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Roche fosters diversity, equity and inclusion, representing the communities we serve.
When dealing with healthcare on a global scale, diversity is an essential ingredient to success.
We believe that inclusion is key to understanding people’s varied healthcare needs.
Together, we embrace individuality and share a passion for exceptional care.
Join Roche, where every voice matters.
The Position
A healthier future.
It’s what drives us to innovate.
To continuously advance science and ensure everyone has access to the healthcare they need today and for generations to come.
Creating a world where we all have more time with the people we love.
That’s what makes us Roche
About Roche Diagnostics:
At Roche Diagnostics, we lead the way in medical diagnostics, committed to enhancing patient outcomes worldwide.
Our Cape Town team plays a vital role in upholding the highest standards of quality and compliance in the exportation of our life-saving medical products.
The Opportunity
Roche Diagnostics Cape Town is seeking for a meticulous and knowledgeable Export and Compliance Specialist to join our dynamic team.
In this role, you will be responsible for managing and implementing effective export compliance programs in line with U.S.
and EU regulations.
You will ensure the seamless airfreight exportation of our diagnostic products while maintaining compliance with all relevant trade regulations including company policies and procedures.
Key Challenges
You will be responsible for the management and continued implementation of effective export compliance programs under the International Traffic in Arms Regulations (ITAR) and the Export Administration Regulations (EAR) for Roche Dia Cape Town.
You will also maintain trade compliance policies, licences and operational procedures and update them according to the regulatory changes brought about by the US or any other government and other procedural changes that apply to export compliance.
You will be responsible for the preparation of routine export documentation and certificates as it relates to trade agreements to prevent export and customs delays.
This in support of routine and ad hoc site relevant shipments.
This role requires an individual that has experience with export compliance and regulatory topics as well as strong organisational and attention to detail skills.
* Manages and responsible for the trade compliance and export licences for transportation of goods.
Includes interface with regulatory body and managing internal and external audits and self-assessments.
* Ensures legal compliance and provides import/export administration and control within government rules and regulations, including appropriate licensing for shipments.
* Drafting timely export licences, technical assistance agreements, and other forms of export licensing requests for submission to regulatory agencies.
* Support in the assignment of classification of goods in the tares customs tariff in acc...
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Type: Permanent Location: Cape Town, ZA-WC
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:57
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Our 2nd shift Operations Supervisor will be a key member of the Operations team in Industry CA.
We are looking for a motivated and driven individual that can drive execution in a diverse complex manufacturing environment that specializes in manufacturing aerospace castings.
You will be responsible for leading a team of up to 25 tenured direct reports on two shifts to produce quality products for our clients.
Who are we?
This is a great opportunity to join a growth-oriented company within the aerospace industry that has been in business for over 100 years! We specialize in manufacturing aluminum and magnesium products for commercial, regional, corporate and military aircraft and engines.
What will you do?
* Make sure hourly employees are assigned departments and receive adequate training and support
* Ensure product quality
* Perform record keeping duties for assigned staff
* Establish and maintain an efficient and productive physical department
* Responsible for employees training, performance, safety, implementation of company policies and related human resource functions
* Collaborate with Product and Industrial Engineers in the development and design of new products and the selling of "standard" times for operations
* Acquire additional certifications and credentials as required for works and career development
What do we have to offer?
* $90-110K annually
* 5% annual bonus potential
* Positive and collaborative work environment
* Flexible schedule (10-hour shifts M-F and every 3rd Saturday)
* Paid training
* Educational Assistance
* 401K with match
* Robust PTO plan
What will you need to be successful?
* High school diploma or BA
* 2+ years of manufacturing and management experience
* MS Office Suite, Statistical Process Control and organizational skills
* Bilingual in Spanish a plus
Consolidated Precision Products (CPP) is an industry-leading manufacturer of highly engineered components and sub-assemblies, supplying the commercial aerospace, military and industrial markets with small-to-large "function critical" products.
CPP provides its customers with a "total solution" source, taking them from concept to finished product with one of the broadest and most diverse product offerings in the industry.
More information about our company can be found at: http://www.cppcorp.com/.
Sponsorship is not available for this role.
Candidates must be legally authorized to work in the U.S.
on a permanent and consistent basis without company sponsorship now and in the future.
This position requires use of information or access to hardware which is subject to the International Traffic in Arms Regulations (ITAR).
All applicants must be U.S.
persons within the meaning of ITAR.
ITAR defines a U.S.
person as a U.S.
Citizen, U.S.
Permanent Resident (i.e.
'Green Card Holder'), Political Asylee, or Refugee.
CPP Corporation is an Equal Opportunity Employer that...
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Type: Permanent Location: City of Industry, US-CA
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:55
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Our 1st Shift Operations Supervisor will be a key member of the Operations team in Industry, CA.
We are looking for a motivated and driven individual that can drive execution in a diverse complex manufacturing environment that specializes in manufacturing aerospace castings.
You will be responsible for leading a team of up to 25 tenured direct reports on two shifts to produce quality products for our clients.
Who are we?
