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Molex's TIS (Transportation and Innovative Solutions) business unit is a segment within Molex that specializes in providing connectivity solutions and technologies tailored for the transportation and industrial sectors.
This unit focuses on developing and delivering a wide array of products and solutions that cater to the specific needs of these industries.
These solutions often involve connectors, cables, components, and integrated systems that address connectivity, data transmission, and control system requirements in transportation (such as automotive and commercial vehicles) and various industrial applications.
We are seeking a driven Senior Quality Engineer to join our Manufacturing Team.
This role works in a collaborative team-based environment out of Molex's Lincoln Nebraska manufacturing facility.
In this role you will be problem solving, leading, and driving improvements in our advanced molding processes supporting the transportation solutions division.
What You Will Do
* Investigate and lead teams to address customer complaints
* Work with customers & internal teams to address concerns
* Utilize problem solving tools & 8D/A3 Methodologies to document investigations
* Drive changes & improvements to processes to mitigate future customer complaints
Improve processes & procedures to eliminate waste
* Analyze trends in cost of poor quality & defect types to identify projects to reduce cost & mitigate risk
* Utilize a structured approach to problem solving & project management
* Analytically, data-driven and problem-solving mindset
Support best in class product development & PPAP
* Work with launch teams on best practices to deploy a successful product
* Provide guidance in the development and analysis of inspection requirements, gaging criteria, SAP requirements, product processing techniques & methodologies.
* Document product launch by use of PPAP & qualification plans
* Help write and revise work instructions & procedures
* Ensure that FMEA, control plan, and process flow documentation are effectively deployed in production and that requirements are periodically reviewed for all processes.
Strengthen the Quality Management System
* Conducting gap assessments and implementing improvements based on innovative solutions or tried and true industry standards
* Utilize quality assurance methods to audit for compliance & drive process control to the process inputs
* Sustain mature processes that drive value for the organization
* Developing & mentoring QE & Technicians to build on the capability of the team to execute the QMS.
Who You Are
* Bachelor's degree in a technical field or equivalent experience, training, and/or certification.
* 7 years of experience in manufacturing and/or quality in a plant setting
* Availability to travel up to 25% domestically and internationally
What Will Put You Ahead
* Supervision of hourly & sala...
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Type: Permanent Location: Lincoln, US-NE
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:26
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Your Job
Georgia-Pacific's Corrugated business has an exciting leadership opportunity in Santa Teresa, NM! We are now hiring a Director of Operations to take on overall operations of this facility with a workforce of around 70 full-time employees including a 16-person leadership team.
The Director of Operations will lead the team to ensure a safe and injury/incident-free environment in a fast-paced manufacturing facility.
If you are a driven leader, we'd like to learn more about you!
The young community of Santa Teresa offers year-round sunshine, enhancing a suburban lifestyle that is located just minutes away from the urban amenities of Las Cruces and El Paso, Texas.
The gateway between New Mexico, Texas, and Mexico, Santa Teresa features a unique location that puts you in the center of spectacular landscapes-from the beautiful desert scenery to the Franklin Mountains.
Our Team
The team at Santa Teresa specializes in the manufacturing of corrugated sheets.
These products are offered in a wide variety of flute sizes and combinations to better meet the needs of our customers.
Come join our team! To learn more about this facility and our Packaging division, please visit: www.gppackaging.com
What You Will Do
* Applying Principled Based Management (PBM®) to drive long term value creation and support business objectives
* Partnering and collaborating with capability resources such as HR, Customer Service, Accounting, and Purchasing
* Work closely with the plant Commercial Team to meet all Customer Expectations and achieve the business plan
* Operating in a fast-paced manufacturing environment with an ability to prioritize and drive actions to closure
* Driving new and fast-growing technologies to upgrade our manufacturing process
* Developing advantaged manufacturing capabilities that enable short- and long-term business priorities and objectives
* Defining operational vision and strategy and establishing organizational direction and focus
* Driving results by fostering creativity and accountability in a performance-oriented culture
* Developing direct reports into promotable roles
* Executing multiple, simultaneous high impact initiatives to achieve overall goals
* Exercising agility with solving problems with the ability to quickly identify profitable opportunities, diagnose errors, prioritize actions, and optimize systems and processes
Who You Are (Basic Qualifications)
* Eight (8) or more years of experience leading manufacturing processes, including work processes, operations excellence, maintenance, reliability, and continuous improvement
* Experience driving talent development initiatives
* Experience within the Corrugated industry
What Will Put You Ahead
* Bachelor's Degree or higher in Engineering, Business Administration, Management, or related field
* Sales experience within the consumer goods industry
* Bi-lingual
At Koch companies, we are entr...
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Type: Permanent Location: Santa Teresa, US-NM
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:25
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Job Description:
Location: 9045 River Road, Indianapolis, IN 46240
A hybrid schedule is open to consideration.
Please note the travel requirements below.
Company Overview
Performing over eighty million utility locates annually, USIC is the most trusted name in underground utility damage prevention and protection.
USIC provides a full suite of public and private utility services throughout the United States, with advanced offerings and superior technology to meet every underground utility damage prevention and protection need.
Our mission is to deliver quality, efficient, safe, and innovative solutions to protect our partners’ infrastructure and critical assets.
Summary
USIC is seeking a seasoned and strategic Director of Product Management to lead our product initiatives and the productization of our portfolio.
In this role, you will drive the development and enhancement of our service offerings, ensuring alignment with market demands and customer needs.
In this role, you will be responsible for overseeing the entire product lifecycle, from ideation to launch, connecting and driving pricing initiatives to drive profitability and market competitiveness.
The ideal candidate will have a strong background in product management within industries such as utilities, construction, or field services, with a focus on optimizing operational efficiency and customer experience.
This role will report to the SVP, Sales and Revenue Operations, and will work across the organization with all functions to lead our product portfolio and corresponding strategic initiatives.
They are a trusted advisor to the business and serve as a strategic leader within the Sales and Revenue Operations organization.
The ideal candidate has a background in Sales, Marketing, or Revenue Operations and experience implementing strategic programs in large, matrixed organizations.
Responsibilities
* Lead the development and execution of the product roadmap tailored for field labor services, in alignment with company goals and market trends.
* Collaborate cross-functionally with operations, sales, marketing, and regulatory teams to define product requirements and ensure successful service delivery.
* Work closely with technology teams to operationalize product offerings through our technology solutions for ease of tracking, delivery, and billing.
* Conduct market research, competitive analysis, and customer feedback to identify opportunities for service enhancement and innovation.
* Collaborate with commercial teams to develop effective go-to-market strategies for new service offerings and geographical expansions.
