AWS, Azure) and SaaS applications.
* Excellent problem-solving skills and attention to detail.
* Strong communication and interpersonal skills.
Preferred Qualifications:
* Certification inBoomi.
* API Security, design, and management
* Identity and access provisioning
* Experience with other integration platforms (e.g., MuleSoft, Informatica).
* Knowledge of programming languages such as Groovy, JavaScript, or Python.
* MSsql, html/javascript frontend, Django Rest Framework, Flask/Flask-Admin, SQLAlchemy, Ansible, and Terraform.
* Familiarity with Agile development methodologies.
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 117,800 - 196,300 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bon...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:22
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Are you a caring, curious, dedicated, and compassionate person that wants to make an impact on the lives of others? If so, Cigna Healthcare, a division of The Cigna Group, is hiring customer service representatives like you to join our US Medical team.
Use your problem-solving and listening skills to answer questions from Cigna Healthcare customers.
As a trusted customer service representative, you'll help answer questions about benefits, eligibility, prior authorizations, and claims.
You'll also suggest other programs that could help the customers overall wellbeing.
We'll prepare you for success with 11-12 weeks of required training during your first 90 days.
This training will give you everything you need to provide excellent service to our customers.
An added benefit is that this position is work at home.
So, you get to enjoy helping people from the comfort of your own home.
How you'll make a difference:
* Answer 40+ calls per day on average from customers and help with their questions.
* Use several computer programs at the same time for each call.
* Solve problems on your own and try to fix issues in one call.
* Meet call center goals and provide accurate information politely and professionally.
* Listen carefully to understand what customers need and use your knowledge to respond effectively and guide them on what to do next.
* Adapt to changes in procedures or guidelines and stay professional and focused while working from home.
* Work with other teams to resolve issues and improve service.
Requirements:
* High School diploma or equivalent
* 2+ years of customer service experience
* A quiet, distraction-free workspace at home
* Clear and effective communication skills
* Comfortable using a computer
* Good organizational skills
* Strong written and verbal communication
* Ability to stay calm and helpful, even in tough situations
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 - 23 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 ...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:21
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Home Infusion Registered Nurse - Accredo
Candidates for this position must live in/near Statesville, NC.
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 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 ...
....Read more...
Type: Permanent Location: Statesville, US-NC
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:20
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Do you crave an intellectually stimulating job that allows you to leverage your clinical expertise while developing new skills and improving the lives of others? Then look no further! As a Radiation Oncology Medical Director at eviCore, part of Evernorth Health Services, a division of The Cigna Group, you'll use your clinical know-how to provide evidence-based medical reviews for patient care.
Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases.
This role offers you the opportunity to build new skills while enhancing the health and vitality of others.
We're seeking a detail-oriented individual with good communication, technology, and typing skills, as well as strong clinical judgment.
Drive growth in your career with our innovative team.
How you'll make a difference:
* You'll start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success.
* Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on eviCore's case management software.
* Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence-based medical necessity and appropriateness of the requested service or treatment.
* Leverage your clinical expertise to recommend alternative services or treatments as necessary.
* Work collaboratively with over 500 eviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making.
What you'll enjoy about working here:
* Benefits start on day one
* Predictable work schedules
* 100% work from home
* 8 Paid Holidays + 23 PTO Days
* 401(K) with company match
* Reimbursement for continuing medical education
* Career growth opportunities across the enterprise
* Networking with peers across multiple medical specialties
Requirements:
* M.D.
or D.O.
with a current, active, U.S.
state medical license and board certified in Radiation Oncology , recognized by the American Board of Medical Specialties, or American Osteopathic Association
* Eligible to acquire additional state licensureas required
* 5 years of relevant clinical experience post residency/fellowship
* Knowledge of applicable state federal laws
* Utilization Review Accreditation Commission and National Committee for Quality Assurance standards is a plus
* Ability to commit to a set, weekly work schedule (Monday through Friday)
* Strong computer skills: ability to work autonomouslywith automated processes, computer applications, and systems
* Meet physical demands of the role including, but not limited to, typing, speaking, and listening 100% of time
* In accordance with our HITECH Security Accreditation, company provided encrypted-workstation is required to be hard-wire connected to a modem or router.
Wireless connectio...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:20
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As a Prolastin Pharmacy Technician, you will be assisting patients in receiving needed medications to help manage rare and/or chronic diseases.