This is a great opportunity to join a growth-oriented company within the aerospace industry that has been in business for over 100 years! We specialize in manufacturing aluminum and magnesium products for commercial, regional, corporate and military aircraft and engines.
What will you do?
* Make sure hourly employees are assigned departments and receive adequate training and support
* Ensure product quality
* Perform record keeping duties for assigned staff
* Establish and maintain an efficient and productive physical department
* Responsible for employees training, performance, safety, implementation of company policies and related human resource functions
* Collaborate with Product and Industrial Engineers in the development and design of new products and the selling of "standard" times for operations
* Acquire additional certifications and credentials as required for works and career development
What do we have to offer?
* $90-110K annually
* 5% annual bonus potential
* Positive and collaborative work environment
* Flexible schedule (10-hour shifts M-F and every 3rd Saturday)
* Paid training
* Educational Assistance
* 401K with match
* Robust PTO plan
What will you need to be successful?
* High school diploma or BA
* 2+ years of manufacturing and management experience
* MS Office Suite, Statistical Process Control and organizational skills
* Bilingual in Spanish a plus
Consolidated Precision Products (CPP) is an industry-leading manufacturer of highly engineered components and sub-assemblies, supplying the commercial aerospace, military and industrial markets with small-to-large "function critical" products.
CPP provides its customers with a "total solution" source, taking them from concept to finished product with one of the broadest and most diverse product offerings in the industry.
More information about our company can be found at: http://www.cppcorp.com/.
Sponsorship is not available for this role.
Candidates must be legally authorized to work in the U.S.
on a permanent and consistent basis without company sponsorship now and in the future.
This position requires use of information or access to hardware which is subject to the International Traffic in Arms Regulations (ITAR).
All applicants must be U.S.
persons within the meaning of ITAR.
ITAR defines a U.S.
person as a U.S.
Citizen, U.S.
Permanent Resident (i.e.
'Green Card Holder'), Political Asylee, or Refugee.
CPP Corporation is an Equal Opportunity Employer tha...
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Type: Permanent Location: City of Industry, US-CA
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:54
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RN Health Coach - Manhattan NY & Secaucus NJ
Sound like you? Great! Here's more on how you'll make a difference :
• Provide onsite face-to-face customer coaching and support.
• Identify customer health education needs through targeted health assessment activities.
Refer customer to other Cigna clinical programs or client specific programs as clinically appropriate
• 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.
• Will promote biometric screenings, including finger sticks, blood pressure, body composition, etc.and other 3rd party biometric screenings and events such as flu and COVID vaccination events
• 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.
• Collaborate with our matrix partners to support the overall health and wellness strategy your aligned client.
What we expect from you :
• Active and unrestricted RN license in respective state, with ability to maintain active licensure is required.
• Strong Clinical skills with at least 3 or more years of experience in health and wellness field.
• At least 1 or more years of health coaching/health education experience
• Current ACLS/BLS/CPR/AED Certification
• High energy level, with dynamic presentation skills is required.
• Positive role model in demonstrating healthy behaviors
• Passion for health improvement
• Ability to work independently
• Customer-centric focus
• 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.
Bonus points for :
• Chronic Disease Management experience
• Motivational interviewing training/experience.
• Smoking cessation and diabetes experience.
This position is with Evernorth, a new business within the Cigna Corporation.
This role will cover the office in Secaucus NJ 1 day a week and Manhattan NYC 1 day a week, 2 days Work Remote.
Cigna is committed to a healthy work force.
New hires must complete a background check, drug and nicotine screen to be employed in this role.
This role is patient facing & you must be fully vaccinated OR be required to undergo testing twice a week.
Note, in some ...
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Type: Permanent Location: Secaucus, US-NJ
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:54
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RN - Care Coordinator - Evernorth Direct Health, Maitland FL
EvernorthDirect Health is an industry leading business providing custom care delivery and wellness services across four key business lines: Wellness Centers, Health Coaching, Wellness Events and COVID 19 solutions.
Evernorth is built on the recognition that health makes progress possible.
Our health services are designed to redefine healthcare as we know it.
But we can't do it alone.
True change takes all of us, united in a shared vision.
Health is what drives us.
But it's just the start.
Together, we can solve the problems others don't, won't or can't.
Sound like you? Great! Here's more on how you'll make a difference :
* Identifies and refers appropriate customers to eligible programs within CIGNA Healthcare (CHC) and all eligible client specific health and wellness programs.
* Supports Care Coordination of the individual customer.
Coordinates the care of the high-risk targeted population in an appropriate, efficient, high quality and cost-effective manner.
Refers to appropriate clinical partners (i.e.
complex case management and / or Specialty Case management)
* Partners, and functions as central conduit between employer, provider (PCP, Onsite Health Clinic) and all available Evernorth programs and resources.
* Supports established process and procedures that ensures thorough review of patient level actionable data and reports used to support identification of customers for outreach and engagement.
* Assure and maintains timely, compliant, efficient documentation and information exchange to drive appropriate outreach, engagement and positive clinical outcomes with aligned population.
* Communicates clearly with all matrix partners, and refers to appropriate internal and external programs to support outcomes.