* Define pricing positioning, messaging, and promotional strategies to drive customer adoption and retention in the B2B market.
* Ensure alignment between service value proposition, pricing strategy, and sales enablement initiatives.
* Work closely with technology teams to operationalize product offerings through our technology...
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Type: Permanent Location: Indianapolis, US-IN
Salary / Rate: 160000
Posted: 2024-09-29 08:35:25
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Your Job
Phillips-Medisize, a Molex Company is seeking a Automation Technician to join our Maumelle, AR facility! As a part of this role, you will be focused on supporting daily production needs, repairs, working with Process Engineers and Maintenance team on conducting installations and upkeep of the molding equipment and all support systems.
Shifts Available:
F Shift: 7pm - 7am Wed - Friday, every other Saturday
E Shift: 7pm - 7am Sun - Tuesday, every other Saturday
Our Team
Phillips-Medisize, a Molex Company, is a end-to-end provider of innovation, development and manufacturing solutions to the medical pharmaceutical and diagnostics industries.
What You Will Do
* Working experience with troubleshooting equipment & preventative maintenance inquiries
* Work directly with different machine supplier Technicians to resolve issues.
* Working on various types of equipment such Machine, Robotics/automation, Hot Runner controllers, Thermolaters, E-Dart, E.O.A tooling
* Experience in troubleshooting and writing PLC logic, Integration of all support equipment with the Molding Machine.
* Collaborating with maintenance, production, engineering and operations team
Who You Are (Basic Qualifications)
* 2 or more years electrical / electronic troubleshooting in a Maintenance / manufacturing environment
* Experience with PLC Systems, including understanding PLC programming logic, and troubleshooting
What Will Put You Ahead
* Technical degree or higher in electronics or related field
* Experience with Injection Molding
* Knowledge with assembly equipment.
HMI programming, experience with servo systems, six axis robots
This position does not qualify for VISA Sponsorship
At Koch companies, we are entrepreneurs.
This means we openly challenge the status quo, find new ways to create value and get rewarded for our individual contributions.
Any compensation range provided for a role is an estimate determined by available market data.
The actual amount may be higher or lower than the range provided considering each candidate's knowledge, skills, abilities, and geographic location.
If you have questions, please speak to your recruiter about the flexibility and detail of our compensation philosophy.
Hiring Philosophy
All Koch companies value diversity of thought, perspectives, aptitudes, experiences, and backgrounds.
We are Military Ready and Second Chance employers.
Learn more about our hiring philosophy here .
Who We Are
As a Molex company, Phillips-Medisize mobilizes and deploys specialized capabilities and services across highly regulated industries, including health care, regulated consumer, automotive and defense.
We design, develop and create innovative and life-changing medical technologies for millions of people around the globe.
At Koch, employees are empowered to do what they do best to make life better.
Learn how our business philosophy helps employees unleash their potential while creati...
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Type: Permanent Location: Maumelle, US-AR
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:24
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Your Job
Are you a safety-minded and team-oriented individual? Do you enjoy working with technology and industrial equipment? If so, don't miss this great opportunity in Darlington, SC!
Georgia-Pacific is searching for Printing Utility Tech to join our Dixie® facility in Darlington, SC.
The starting hourly wage is $19/hour with the potential to earn more depending on experience.
Our Team
Our Darlington facility manufactures Dixie® paper products.
The Printing Technician position will be part of a shift team responsible for overseeing the safe and efficient operation of our industrial printing presses as part of the overall plate and bowl making process.
To learn more about Dixie®, please visit: www.dixie.com.
What You Will Do
* Ensure safe and efficient set up and operation of the printing equipment
* Conduct changeovers by setting up assigned equipment for change in material or product
* Operate and clean equipment to maintain production
* Check, test, and measure product for quality specifications.
Examine for visual defects
* Prep raw materials for production run
Who You Are (Basic Qualifications)
* High school diploma or GED
* 6 months or more of experience in a team environment
What Will Put You Ahead
* 1-3 years of related manufacturing experience
* Accurately and safely use equipment including the printing press, measuring equipment, and hand tools
* Accurately record and maintain records pertaining to production time and quality
* Mechanical skills related to production or manufacturing
At Koch companies, we are entrepreneurs.
This means we openly challenge the status quo, find new ways to create value and get rewarded for our individual contributions.
Any compensation range provided for a role is an estimate determined by available market data.
The actual amount may be higher or lower than the range provided considering each candidate's knowledge, skills, abilities, and geographic location.
If you have questions, please speak to your recruiter about the flexibility and detail of our compensation philosophy.
Hiring Philosophy
All Koch companies value diversity of thought, perspectives, aptitudes, experiences, and backgrounds.
We are Military Ready and Second Chance employers.
Learn more about our hiring philosophy here .
Who We Are
As a Koch company and a leading manufacturer of bath tissue, paper towels, paper-based packaging, cellulose, specialty fibers, building products and much more, Georgia-Pacific works to meet evolving needs of customers worldwide with quality products.
In addition to the products we make, we operate one of the largest recycling businesses.
Our more than 30,000 employees in over 150 locations are empowered to innovate every day - to make everyday products even better.
At Koch, employees are empowered to do what they do best to make life better.
Learn how our business philosophy helps employees unleash their potential while creating value for...
....Read more...
Type: Permanent Location: Darlington, US-SC
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:24
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Your Job
Koch Capabilities is building something new and valuable, a data platform that enables efficient and repeatable process transformation across our enterprise and makes many types of data available for automation and analytics that was not previously possible.
Developing this new platform in support of our Innovation Vision will be critical to our success at Koch Industries.
The Platform Security Engineer role is a key part of the security product team, working closely with the security product owner, architect, and analyst to build and execute the security model and policy to protect our sensitive information by partnering with the data products and shared capabilities.
Our Team
The DMET (Data Management, Enablement and Transformation) team is focused on developing a long-term sustainable capability utilizing data and technology to transform finance.
This includes a diverse group with multiple teams focused on data platform technologies, specific data products and transformation with an emphasis on data security.
Our strategy will empower the finance and tax organizations to create superior value while consuming fewer resources, unlocking analytical capabilities, mitigating risk, and meeting ever-changing regulatory requirements.
What You Will Do
* Design and build end to end SQL and NoSQL database solutions.
This includes translating business requirements, recommending technologies, developing code, mentoring team members, and overseeing QA and Production deployment processes.
* Load and process disparate data sets using technologies including but not limited to DBT, PostgreSQL, Elastic search, Snowflake, Spark, Java, and Python.
* Work with teams to enforce compliance with security standards.
* Provide tier III support as needed for issues relating to security.