You'll be empowered to engage patients, insurance companies, and multiple departments to process orders and ensure timely shipment of medications.
This role is very detail oriented, and you'll spend the majority of your day working on our computer system.
Here's a little more on how you'll make a difference:
* Accurately enter prescriptions into our system.
Use the knowledge you gain from training, your problem-solving skills and support from your team to accurately enter patient prescriptions.
* You'll ensure that the medication prescription is accurately entered so it can be evaluated under insurance coverage and dispensed correctly.
* Interact directly with healthcare providers.
You'll research issues on with pharmacist and doctors' office and provide guidance to our patients about medication coverage.
* Juggle multiple tasks without sacrificing attention to detail.
You will be busy handling multiple requests at any given time as well as documenting information in our computer system.
What you need to do the job:
* High School Diploma, or GED required.
* minimum of six months related experience.
* Valid Tennessee Pharmacy technician license required.
* Pharmacy Technician Certification required.
* Microsoft Office proficiency and data entry skills
* Basic math skills (addition/subtraction/multiplication)
* Strong attention to detail, accuracy and quality
* Excellent verbal and written communication skills
* Position must reside in state of Tennessee either 50 miles from Memphis or Nashville.
* Must be able to come onsite if a business need would occur.
Current site locations are: 1680 Century Center Pkwy, Memphis Tn 38134 OR 730 Cool Springs Blvd Franklin, TN 37067
Why Join Us?
Health coverage effective day 1 (including medical, dental, vision)
Holiday, PTO and OT pay
401K with company match
Tuition reimbursement
Fun, friendly and unique culture - bring your whole self to work every day!
Growth and advancement potential
Work Schedule: recruiting for the following Monday through Friday shifts:
* 7 AM to 4 PM CT
* 8 AM to 5 PM CT
* 9 AM to 6 PM CT
* 10 AM to 7 PM CT
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality.
We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people.
Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to...
....Read more...
Type: Permanent Location: Memphis, US-TN
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:19
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Medical Director, Post-Acute Care
Summary:
The Medical Director (MD) provides timely expert medical review of medical necessity requests for clinical services that do not meet utilization review criteria and renders a clinical opinion about the medical service under review while located in a state or territory of the United States.
Responsibilities include:
* Provide timely expert medical review of medical necessity requests for clinical services (including post-acute care) and render a clinical opinion about the medical service under review, including post-decision reviews.
* Provide timely and collegial peer-to-peer discussions with treating physicians to clarify clinical information and to explain review outcome decisions.
* Document all actions related to clinical review sessions and attest to review qualifications as required.
* Conduct weekly Case Conferences with nursing and social worker teams; discussing every assigned member receiving care in a post-acute care facility, focusing on discharge planning, complex medical care management, quality of care, appropriate level of care, and appropriate length of stay.
* Maintain necessary credentials and immediately inform the Company of any adverse actions relating to medical licenses and/or board certifications.
* Support the review of clinical guidelines.
* Support and communicate company policies and procedures to the provider community.
* Testify at ALJ Hearings when your cases are being appealed
* Assist with staff educational training and in-service programs and serve as a clinical resource for staff.
* Serve as a Subject Matter Expert when Medical Directors and/or Senior Medical Directors are unavailable.
* Available for scheduled weekend call from home based on business needs.
* Participate in Joint Operating Committee meetings and other Virtual events with the Provider Engagement Team in your geographic territory.
* Review and document on cases that are appealed and work with the providers proactively to help with accurate case adjudication
* Participate in all required educational and quality improvement activities and maintain passing scores in all assessments.
* Assist in reviewing case determinations from clients responding to a provider or member complaint
* Other duties as assigned
Minimum Education, Licensure and Professional Certification requirement:
* M.D.
or D.O.
degree from accredited institution.
* Minimum of five (5) years of clinical practice experience after completion of all graduate medical education training, including residency and fellowship (when applicable)
* Active board certification, primary care specialties (Family Medicine, Internal Medicine, Emergency Medicine) or Physical Medicine and Rehabilitation required.
* Active unrestricted license to practice medicine in a state or territory of the United States as a utilization review doctor of medicine or doc...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:18
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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 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 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 wit...
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Type: Permanent Location: Lubbock, US-TX
Salary / Rate: Not Specified
Posted: 2024-09-27 08:31:18