* Identifies cases appropriate for complex case management and follows process for referral.
* Works effectively with Evernorth's internal team to support coordination of care and data analysis.
* Identifies and builds effective relationships with local network providers.
Provides steerage to high quality network providers and referrals to the onsite health center.
* Identifies gaps in care and works with providers and/ or local community resources to close gaps in care.
* Establishes and maintains a positive, professional, and collaborative relationship with customer/employee, employer, providers of care, and Evernorth partners to support improved outcomes (clinical, quality and cost) of aligned employee population.
* Partners and coordinates with health management matrix partners for additional engagement and promotion opportunities
* Acts as resource to direct customers with specific non-clinical questions to the appropriate resource.
* This position is with Evernorth, a new business within the Cigna Corporation.
What we expect from you:
•RNwith current unrestricted state licensure within home st...
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Type: Permanent Location: Maitland, US-FL
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:53
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Accredo is looking for a Production Supervisor who will work at one of our facilities in Whitestown, Indiana.
In this role the shift you'll cover Monday -Friday, 12:30p - 9p, EST.
Job Summary
Leads Operations Management team consisting of experienced administrative, operative, and or technical roles in the Professional career track.
Typically responsible for a large number of direct and indirect reports in a process or transactional operations environment.
Coordinates schedules and workflow for the team.
Focuses on team completion of assignments and routines.
Ensures the orientation and training of employees.
Recommends and implements programs to support customer needs.
This role typically leads a team focusing on Business Operations.
Job Description
As a Production Supervisor, you will be r esponsible for day-to-day operations of a team of associates in Pharmacy Operations monitoring productivity and performance standards while planning and directing workflow and project assignments.
Role Responsibilities :
* Promote a positive team environment and ensure best practices are shared
* Assist in development of programs and process improvements to enhance the level of internal and external customer service provided
* Oversee team and individual performance standards and service standards are met
* Develop, coach, and provide feedback to employees concerning quality, reliability, accountability and productivity
Role Requirements :
* Bachelor's Degree or High School Diploma and equivalent work experience is required
* Work experience in a manufacturing/distribution setting strongly preferred
* Demonstrated leadership skills and the ability to effectively develop and assist team members
* General PC knowledge; MS Office, Internet, email
* Excellent oral, written and phone communication skills
* Experience in training and coaching less experienced staff
* Advanced problem solving skills
* The ability to work collaboratively with other departments to resolve complex issues with innovative solutions
* Ability to adapt to a dynamic working environment, make independent decisions
* Demonstrated ability to handle difficult conversations in a professional manner
* Ability to work closing shift: Monday -Friday, 12:30p - 9p, EST
Through our range of health care products and services offered, Accredo team members provide in-depth care for patients with chronic health conditions like hemophilia, oncology, rheumatoid arthritis and growth hormone deficiency.
In addition to health care products, we provide comprehensive management services - including outcomes measurement, counseling, clinical care management programs, social services and reimbursement services.
By performing in these very high-touch roles, employees have a daily opportunity to make a positive impact on their patients' lives.
If you will be working at home occasionally or permanently, the internet connection must b...
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Type: Permanent Location: Whitestown, US-IN
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:52
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The individual will be responsible for facilitating the resolution of operation model and process gaps are identified by the issue management team.
This individual will work across the various domains of the Medicare organization, working closely with our business partners and Issue Managers in resolving known issues.
The role is highly valued will support the issue managers by identifying and removing barriers to effective resolution.
This individual must be able to analyze processes and ask the right questions, and easily navigate the organization to be effective in aiding in issue resolution.
Key Responsibilities:
* Cross-functional collaboration:
+ Build & maintain strong relationships with key stakeholders upstream and downstream
+ Establish rapport and close collaborative relationship with the operations and technical teams
+ Facilitate open communication and collaboration to ensure alignment and support of issue management initiatives
* Stakeholder engagement & management:
+ Foster trust and rapport with stakeholders ensuring strong, collaborative relationships
+ Understand stakeholders' perspectives and motivations to help in addressing their needs effectively
+ Navigate conflicts and find mutually beneficial solutions
+ Adjust approach based on changing circumstances and stakeholder feedback
* Data analysis & reporting:
+ Work closely with Reporting and Analytics lead based on findings and use reporting data to make informed decisions regarding operating models
* Risk management:
+ Identify potential risks associated with operational gaps and work with impacted business teams to define mitigation strategies to minimize impact on the business
Required Experience / Qualifications:
* Must be a currentemployee or contractor with The Cigna Group,Evernorth Health Services, or one of theirsubsidiaries
* Exceptional communication and interpersonal skills, with the ability to build relationships and influence stakeholders at all levels
* Excellent analytical/troubleshooting skills
* Critical Thinking - Expert at making sense out of data and ability to connect the dots quickly
* Attention to detail
* Expert with Microsoft business application suite, including Visio, Excel, PowerPoint and Word
* Ability and desire to thrive in a proactive, fast paced environment
* Demonstrate ability to take initiative and drive process improvements
Desired Experience / Qualifications:
* BA/BS degree or higher strongly preferred in Computer Science, Business or related degree or 4 or more years of job-related experience preferred
* 3+ years of experience working in or with operations, Medicare experience a plus
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 1...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:52
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As a Pharmacy Operations Representative, you will be responsible for the operation of automated equipment in a fast-paced atmosphere.