* Consult with teams evaluating new data products, tools and technology for the platform to provide input from a security lens.
* Code applications that adhere to enterprise design patterns.
* Resolve technical issues through debugging, research, and investigation.
* Ensure compliance with Koch policies around cloud networking and data security.
Who You Are (Basic Qualifications)
* Experience in creating, administering, or enforcing strict data security models and policies.
* Experience with Role Based Access Control, Attribute Based Access Control/Row Level Security, Data Masking, Encryption, and other modern best practices for securing data.
* Hands-on experience in data engineering, business intelligence, data modeling.
* Experience building, scaling, optimizing, and maintaining high volume systems.
* Experience mentoring team members and helping set standards and frameworks.
* Strong coding experience in developing enterprise applications using Python, Java, and SQL.
* Understanding of DevOps/DataOps and CI/CD toolset such as git, GitLab CI, GitHub Actions.
What Will Put You Ahead
* Exper...
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Type: Permanent Location: Atlanta, US-GA
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:22
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Your Job
Georgia-Pacific is hiring Mechanical and Electrical Reliability Engineers to join our team in Toledo, OR (Containerboard)! This position reports to the Manufacturing Excellence Leader and will utilize a core set of principles to drive continuous improvement in safety and performance.
The successful candidate will use their experience and knowledge to support our mill's reliability efforts.
The rotational engineer will have a focus on learning reliability best practices in the different operational departments within the Toledo mill.
Identified candidates will have an opportunity to work with various groups to grow and expand their knowledge and skillets.
Our Team
Georgia-Pacific Toledo is a producer of brown paper used to make cardboard and is a leader in recycling in the Northwest.
The Toledo Mill is located within a 10-minute drive to the Pacific Ocean.
Many outdoor activities are available near the mill including fishing, hiking, mountain biking, kayaking, and boating.
What You Will Do
* Drive a culture of safety and environmental excellence through critical hazard identification, risk reduction, and risk mitigation
* Collaborate directly with operators, shift leaders and asset managers to meet the business objectives of the department and influence continuous improvement
* Learn reliability best practices including essential crafts and skills, precision maintenance, lubrication and vibration analysis to enhance your knowledge while applying principles to solve issues.
* Assist with providing reliability support to Maintenance and Operations (troubleshooting, problem solving, cost estimating and implementation of mechanical design solutions)
* Partner with the Reliability Department on Root Cause Failure Analysis (RCFA) and Failure Mode Effects Analysis (FMEA) efforts to identify root causes of complex and/or repetitive problems and put in place executable corrective actions
* Collaborate on the implementation of preventative and predictive maintenance strategies for new and existing equipment
Who You Are (Basic Qualifications)
* Bachelor's Degree or higher in an Engineering discipline (i.e.
Chemical, Mechanical, Industrial, Pulp & Paper)
* Experience with continuous manufacturing processes through work experience or project-based work
* Experience using Microsoft Office tools in the following manner: Excel (sorting data, creating tables and creating graphs); Outlook (scheduling tasks, calendar invitations and general professional correspondence); and Word (document creation/editing)
What Will Put You Ahead
* Two (2) or more years of experience working in a manufacturing, industrial, or military environment
* One (1) or more years of experience of reliability experience in manufacturing, industrial, chemistry, oil & gas or military environment
* Experience with paper processes and equipment operation
* Experience with chemical process safety
* Six Sigma tr...
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Type: Permanent Location: Toledo, US-OR
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:20
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Your Job
Molex creates connections for life by enabling technologies that transform the future and improve lives.
With a presence in more than 40 countries, Molex offers a complete range of connectivity products, services, and solutions for the data communications, medical, industrial, automotive and consumer electronics industries.
Molex is looking for a Project Manager to lead cross-functional teams that manage daily production.
This role centers around ongoing production and the execution of multiple projects by driving accountability for successful project execution by following the Molex Busbar PDP.
Our Team
Molex's facility in Monee, Illinois, is a manufacturing site that specializes in producing busbars.
Busbars are conductive strips or bars typically made of copper or aluminum used in electrical power distribution systems.
These facilities often focus on creating high-quality busbars that meet industry standards for various applications, such as power distribution in switchgear, datacenters, infotech equipment, electric vehicles, electrification and other electrical systems.
Molex, as a company, is known for its expertise in electronic solutions, connectivity, and interconnect products across various industries.
What You Will Do
* Manage daily operations of the manufacturing plant specific to key customers, assess efficiency and productivity, and implement improvements as needed
* Collaborate with operations on production process, timelines, capacity, supply chain, and human resources to meet these goals
* Coordinate with, motivate and support staff, promote a strong team environment, and ensure all procedures, safety standards, and regulations are strictly followed
* Develop plans, prepare reports for senior management, and ensure adherence to the company's financial goals
* Be the Customer focal point during key current customer programs
* Translate requirements into executable project deliverables and expectations
* Deliver on commitments to key customers exercising Program Management Tools
* Craft production support timelines and lead day-to-day activities across multiple Molex global sites to meet timing goals and drive forward progress
* Facilitate critical project milestone reviews that drive decisions and mitigate late deliveries, schedules, cost risks to meet customer requirements
* Present reports on project execution that highlight areas of success, improvement as well as lessons learned
* Welcome change management ideas & transformation that drive process improvements and encourages our corporate culture
Who You Are (Basic Qualifications)
* Bachelor's degree in related field: Management, Operations, Technical, Engineering
* Progressive experience in Project/Program Management focused on production, timelines, and issues related to the production process
* Experience leading program/portfolio management and delivering to agreed timing and quality e...
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Type: Permanent Location: Monee, US-IL
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:19
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Your Job
We are seeking a Category Buyer for our Strategic Sourcing & Procurement organization within Georgia-Pacific.
As a part of our Strategic Sourcing and Procurement organization, the chemical buyer reports to the Sourcing Execution Leader.
You will be responsible for procurement of chemicals across Georgia Pacific ensuring adherence to category strategy.
You must be self-directed, work with a high sense of urgency and possess the ability to solve problems and collaborate with other disciplines to meet the needs of Operations.
You will be asked to continuously improve the process and drive efficiencies across the enterprise.
Our Team
This team supports the strategic vision for sourcing and purchasing across Georgia Pacific.
This role will be based in Atlanta at GP Center or an approved GP Facility location, and will require 25% travel.
What You Will Do
* Support the strategic vision for sourcing and purchasing across Georgia Pacific.
* Liaise with strategic sourcing and operational personnel at related sites; understand and support their priorities while executing the strategy associated with specific chemicals to drive value to the bottom line.
* Ensure supply to facilities while continuously improving the process to a standardized approach.