Safety and quality are of the highest importance in our pharmacy environment.
Work schedule may need to be adjusted to accomplish certain critical demands.
What we Offer:
* An Independent work environment supporting effective communication, positive morale, and manager/mentor coaching to provide successful career pathing.
* Comradery and Engagement with emphasis in Quarterly Standouts, appreciation lunches and social events!
* Continuous focus in on site training and skills development.
* Professional work environment, including a climate-controlled fulfillment center.
How you'll make a difference:
* Ensure flow of patient orders by eliminating bottlenecks upstream & downstream.
* Respond to machine faults within established time periods.
* Ensure the mechanical equipment has the necessary consumable supplies to operate effectively, replenish as necessary.
* Perform scheduled quality checks as assigned, escalating if defects are detected
* Monitor the area's Work To List to ensure proper workflow.
* Escalate machine downtime issues to appropriate teams and leadership as needed.
* Keep work areas cleaned, organized, and maintained in accordance with 6S Standards.
* Perform Preventative Maintenance on equipment as assigned.
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!
What you should have:
* 2 years of experience in an automated work environment preferred
* General PC knowledge
* Ability to adapt in a dynamic work environment, solve problems, and make decisions
* Ability to train and coach less experienced staff
* Detail oriented with organizational skills
* Willingness to work a flexible schedule to accommodate business needs and maintain prompt attendance
* Knowledge of Express Scripts products and services (Preferred)
* Knowledge of pharmacy standard concepts, practices, and procedures
* Ability to stand for long periods of time.
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,...
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Type: Permanent Location: Whitestown, US-IN
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:51
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Work Location: Position supports the East Tennessee market.
Must reside within Chattanooga, Knoxville or TriCities.
The Director, Provider Contracting serves as an integral member of the Provider Contracting Team supporting East Tennessee.
This role assists in developing the strategic direction and management of the day to day contracting and network management activities for Chattanooga, Knoxville and TriCities.
DUTIES AND RESPONSIBILITIES
* Manages complex contracting and negotiations for fee for service and value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups).
* Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
* Initiates and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management.
Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service.
* Manages strategic positioning for provider contracting, develops networks and identifies opportunities for greater value-orientation and risk arrangements.
* Contributes to the development of alternative network initiatives.
Supports and provides direction to develop network analytics required for the network solution.
* Works to meet unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position.
* Creates and manages initiatives that improve total medical cost and quality.
* Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist with total medical cost initiatives.
* Prepares, analyzes, reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms.
* Creates "HCP" agreements that meet internal operational standards and external provider expectations.
Ensures the accurate implementation, and administration through matrix partners.
* Assists in resolving elevated and complex provider service complaints.
Researches problems and negotiates with internal/external partners/customers to resolve highly complex and/or escalated issues.
* Manages key provider relationships and is accountable for critical interface with providers and business staff.
* Demonstrates knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape.
* Responsible for accurate and timely contract loading and submissions and interface with matrix partners for network implementation and maintenance.
* May provide guidance or expertise to less experienced specialists.
POSITION REQUIREMENTS
* Should possess a bachelor degree; preferably in the areas of Finance, Economics, Healthcare or Business related.
Significant industry experience will be considere...
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Type: Permanent Location: Chattanooga, US-TN
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:50
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The Advocate role is a non-clinical customer service position within an inbound call center that supports Evernorth Behavioral Health.
Advocates are responsible for handling inbound calls from both members and providers or their office support staff regarding mental health or substance use disorder services.
Advocates guide and assist the members and providers to help them work with Cigna/Evernorth more effectively and ensure first-call resolution.
The types of calls an Advocate service may include but are not limited to: triaging and assessing the need for clinical intervention, inquiries about provider referrals and access to care, eligibility, and benefits.
Due to the wide variety of call types, several applications are required to service these inquiries, and multiple applications are often needed within the same call.
Independent problem-solving, multitasking, and technical savvy are essential in order to be able to carry out the responsibilities of this role.
Calls must be serviced helpfully and professionally.
The nature of discussions within the Behavioral Advocate role often delves into personal and sensitive topics with members.
It demands a nuanced understanding of mental health and substance use issues.
This role differs from its medical counterpart in that mental health is a sensitive subject and staff are helping members navigate complex and emotional mental health challenges.
Responsibilities:
The primary responsibility of this role is to answer inbound calls from members and providers.
The work environment is structured, and the majority of the day will be spent answering these calls from a queue.
Occasional outbound calls may be necessary for issues requiring follow-up.