* Collaborate with cross-functional teams in chemicals space.
* Identify opportunities to transform procurement job functions through utilization of tools and technologies to become best in class.
* Implement processes to improve purchasing efficiencies and automation.
* Optimize working capital and on-hand inventory levels.
* Engage with supply base and suppliers to foster collaboration and partnership.
* Connect with KBX and transportation partners to drive process efficiencies.
* Ensure compliance with all safety, purchasing, fiduciary, inventory and environmental policies and procedures.
Who You Are (Basic Qualifications)
* Bachelor's Degree and 2+ years' experience in procurement, purchasing or manufacturing operations, OR high school diploma and 5+ years' experience in procurement, purchasing or manufacturing operations.
* Microsoft Excel skills to include pivot tables and data visualization tools.
* Willingness to work in multiple ERP systems including MP2, M3, Asset Suite and S4.
* Experience working with suppliers.
* Willing and able to travel.
What Will Put You Ahead
* Bachelor's Degree or higher in engineering, supply chain management, logistics or business administration
* Experience in analyzing processes and developing and implementing solutions.
* Experience in the manufacturing industry
* At least 1 year experience with data analytics work, or the equivalent combination of education and experience.
At Koch companies, we are entrepreneurs.
This means we openly challenge the status quo, find new ways to create value and get rewarded for our individual contributions.
Any compensation ...
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Type: Permanent Location: Atlanta, US-GA
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:19
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Your Job
Molex creates connections for life by enabling technologies that transform the future and improve lives.
With a presence in more than 40 countries, Molex offers a complete range of connectivity products, services and solutions for the data communications, medical, industrial, automotive and consumer electronics industries.
The Sr SAP Solutions Architect will develop, communicate, and evangelize SAP functional strategies that result in standardized business solutions.
The ideal candidate will be responsible for establishing relationships and collaborating with internal teams, external consultants, and SAP to construct functional product roadmaps that ensure continued support of current functionality, while planning for upgrades, migrations, and optimizing the SAP platforms.
Our Team
We are a global team with end-to-end responsibility for Molex ERP systems that is focused on leveraging digital and technological solutions to drive innovation and efficiency across Molex's supply chain, operations, finance, and other core capabilities.
We lead ERP initiatives, focusing on solution architecture, delivery, and execution of key global projects that modernize our core ERP solutions.
What You Will Do
* Drive a strategic and tactical roadmap for the alignment of business operations and SAP functionality.
* Collaborate with vendors, consultants, and internal teams to understand and analyze the functional and technical needs of the business and develop solutions compliant with IT General Controls and other regulatory requirements to meet those needs.
* Responsible and accountable for the functional architecture of SAP and all associated interfaces, including business processes, process re-engineering, and process improvement.
* Provide counsel to the SAP teams on the design, definition, and execution of related business process workflows that accompany solutions.
* Drive the functional "vision" and functional design specifications of assigned projects.
* Review and approve assigned project plans, and results, to ensure solution footprint is consistent with the overall functional architecture.
* Establish standards and requirements to evaluate and direct enhancements and solutions.
* Develop deep subject matter knowledge about the SAP systems, environment, and company culture, and use that knowledge to identify and deliver solutions across platform operations, maintenance, upgrades, and optimization.
* Identify opportunities to replace home-grown systems with standard SAP solutions; maximize use of standard functionality before exploring customizations.
* Establish or modify strategy, standards, and procedures for SAP configuration and implementation.
* Provide work effort and cost estimates of SAP projects as requested.
* Stay current with SAP's solution offerings, and Molex industry business requirements.
* Interface effectively with Senior Leaders, briefing solution architectu...
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Type: Permanent Location: Lisle, US-IL
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:18
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Summary
The Medicare Risk Adjustment Advanced Analytics team is searching for a highly motivated and collaborative person to build new data processes, expand technology capabilities, and enable analytics.
You will work closely with colleagues across the Risk Adjustment business, data science, and data analytics teams to develop new assets, data solutions, and pipelines while following best practices and data governance standards.
You are a data management expert who enjoys collaborating in a matrix organization.
You are curious and enjoy exploring data and understanding the business implications behind your deliverables.
You excel at translating complex datasets into clean, easy-to-use solutions and creatively solving problems.
You are self-motivated and enjoy working in a fast paced environment.
Responsibilities
* Responsible for the extraction and analysis of healthcare information
* Responsible for the automation and scheduling of business critical processes
* Develop reporting in collaboration with analytics partners to monitor data quality
* Work effectively and efficiently on multiple tasks and deadlines, while producing high quality results
* Ensure quality and integrity of data and follow best practices while exploring innovative solutions
* Drive opportunities to improve the efficiency of or otherwise enhance existing processes
Qualifications
* 3+ years of programming experience; Healthcare related experience a plus
* Experience with Python specifically as it relates to data automation
* Experience with SQL and Teradata
* Experience with Airflow development preferred
* Experience with Databricks, AirByte and/or DBT is highly desired
* Experience in designing and deploying complex datasets/datamarts preferred
* Ability to distill useful data assets from large and complex data sets
* Experience working with non-technical business partners in consultative manner
* Strong communication skills (e.g.
experience translating complex topics into easy-to-follow slides/materials)
* Ability to independently prioritize and manage multiple responsibilities and comfortable with ambiguity
* Bachelor's Degree or higher in a quantitative field (e.g.
mathematics, statistics, IT, business, MIS, actuarial science, finance, etc.) highly 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.
For this position, we anticipate offering an annual salary of 74,600 - 124,400 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 hea...
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Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:17
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The Cigna Group Sales and Contracting Development Program
Sales Associate
Start Date July 14, 2025
It's fun to work in a company where people truly BELIEVE in what they are doing! We're committed to bringing passion and customer focus to the business.
If you're looking for a challenging, ever-evolving career, you've come to the right place.
The Cigna Group's Sales and Contracting Development Program provides professional development for multiple new and existing business sales roles across Cigna Employer, Dental, and Supplemental businesses .
Our training program will provide you with an in-depth understanding of what it takes to succeed in healthcare sales.
Throughout this multi-week program, participants are in a variety of environments including a virtual classroom, in-person training, structured fieldwork, mentoring, and coaching.
Upon completion, you will have the necessary tools to combat the versatility of healthcare, understand its complexities, and experience a fulfilling career in sales.
About The Cigna Group Sales and Contracting Development Program
The Cigna Group's Sales and Contracting Development Program (SCDP) is an intensive multi-week (July-September) training program designed for early career hires, focused on developing business acumen, negotiation, and relationship building skills required to quickly onboard and contribute to The Cigna Group's focus on high quality, affordable healthcare.