Within a call, an Advocate may:
* Use active listening and empathy skills to triage and assess for risk of harm and substance use concerns
* Coordinate with multiple matrix partners, and facilitate seamless handoffs to clinical partners for timely support
* Communicate eligibility, generate a list of provider referrals, quote benefits, or advise of authorization requirements for services
* Write authorizations to ensure claims are paid correctly
* Provide follow-up on issues by making outbound calls when necessary
* Send resources to members and providers via email
* Submit a complaint on the member's or provider's behalf
* Independently problem-solve to ensure accurate information is given, and exceptional customer service and first-call resolution is achieved
Qualifications
* Bachelor's degree in the mental health field or psychology/social work-related field (family communications, health coaching, community/public health or other related major), is strongly preferred .
Alternatively, a bachelor's degree in another field or equivalent work experience, combined with 2+ years of experience in the behavioral health field will be considered
* Customer Service experience
* Prior experience working in a ...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:50
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Provides expert content/professional leadership on complex Application Development assignments/projects.
Acts as the principal designer for major systems with moderately complexity and their subsystems utilizing a thorough understanding of available technology, tools and existing designs.
Provides comprehensive consultation to business unit and IT management and staff on all phases of application programming for QNXT and processes for diverse development platforms, computing environments (e.g., host based, distributed systems, client server, software, hardware, technologies and tools, etc.).
Works closely with client and IT management and staff to identify application development solutions, new or modified programs, reuse of existing code through the use of program development software alternatives, or integration of purchased solutions or a combination of the available alternatives.
Researches and evaluates alternative solutions and recommends the most efficient and cost effective application programming solution.
May code new or modified programs, reuse existing code through the use of program development software alternatives and/or integrates purchased solutions.
Documents, tests, implements and provides on-going support for the applications.
Exercises considerable creativity, foresight, and judgment in conceiving, planning, and delivering initiatives.
Uses deep professional knowledge and acumen to advise functional leaders.
Focuses on providing thought leadership within Application Development but works on broader projects, which require understanding of wider business.
Recognized internally as a subject matter expert.
Required Skills
Visual Studio Development (C#, SSIS, SSRS)
SQL Server Development (T-SQL, SSIS)
QNXT Claim System - Enrollment
Must be a current contractor with Cigna, Express Scripts, or Evernorth.
Evernorth is a new business within the Cigna Corporation.
Additional Desired Skills
Agile
TFS
GitHub / GitLab
CI/CD (Continuous Improvement / Continues Deployment)
Education
Computer Science degree or certifications in MS development, or 3+ years experience in 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 98,200 - 163,600 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, compa...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:49
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We are seeking a motivated and collaborativeQNXT Systems Analystto provide skilled leadershipon complex assignments/projects.This candidate exercises considerable creativity, foresight, and judgment in conceiving, planning, and delivering initiatives.Additionally, they will focus on providing thought leadership withinthe systemsanalysisspace,and willwork onprojectsthatrequirebroader understanding ofthebusiness.
Key Responsibilities:
* Analyze,design and prepare application/system specifications forInformationSystems solutions which address business needs and methods for testing and installation
* Develop familiarity with application data and data stores across the HealthCare business and develop expertise in logical data mapping to be applied on Integration projects.
* Analyze and revise existing system logic and documentation as necessary
* Coordinate with other ITareas(e.g.business analysts, development team)
* Seek out, include, analyze and document business and user requirements, and translate into proper system requirement specifications
* Function as subject matter expert for system related issues
Required Experience/ Qualifications:
* Prior QNXT experience required
* Problemsolving andanalyticalskills
* Microsoft SQL query skills
* Ability tomanagecompetingpriorities in a fast-paced environment
Desired Experience / Qualifications:
* Claimsand Enrollment knowledge
* Medicare/Medicaid/Medicare-Medicaid Plan
* Team leadership experience
* Bachelor's degree in a related discipline and/or equivalent work experience
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an annual salary of 101,300 - 168,800 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure.
That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health.
Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
For more details on our employee benefits programs, visit Life at Cigna Group .
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life.
We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality.
Join us in dr...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:48
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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.
Summary
This Business Analytics Advisor role focuses on evaluating cost and quality of care opportunities for a high-profile health system in the Southeast.
The qualified candidate will query underlying data sources, using DBMS applications, to research information, analyze results, create adhoc reports and answer provider performance questions from clinician's and business stakeholders.
This role interacts directly with external health system executives and, internally, with Cigna's Market Medical Executive (MME), Account Management team, clinical consultants and market contracting stakeholders.
This is an analytics-based, technical role, involving a strong interpersonal communication skillset.
Presentations to senior leadership, explanations of underlying performance drivers and analytic results and providing answers to associated clinical questions are important aspects of this position.
Responsibilities
* Collaborate with matrix partners to identify and describe the business requests - clearly defining the desired data, information and metrics necessary for investigation
* Present results and analysis in an understandable fashion to key business stakeholders; ability to field questions on the run and provide appropriate and confident responses
* Utilize various DBMS applications to query, extract and manipulate healthcare data - ranging from claim level to summary level data - to create adhoc comparative and performance summary reports
* Liaison between Cigna Client Reporting Business and Cigna Account Executive for communicating and assisting with client-based reporting requests
Experience
* Healthcare Managed Care or Accountable Care Organization (ACO) experience strongly preferred
* Knowledge of PPO and managed care environments, including product offerings and healthcare provider value-based reimbursement programs helpful
* 5+ years SQL Coding Experience
* 2+ years SQL experience in SAS environment or with SAS EG
* Experience connecting to and working with various data repositories
* Advanced Excel experience required - pivot tables, vlookup, arrays
* Lead financial discussions and effectively communicate provider performance results
* Communicate analytical findings/gaps/solutions to senior management and clients in value-based arrangements
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 ...