The SCDP has two strategic tracks, the Sales Track and Network Track to onboard The Cigna Group's next generation of client and provider facing Sales and Network Professionals.
As a Sales Track associate, you will attend a blend of virtual classroom, in-person training, field-based learning activities, mentoring, and coaching.
* Curriculum covers topics all about The Cigna Group and Cigna Healthcare, the insurance industry, functional elements and specific role-based training.
* The in-program experience includes multiple virtual interactive and collaborative learning activities coupled with practical network applications.
Sessions will be led by facilitators and Subject Matter Experts.
* The in-program experience also includes multiple non-consecutive weeks onsite at Cigna Headquarters for cohort networking opportunities and in-person coaching/learning.
* Field Experiences will take place virtually or in the associated office/market in which the program participant has been hired into.
Formal activities and assessments will take place, led by the local market team and hiring manager.
During this time participants can work alongside their local team and reinforce program concepts with real-life/in-role experiences.
Upon completion of the program, Sales Track Associates will begin careers in sales roles across Cigna Employer, Dental, or Supplemental businesses.
All track participants will complete program with an understanding of the following:
* Cigna medical, dental, and/or supplemental products and servic...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:17
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Position Summary
This Financial Analysis Advisor position will provide support to the Centene account.
Specifically, the responsibilities of the role will include:
* Provides advanced professional input on DOI complaints with Centene client focus.
* Reviews and provides determination of pharmacy appeals.
* Communicates externally to pharmacies and clients, providing professional responses to inquires and appeals.
* Responsible for conducting moderate to complex compliance analysis, projects and/or reporting.
* Assist in development and QA of reports and recommend improvements in compliance reporting systems.
* May conduct audits to ensure data controls are maintained.
* May design, enhance and maintain system applications for processing and reporting compliance information
Essential Functions
* Extract, analyze, validate, and communicate intelligence from large sets of data
* Supports and develops compliance monitoring
* Develop new analytic resources and views of data from in-depth analysis and understanding
* Assist with internal and external audit request
* Develop, help maintain, and troubleshoot complex internal MS Excel spreadsheets, SQL coding and R coding scripts
* Assists with Ad-Hoc requests
* Reviews and replies to pharmacy appeals, DOI requests and pharmacy emails
Qualifications
* Bachelor's Degree in Finance, Accounting or related field preferred, MBA a plus.
* At least 4 years in a finance, accounting or highly analytical position
* Experience in healthcare / insurance industry preferred
* Technical knowledge of relational database concepts, querying, data warehouses and decision support tools, including but not limited to: SQL, Excel, and R
* Ability to utilize independent judgment and discretion, identify variances, and recommend solutions
* Experience in a highly regulated business environment
* Ability to communicate results of analytics to a multitude of individuals/groups
* Strong analytical and problem-solving skills
* A self-motivated team player who thrives on challenges, is comfortable working in a fast-paced, dynamic environment, and is ready for development within our Company
* Innovative and 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.
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 (inc...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:16
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At EVERNORTH Care Group, we are committed to providing our customers with benefits, expertise, and services that improve their health, well-being, and sense of security.
Our people are the key to success in a changing and increasingly competitive marketplace.
The collective skills, behaviors, and work experiences of all EVERNORTH Care Group employees enable us to make a real difference in the lives of our customers.
We seek the most talented and creative minds in the industry to develop innovative solutions our customers value and expect.
EVERNORTH Care Group is committed to recruiting, developing, motivating, and retaining a diverse workforce representing the best and brightest both inside and outside of our industry - a workforce that reflects our customers and the communities where we operate.
Role Summary
Responsible for implementing and/or supervising the development of specific pharmacy services and new programs and plans.
Coordinates and directs all activities related to the compounding, dispensing, delivery, receipt, and handling of medications and associated products within regulatory guidelines.
Major Duties
EVERNORTH Care Group pharmacies offer a full line of prescription services along with over the counter medications.
The pharmacists work closely with the health care providers to insure optimal therapeutic outcomes for our patients through continual collaboration with the team of health care providers with the health care centers.
As a Pharmacy Supervisor you will:
1.
Prepare, compound, label, package and dispense medication
2.
Comply with Federal, State and Company regulations governing all aspects of pharmacy practice
3.
Manage pharmacy operations within the department budget and according to departmental purchasing and inventory control policies
4.
Manage the ordering and maintenance of medications, chemicals and other pharmacy stock items.
5.
Provides medication and medication information to non-physician providers, nurses and physicians.
6.
Maintains sanitary work area and equipment
7.
Provides excellent customer service, both internal and external
8.
This position requires in depth knowledge of pharmaceutical science to assure the accurate compounding of drugs.
The incumbent offers pharmaceutical counsel to patients in explaining the impact as well as the side effects of various medications and their compatibility with other substances.
Ideal candidate will have:
- Pharmacist - PharmD Degree or BPharm required
- Current Pharmacy Licensure in State of Arizona required
- Three years experience in an outpatient pharmacy setting.
- Experience with automated pharmacy computer system.
- Additional clinical credentials
- Management experience preferred.
- Bilingual; English/Spanish preferred.
- Experience with Microsoft Outlook, Word and Excel
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...
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Type: Permanent Location: Chandler, US-AZ
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:15
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eviCore is hiring two Implementations, Project Managers.
The Implementations Project Manager will be responsible for directing all aspects of new client implementations, client expansions and existing clients implementing new programs/features.
Maintains ultimate responsibility for the successful completion of an implementation and the quality of the deliverables provided by the implementation team.
This position produces project schedules, manages issues and risks, manages the change control process, organizes tasks and resources, reports on progress and communicates directly with the client Project Manager.
RESPONSIBILITIES:
* Understand client strategy and developing relationships within the client implementation team
* Influence stakeholders in a clear, confident and collaborative manner when articulating concepts, challenges, complexities in order to drive standards and best practices.
* Demonstrate and promote a genuine concern for the stakeholder, listen fully and actively to truly understand what others are saying, make decisions based on an understanding of the real stakeholder need.
* Coordinate resources and schedules for project/program implementations, including project deliverables, goals and milestones.
* Create strategies for risk mitigation and contingency planning.
* Provide leadership and direction to resolve project risks and deliver implementations on time, within budget and at the required level of quality.
* Create project documentation and daily review and thorough timely updates to all project documentation.
* Contribute to the continued improvement of the implementation process.
* Participate in planning sessions and other related meetings and sessions with internal business users as well as our external clients.
* Communicate all decisions made during the implementation both externally and internally within eviCore.
QUALIFICATIONS:
* Bachelors degree preferred.