....Read more...
Type: Permanent Location: Atlanta, US-GA
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:48
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Clinical Program Sr.
Manager - Commercial Formulary Solutions
JOB PROFILE SUMMARY
The Sr.
Manager, Formulary Solutions is a dynamic role responsible for assisting with the strategic formulary development and maintenance of our Express Scripts standard Commercial formulary offerings as well as overseeing Marketplace Formulary consultation.
An emphasis will be placed on, but not limited to, creating financial models to evaluate optimum formulary value within clinical guidance as well as leading marketplace formulary consultation training and development program.
This role will work cross-functionally with Pharma Contracting, Sales & Account Management, Regulated Markets, and Finance partners.
ESSENTIAL FUNCTIONS:
* Collaborate with our Institute for Clinical Guidance and Oversight in conjunction with Pharma Contracting & Strategy partners to identify strategic formulary opportunities, requiring expertise in contract interpretation
* Oversee the strategy and review of the Sr.
Advisor/Advisor's financial formulary modeling and help support department training needs, including content development as necessary
* Provide expert standard Commercial formulary modeling and present recommendations to Value Assessment Committee
* Provide consultation and clinical perspective on complex rebate modeling formulary matters
* Create and lead marketplace consultative formulary support model, including content development for onboarding and benchmark reporting analysis and interpretation
* Ensures optimization of work processes for modeling needs of the standard Commercial formularies to achieve department goals
* Create and deliver internal and external presentations for account team trainings, as well as consultant and client meetings
* Support modeling strategies from a clinical perspective (Competitive Product Category, Utilization Management interpretation) and serve as a primary point of contact for modeling tool enhancements.
* Act as a resource to field clinical questions from other formulary consulting team members, as well as cross-functional partners and account teams
QUALIFICATIONS:
* Pharm.D.
* Current active U.S.
Pharmacist License
* 4-8 years of pharmacy/ PBM/ Managed Care/healthcare related experience required
* 2+ years of formulary management/development experience preferred
* Leadership experience preferred
* Detail Oriented, Organizational and Analytical skills
* Excellent PC skills - including Excel, PowerPoint and MS Access, experience with database
* Financial or analytical modeling experience
* Familiarity with pharmaceutical rebate contracts and marketplace formularies, a plus
* Proven ability to work in a fast paced - ever changing environment
* Excellent relationship building and cross functional skills
* Ability to travel approximately 10%.
If you will be working at home occasionally or permanently, the internet connection mu...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:47
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Enterprise Architecture Senior Architect
Career Architecture Title: IT Principal Architect, Enterprise Architecture
Role Title: Senior Architect, Enterprise Architecture Contact Center & Service Transformation
POSITION SUMMARY
This position plays a pivotal role in the alignment of business vision, technology strategy and investment portfolio execution in our Contact Center and Service Transformation team.
This team is focused on driving the enterprise strategy to unlock accretive value through service delivery transformation and associated customer, agent, and provider experience uplift.
This team will identify horizontal capabilities, align line of business initiatives that move in the direction of destination state, and develop the roadmap of incremental milestones along the way.
You will be an integral part of delivering critical technology and business capabilities that enable differentiated healthcare products as part of our market growth strategy.
As a Senior Architect, you will engage broadly across Enterprise Architecture, Technology, and business Operations partners.
You will engage by initiating, forming, and driving the execution of strategies, roadmaps and architectures that will include modernizing our delivery approach to extract value from our current business as well as increasing value through the introduction of horizontal, composable, digital-first platforms.
In addition, the person in this role should provide a level of thought leadership by bringing an outside-in perspective in making key decisions.
This role requires high levels of influence within our business, technology and Enterprise Architecture organizations, extensive business knowledge and savvy, innovative problem-solving skills, and the ability to marry business and technology into a cohesive value-oriented strategy.
This role is expected to serve as a trusted partner and advisor at all levels within the company.
This role will also provide architectural operations support upon request.
Key areas of focus:
* Develop the enterprise strategy for service delivery, use of horizontal platforms, and value-based milestones to get there
* Contact center platform consolidation / modernization, cloud migration
* New channels and capabilities, self-service, and augmented contact experiences
* Orchestrate and execute test/learn experiments to gather proof points that confirm forecasted value and guide investment decisions
DUTIES & RESPONSIBILITIES:
* Serves as internal leadership consultant, trusted advisor, and tech-savvy business leader with expert knowledge on industry-relevant and emerging technologies as well as agile, iterative, systems-thinking approaches who can guide Business and Technology on how to leverage
* Partners with Technology and Business drive right-sized and timely decisions with well-considered tradeoffs and optionality that advances an aligned Technology and Business strategy
* Articulates strategy and "conn...
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Type: Permanent Location: Austin, US-TX
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:46
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Summary
The Data Scientist Lead Analyst will contribute to the Medicare Clinical and Customer strategy, performing research and analysis within the Clinical, STARS, and Risk Adjustment Analytics team.
Reporting to the Senior Manager of Clinical & Customer Data Science, the data scientist will analyze healthcare claims, clinical outcomes, customer enrollment patterns, and financial information to make recommendations based on relevant findings.
The Clinical, STARS, and Risk Adjustment Analytics team seeks to provide operational and analytical support to our partners to improve clinical programs, customer value, growth, and retention for Cigna Medicare.
This role will help us accomplish this through data science, strategic insights, and collaboration with our internal partners.
The Data Scientist Lead analyst will interface across multiple business areas, including, but not limited to clinical, pricing, reporting, product development, operations, and marketing departments as needed.
The ideal candidate for this role will be highly motivated, flexible, embrace change, as well as develop analytical and statistical models and methodologies to predict, quantify, and/or forecast business metrics.
Responsibilities
* Extract and analyze large healthcare claims using SAS, SQL, R, Python, Teradata, Hadoop, etc.
for predictive modeling, machine learning, and other data science techniques
* Document the methodology, process, code, and results of their work
* Proactively works with more senior team members to understand project goals and priorities
* Clearly and concisely communicates project results and methodologies
* Demonstrates problem solving skills
* Present technical topics and results to non-technical stakeholders
* Use data science techniques to classify, quantify, and/or forecast business metrics that help customers make sound business decisions related to clinical and customer strategy
Qualifications
* 2+ years' common health care data knowledge (e.g., claims, EHR, laboratory data)
* Familiarity with applied machine learning and model development
* Ability to develop and deploy ML/predictive models to production and cloud environment
* Familiarity with Python, SQL, Git and/or related tools
* Training in data analytics, statistical methods, and machine learning w/ Python, R, Keras, TensorFlow and/or similar tools
* Follows best programming practices and writes clean, documented, and well-structured code
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 83,000 - 138,300 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 ...
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Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:46
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Onsite Health Educator - Evernorth Direct Health
• Provide onsite face-to-face customer coaching and support
• 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.
This position is with Evernorth, a new business within the Cigna Corporation.
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.
• Current ACLS/BLS/CPR/AED Certification
• High energy level, with dynamic presentation skills is required.
• Positive role model in demonstrating healthy behaviors
• Passion for health improvement
• Ability to work independently
• Customer-centric focus
• 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.
•Bilingual English Spanish
Bonus points for :
• Registered Dietitian
• CHES (Certified Health Education Specialist)
• Motivational interviewing training/experience.
• Smoking cessation and diabetes experience.
This role is based in the office in Scottsdale AZ.
Remote work is not an option.
Cigna is committed to a healthy work force.
New hires must complete a background check, drug and nicotine screen to be employed in this role.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps 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 gro...
....Read more...
Type: Permanent Location: Orlando, US-FL
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:45
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Are you ready to step into a position that combines your communication skills, attention to detail, ability to multitask, and unrelenting drive to help others? We are looking for an Operations Sr Analyst/Primary Program Manager to join our team.
This person will be a client facing point of contact for our external partners (i.e.
Reimbursement Hubs and Pharma Manufacturers) and act as a liaison between those customers and our internal operations teams.
Here's how you'll make an impact:
* Interact with internal and external partners at all levels the majority of your workday.
* Manage the relationship between your aligned pharmaceutical client(s), their HUBs and their program(s).
* Act as a liaison to answer questions related to Accredo processes, service issues and mitigate any escalations.
* Understand the nuances of how to position Accredo externally in a professional and discreet manner (what to say/not to say).
* Develops strong relationships, instills trust with partners and incorporates a strategic mindset, anticipating potential needs or concerns.
* Own responsibility for the overall health and performance of the program, specific products and services, and provide updates to stakeholders.
* Research, gather, analyze and communicate data efficiently.
Identify and track trends, perform root-cause analysis and drive process improvement initiatives.
* Understand and be fluent in key performance metrics for specific specialty drug(s) and assist in expeditiously resolving delays.
* Create presentations and host meetings with operations leaders, account teams, HUBs and manufacturers to review metrics, program performance, support clinical/nonclinical in-services, and QBRs to showcase the value of this role.
* Perform work independently, adapt to a dynamic working environment and be an effective change agent.
What you need to do the job:
* High School Diploma or GED required.
Bachelor's degree a plus.
* 2+ yrs (Accredo) specialty pharmacy related experience preferred.
* 2+ yrs client management, program support, and collaboration with matrix partners.
* 1+ years of managing escalated issues and handling difficult conversations in a clear and professional manner.
* Exceptional communication skills (both written and verbal)
* High attention to detail, impeccable organization, time management, advanced critical thinking and problem solving skills.
* Proven ability to multi-task, prioritize, and support multiple projects while meeting deliverables.
* Proficient computer skills including all Microsoft office applications required.