* 5+ years of Project Management , including scheduling and budgeting experience
* Familiarity of the waterfall process
* 3+ years Healthcare Operations and/or Healthcare IT experience
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
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...
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Type: Permanent Location: Franklin, US-TN
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:15
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Cigna is hiring! Do you have a unique blend of traditional accounting knowledge and control mindset with project management skills and ability to find creative solutions for new product deployments? Join our team as a Senior Accounting Advisor for the Shared Services group, where you will have the opportunity to interact with teams, at all levels, across the Accounting and Finance function as well as engage with senior leaders of the organization to deploy creative solutions.
This position requires excellent communication skills, a high level of adaptability and resilience, and a strategic mindset to develop contemporary technology solutions and properly documented processes.
If you're looking for an opportunity to take that next step in your career, then please read further.
Major Duties & Critical Tasks
* Contribute to the Accounting Shared Services Organization success by actively participating in and assuming new responsibilities across multiple functional areas.
* Assist, as part of cross-functional team, in the development and implementation of highly complex and time sensitive initiatives.
* Actively partners with business associates to analyze and understand accounting implications of enterprise projects or new business initiatives.
* Deliver process improvements that drive enhanced operational efficiency that eliminate complex manual processes.
* Accountable for delivery and continuously enhancing performance of Behavioral general accounting and reporting activities which include closing activities (journal entries, allocations, ledger analysis, etc.).
* Train and develop offshore Accounting Staff and ensure that service level agreements are met.
* Maintain a well-designed and effective internal control environment.
Perform quarterly and year end Sarbanes-Oxley (SOX) and Model Audit Rule (MAR) compliance responsibilities
* Provide Accounting subject matter expertise and support as needed to support Accounting and Finance Organization initiatives.
* Form strong partnerships with IT operations, tax, actuarial, finance, and audit (internal & external) areas to facilitate strong accounting compliance.
* Troubleshoot and work to bring finality to issues affecting financial reporting and controls, and to keep apprised of new issues/products that may affect financial reporting results.
Expected Contributions/Results:
* Support the wider finance team in various ad hoc projects, lead special projects as assigned by management, or as deemed necessary to support departmental, divisional, and company priorities and business objectives.
* Understand business fundamentals and prepare quarterly and annual close analysis and commentary for senior leadership in a fast-paced changing environment.
* Preparation of monthly management results in accordance with GAAP & SAP within strict reporting deadlines
* Ensuring 100% compliance with Cigna's balance sheet reconciliation policy for ...
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Type: Permanent Location: Miami, US-FL
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:14
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Home Infusion Nurse (RN):
Candidates for this position should live in the Huntington/Parkersburg, WV region.
This position is anticipated to need around 24 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 o...
....Read more...
Type: Permanent Location: Huntington, US-WV
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:14
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REQUIRED WORK HOURS:
Full time job with a minimum of forty hours per week five days a week.
Shift days and times may vary due to business need.
All staff schedules include rotating shifts, weekends and holiday time.
As a 24/7 Clinical Navigation & Support (CN&S) Care Manager (CM) you will deliver a guided, predictable and streamlined care experience for customers.
The CN&S team is the destination for customers identifying a clinical need by providing one unique entry to address in the moment needs of the customer.
You will help customers navigate the mental health system, including utilization of benefits and accessing direct care services.
As clinicians we support customers and families facing challenges big and small.
We want to make sure accessing care is easy and sensible.
You will help customers to process the unexpected from an evidence-based perspective, tapping into customer's strengths.
Common situations include routine/acute/urgent/emergent need for care in order to direct customers toward specialized or higher levels of care (HLOC).
A CM for the CN & S team works on a queue, taking telephonic calls in the moment, as well as scheduled calendar appointments.
CMs work in a team oriented, fast-paced environment.
The team is staffed 24/7 in support of the full organization.
CMs engages in a dialogue with the customer to assess the current need and provide a quality customer service experience.
CMs will meet the customer where they are, assess their need and triage appropriately.
CMs seek to reduce barriers and navigate the customer to the right care at the right time.
CMs will deliver a quality experience in one interaction.
In addition, CMs support 100% follow up, working with the customer until that in the moment issue has been resolved.
The CM performs some or all of the following functions:
* Clinical case assessment of needs and crisis risk assessment
* Employee Assistance Consultation (EAC) for employer
* Employee Assistance Telephonic Consultation for employees and members of household
* Behavioral Telephonic Consultation
* Confide Services Assessment
* Brief Case Management
* Utilization Management
Duties and Responsibilities:
* Assess the customer's immediate risk and need, and provide clinically appropriate referrals for care and treatment
* De-escalate and safety planning
* Use clinical expertise, professional judgment and best practice
* Determine the biopsychosocial need(s) of the customer
* Educate customers about their benefit plan coverage, how to access coverage via digital application and platforms
* Assist customers with navigating access to care
* Provides customers with solutions and next steps
* Partner with peers and leaders promoting and embracing a culture of change; supporting all parties through the change process
* Demonstrate the ability to be agile and flexible in their work process.
* Deliver excellent clinical judgm...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:13
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Job Description
The Digital Engagement team's goal is to drive behavior change and enable customers to access the health services they need, when they need them, to optimize health outcomes and lower cost of care.
The group is comprised of a cross-functional team of resources with deep domain expertise who leverage the Agile framework to manage healthcare customer communication projects of high value and high potential.
The Customer Engagement Strategist is an essential member of the Digital Engagement team and leads enterprise customer communication strategy, including new customer onboarding, feature updates, personalized offers & invitations to join specialty programs.
They are responsible for driving behavior change experimentation through highly personalized and targeted communications.
As an Engagement Strategist, you will be responsible to:
* Identify new opportunities as they relate to Digital Engagement team objectives and KPIs.
* Define customer-centric, data-driven strategies for each opportunity, including use case, targeted population, channel & frequency and measurement plan.
* Design multichannel campaign workflow and journey.
* Document scope, lead specific A/B/n tests, own hypotheses and test briefs.
* Drive end-to-end experiment execution with cross-functional team and maintain cross-functional alignment.
* Provide strategic direction from concept/test brief to launch/execution plan for the entire team.
* Manage learnings and insights; apply learnings to existing and future experiments and campaigns.
* Develop internal documentation and communication, which may involve conducting training sessions.
* Manage and obtain approvals.
Engagement Strategist required skillset:
* 6+ years experience in leading consumer engagement strategy and design across multiple channels (email, SMS, push, direct mail, agent, web and mobile experiences).
* Hands on experience of executing direct to consumer behavior change initiatives.
* Outstanding verbal and written communication skills and ability to communicate and influence across all levels of organization.
* Experience leading in Agile and rapid test and learn environment.
* Experience working with data and analytics teams, for both tactical campaign measurement and strategic planning.
* Knowledge of behavioral science principles.
* Excels in an iterative, collaborative environment with multiple matrixed partners.
* Creative, proactive approach to problem solving with a growth mindset.
Preferred skillset:
* Experience using Confluence, Jira, Figma, Aurelius, and Tableau
* Experience working with Customer Data Platforms and/or Customer Relationship Management tools such as Teradata, Redpoint Interactive or Braze.
* Experience working with communications delivery and execution teams.
If you will be working at home occasionally or permanently, the internet connection must be obtained throug...
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Type: Permanent Location: Santa Monica, US-CA
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:12
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Nurse Case Management Lead Analyst -Remote -Full-Time
Bilingual in Dari or Pashto language
Required Work Hours: 9:00 a.m.-5:30 p.m.
PST.
Major Job Responsibilities and Required Results for CM:
* Obtains informed verbal consent and takes all steps to obtain written consent.
* Acts with speed and purpose to identify, support and resolve customer healthcare needs.
* Establishes a collaborative relationship with the Customer, client (plan participant), family, physician(s), and other providers to determine medical history and current status to assess the appropriate level of care and options for alternative care.
* Sets a plan for short-term and long-term goals, time frames for follow-up, resources available (internal and community), involves all appropriate parties (client, physician, providers, employers, etc), and identifies anticipated case results/outcomes and criteria for case closure.
* Promotes quality cost-effective outcomes managing care needs through the continuum of care utilizing effective verbal and written communication skills and consumerism approach through education and health advocacy to our customers
* Implements, coordinates, monitors and evaluates the case management plan as appropriate.
* Documents findings in a clear, concise, and accurate manner.
* Acts as liaison between account, client/family, physician(s) and facilities/agencies.
* Builds solid working relationships with internal team members and across Picerno organization.
* Maintains accurate record (system) of case management interventions including cost/benefit analysis, savings, and data collection.
* Adheres to quality assurance standards and all case management policy and procedures.
* Demonstrates sensitivity to culturally diverse situations, clients and customers.
Any other assigned tasks as deemed necessary to meet business needs.
* Ensures the member's privacy, confidentiality, and safety are maintained, adheres to ethical and accreditation standards, serves as a member advocate, and adheres to legal and regulatory standards.
* Based on experience, may provide leadership, preceptor/mentorship, support and coverage to other case management staff and assist case managers in achieving positive outcomes and savings
* Complies with all accreditation, State and Federal mandates.
* Completes training as required per role and demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate
* Participates in unit and corporate training initiatives and demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate.
Additional Roles and Responsibilities Specific to CM Role:
* Will manage a large volume of outbound calls, are required to be available during all scheduled times, and manage calls and after call work in a timely manner.
* Must like fast paced work, be able to thinking cr...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:11
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Primary Function:
Coordinate and manage relationships with participating provider practices.
Maintain detailed understanding of HEDIS / STAR performance measures.
Develop and maintain a process to ensure all customers in participating provider practices meet all quality metrics.
Responsible for coordinating the delivery of cost-effective, quality -based health care services for health plan customers by development and implementation of alternative treatment plans that address individual needs of the customer, their benefit plan, and community resources.
Plans, implements, and evaluates appropriate health care services in conjunction with the physician treatment plan.
Utilizes clinical skills to assess, plan, implement, coordinates, monitor and evaluates options and services in order to facilitate appropriate healthcare outcomes for customers.
Responsibilities:
• Identifies gaps in needed quality metrics for customers and communicates to provider
• Maintains physical presence in participating provider practices
• Identifies high-risk/high-cost patients for possible case management intervention.
• Interfaces with providers of medical services and equipment to facilitate effective communication, referrals, development of discharge planning, and alternative treatment plan development.
• Identifies customer needs, coordinates and supports planned and unplanned transitions and post discharge follow up calls which may include primary care physician and specialist appointment scheduling
• Collaborates with the attending physician to achieve identified patient outcomes.
• Attend and participate in weekly Complete Health Team rounds
• Perform telephonic outreach or home visits, as needed
• Communicates with all departments to resolve issues or document trends.
• Understands and follows administrative guidelines (policy and procedure) of the unit.
• Attends and actively participates in staff meetings.
• Other Duties as assigned.
Experience:
• Current Licensure as a LPN/LVN or RN, in the state of Texas in good standing.
• Associates degree, diploma or B.S.
in Nursing.
• Three to Five (3-5) years recent experience in an acute-care environment, case-management or utilization management position (experience can be a combination of LVN/RN licensure)
• Previous HEDIS and/or CMS STARs experience a plus
• Bilingual - preferred Spanish both conversational and written
Job Related Skills:
• Verbal and written communication skills
• Interpersonal skills
• Basic Mathematical and statistical ability
• Organizational skills
• Typing and computer knowledge- able to type 35WPM
• Knowledge of utilization review requirements and procedures
• Knowledge of current health care practices and appropriate treatments.
• Knowledge of community resources
• Ability to travel to and work at participating provider offices • Works independently with minimum of supervision
If you will be working at home...
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Type: Permanent Location: Harlingen, US-TX
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:10
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Bilingual Nurse Case Management Lead Analyst -Remote -Full-Time
Fluent in Dari/ Pashto Language
Required Work Hours: 9:00 a.m.-5:30 p.m.
PST.
Major Job Responsibilities and Required Results for CM:
* Obtains informed verbal consent and takes all steps to obtain written consent.
* Acts with speed and purpose to identify, support and resolve customer healthcare needs.
* Establishes a collaborative relationship with the Customer, client (plan participant), family, physician(s), and other providers to determine medical history and current status to assess the appropriate level of care and options for alternative care.
* Sets a plan for short-term and long-term goals, time frames for follow-up, resources available (internal and community), involves all appropriate parties (client, physician, providers, employers, etc), and identifies anticipated case results/outcomes and criteria for case closure.
* Promotes quality cost-effective outcomes managing care needs through the continuum of care utilizing effective verbal and written communication skills and consumerism approach through education and health advocacy to our customers
* Implements, coordinates, monitors and evaluates the case management plan as appropriate.
* Documents findings in a clear, concise, and accurate manner.
* Acts as liaison between account, client/family, physician(s) and facilities/agencies.
* Builds solid working relationships with internal team members and across Picerno organization.
* Maintains accurate record (system) of case management interventions including cost/benefit analysis, savings, and data collection.
* Adheres to quality assurance standards and all case management policy and procedures.
* Demonstrates sensitivity to culturally diverse situations, clients and customers.
Any other assigned tasks as deemed necessary to meet business needs.
* Ensures the member's privacy, confidentiality, and safety are maintained, adheres to ethical and accreditation standards, serves as a member advocate, and adheres to legal and regulatory standards.
* Based on experience, may provide leadership, preceptor/mentorship, support and coverage to other case management staff and assist case managers in achieving positive outcomes and savings
* Complies with all accreditation, State and Federal mandates.
* Completes training as required per role and demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate
* Participates in unit and corporate training initiatives and demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate.
Additional Roles and Responsibilities Specific to CM Role:
* Will manage a large volume of outbound calls, are required to be available during all scheduled times, and manage calls and after call work in a timely manner.
* Must like fast paced work, be able to think...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:10
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Summary of Position:
Evernorth Home Based Care (ENHB), a division of The Cigna Group, is the premier home-based healthcare provider and medical services company.
We are an innovative, multi-specialty practice experiencing tremendous growth nationwide.
At ENHB our focus is comprehensive care at home to improve outcomes and reduce total healthcare costs.
We are a group of clinical professionals that understand the needs of patients, medical professionals, health systems and payers.
A main focus of our practice is:
* Comprehensive Health Risk Assessments (HRA): health plans contract with ENHB to conduct in-home comprehensive health assessments in order to ensure patient's medical well-being and to provide accurate data for HCC (Hierarchical Condition Categories) coding, STAR ratings and reimbursement.
* ENHB In Home Primary Care Program (Model 2): health plans look to us to conduct in-home longitudinal care for medically complex patients with chronic illnesses in an effort improve clinical outcomes.
Our team collaborates with the patients' primary care physicians (PCPs), and our visits serve as an adjunct to the care delivered by the PCP.
* ENHB In Home Primary Care Program (Model 1): ENHB contracts with and receives referrals from health plans to assume primary care of chronically ill patients with high admission rates and multiple emergency department visits in an effort to improve clinical outcomes.
Nurse practitioners work alongside physicians delivering care in the patient's home.
Duties & Responsibilities:
General duties:
* Function as day-to-day clinical leader, providing decision support to nurse practitioners and collaborating with the multidisciplinary team
* Perform preventive visits daily to optimize chronic conditions, assess home environment, and develop proactive care plans
* Educating patients and/or patient's family on chronic medical conditions, preventative care, and medication adherence compliance;
* Perform urgent care visits in the home and telephonically to avoid unnecessary ED transfers and hospital admissions
* Leverage the support of care team such as: nurse care manager, behavioral health, social work, and pharmacy to meet patients' medical, biopsychosocial, and financial needs
* Assume responsibility as home based PCP in some cases where there is no PCP and in other cases co-manage the patient with the PCP and serve as an extension of clinical care into the home
* Coordinate with other physicians across the continuum of care, including hospitalist, specialists, PCP's (in some cases), and SNF providers to smooth transitions and prevent readmissions
* Perform Telehealth visits at times when needed
* Complete appropriate and thorough clinical documentation of acute and chronic health issues through patient encounter in EMR system;
* Complete EMR documentation in a timely manner; Ensuring all appropriate consent forms are signed and dated; Interpreting la...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:09
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WORK LOCATION: HYBRID position aligned to the San Diego, CA market.
The Director, Provider Contracting serves as an integral member of the Provider Contracting Team and reports to the Provider Contracting Senior Manager or VP of 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).
* May lead a team with direct reports.
* Point person for complex projects related to contracting strategy in the market.
* Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
* Initiates and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management.
Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service.
* Manages strategic positioning for provider contracting, develops networks and identifies opportunities for greater value-orientation and risk arrangements.
* Contributes to the development of alternative network initiatives.
Supports and provides direction to develop network analytics required for the network solution.
* Works to meet unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position.
* Creates and manages initiatives that improve total medical cost and quality.
* Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist with total medical cost initiatives.
* Prepares, analyzes, reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms.
* Creates "HCP" agreements that meet internal operational standards and external provider expectations.
Ensures the accurate implementation, and administration through matrix partners.
* Leads 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.
POSITION REQUIREMENTS
* Should possess a bachelor degree; preferably in the areas of Finance, Economics, Healthcare or Business related.
Sign...
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Type: Permanent Location: San Diego, US-CA
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:08
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Are you the type of person that enjoys helping others? If you have a background in customer service or experience in healthcare, specifically benefits and claims processing, you might be the perfect fit to join our team as a Care Navigator Representative.
As a Care Navigator, you'll proactively support customers and help them understand their Cigna Healthcare medical plans and educate customers on Evernorth programs and services.
You'll do this by actively listening, address customer needs, then offer programs and solutions from their plan.
You'll be expected to go above and beyond with each call, but you won't be alone.
You'll be on a team of highly trained and skilled professionals that will be there to help you answer difficult questions and offer solutions.
YOUR RESPONSIBILITIES:
* Provide high level of service for inbound customer calls about their medical benefits by direct messaging, plus you may also provide digital chat support to customers.
* Listen and understand customers unique needs, seeking more information through probing questions with the goal of offering programs and services that apply to their past, current or future needs.
* Have a strong understanding of the full suite of benefit and programs, and you'll connect with other teams (Medical benefit, Clinical, Social Work, etc.) appropriately.
* Investigate and resolves escalations, determine barriers to care, and help to resolve complaints by reviewing policies and procedures.
When scripts or instructions are not available, you'll determine the best solution and guide the customer.
* Proactively offer outreaches to providers, doctor or vendors as needed to bring next steps into action or resolution removing effort from the customer.
You may serve as the liason between customers, health plans, services centers, etc.
* Takes ownership and provides timely follow-up on any takeaway from customer interactions.
i.e., Evernorth app tickets, prior authorizations pending, findings from claim discrepancies, etc.
* Assists customer with the Evernorth app including but not limited to 1) Helping download, register, and log into the app; 2) Inform of all app features and highlight navigation steps to find vendor offerings; 3) Educate on Wellness Rewards and value propositions; 4) Troubleshoot app & provide follow-up on tickets submitted for resolution.
* Be highly coachable and open to feedback to improve customer experience driving a consistently accurate quality of service.
QUALIFICATIONS:
* Associate degree or higher required and/or 4+ years' work experience in healthcare orcustomer servicefield.
* Ability to actively listen to understand current needs and complexities while identifying next steps & potential future needs.
* Excellent written and verbal interpersonalcommunication skills.
* Adept with Knowledge Exchange & initiative-taking resource utilization.
* Confidence with technology, innovational progress, and ...
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Type: Permanent Location: Glendale, US-CA
Salary / Rate: Not Specified
Posted: 2024-09-29 08:35:08