RxHome and CSP familiarity preferred.
* Professional presence while meeting virtually, both on and off camera
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 uplo...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:44
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POSITION SUMMARY
This position will be responsible for the application of client payments (ACH, Check) to invoices and for preparing daily reconciliations of deposits.This role will also be responsible for reviewing and classifying miscellaneous correspondence for Workers' Compensation and Commercial book of business, and handing mail related Medicare Part D Member Recovery Program.
ESSENTIAL FUNCTIONS
* Reconciliation of deposits.
* Application of client payments to invoices.
* Researching and taking action on miscellaneous correspondence.
* Building and maintaining relationships with client contacts.
* Researching member payments related to the Member Recovery program.
* Other projects/assignments as needed.
QUALIFICATIONS
* 1+ years data entry and payment posting experience preferred.
* Experience in banking and reconciliation preferred.
* PC skills, Microsoft Office programs, Strong Excel skills with the ability to easily learn new software.
* Experience working with cross functional departments to research and resolve issues.
* Understanding of business operations and processes.
* Demonstrated customer service and relationship building skills.
* Demonstrated ability to manage a heavy workload.
* Excellent documentation / organizational skills
* Good verbal and written communication skills.
* Willingness to work a flexible schedule to accommodate departmental deadlines.
Working Hours: Flex schedule between 7:00am - 5:00pm
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 r...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:44
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Job Summary:
The Risk Adjustment Quality & Review Analyst in IFP brings medical coding and Hierarchical Condition Category expertise to the role, evaluates complex medical conditions, determines compliance of medical documentation, identifies trends, and suggests improvements in data and processes for Continuous Quality Improvement (CQI).
Key Job Functions:
• Conduct medical records reviews with accurate diagnosis code abstraction in accordance with Official Coding Guidelines and Conventions, Cigna IFP Coding Guidelines and Best Practices, HHS Protocols and any additional applicable rule set.
• Utilize HHS' Risk Adjustment Model to confirm accuracy of Hierarchical Condition Categories (HCC) identified from abstracted ICD-10-CM diagnosis codes for the correct Benefit Year.
• Apply longitudinal thinking to identify all valid and appropriate data elements and opportunities for data capture, through the lens of HHS' Risk Adjustment.
• Perform various documentation and data audits with identification of gaps and/or inaccuracies in risk adjustment data and identification of compliance risks in support of IFP Risk Adjustment (RA) programs, including the Risk Adjustment Data Validation (RADV) audit and the Supplement Diagnosis submission program.
Inclusive of Quality Audits for vendor coding partners.
• Collaborate and coordinate with team members and matrix partners to facilitate various aspects of coding and Risk Adjustment education with internal and external partners.
• Coordinate with stake holders to execute efficient and compliant RA programs, raising any identified risks or program gaps to management in a timely manner.
• Communicate effectively across all audiences (verbal & written).
• Develop and implement internal program processes ensuring CMS/HHS compliant programs, including contributing to Cigna IFP Coding Guideline updates and policy determinations, as needed.
Education & Experience:
The Quality Review & Audit Analyst will have a high school diploma and at least 2 years' experience in one of the following Coding Certifications by either the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC): Certified Professional Coder (CPC) Certified Coding Specialist for Providers (CCS-P) Certified Coding Specialist for Hospitals (CCS-H) Registered Health Information Technician (RHIT) o Registered Health Information Administrator (RHIA) Certified Risk Adjustment Coder (CRC) certification Individuals who have a certification other than the CRC must become CRC certified within 6 months of hire.
Minimum Qualifications:
• Experience with medical documentation audits and medical chart reviews and proficiency with ICD-10-CM coding guidelines and conventions
• Familiarity with CMS regulations for Risk Adjustment programs and policies related to documentation and coding compliance, with both Inpatient and Outpatient documentation
• HCC coding experience pref...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:43
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The Clinical Product Advisor is responsible for service innovation and product design, focused on advancing behavioral' s current and future clinical and health advocacy programs using evidenced based best clinical practices, opportunity analytics.
Using a value-based design approach, and other design methods (proof of concept), the Clinical Program Advisor is responsible for independently executing "test and learn" pilots along with current program enhancements.
Critical focus is placed on the Triple Aim: advancing our programs and care approaches, aligning with the provider/delivery system in support of delivering better quality outcomes, and a better patient experience while holding down cost.
The team has responsibility for collaborating and aligning with clinical teams across the enterprise, solutions, operations, analytics, network, and IT partners.
Key Responsibilities (not limited to)
Clinical Program design focused on health improvement goals, driving healthcare costs down and meeting organizational targets.
Focus on ongoing quality improvement, health disparities/literacy, operational efficiency, process and tools, improved customer/healthcare professional experience and engagement.
Responsible for or key team member to:
* Lead launch of pilots/proof of concepts focused on improvement of health outcomes and service design enhancements including increasing the likelihood of desired outcomes [compared to a baseline] and reducing health disparities among specified populations
* Research and define advanced clinical and administrative techniques associated with integrated health trends, case management and utilization management to generate new innovative solutions to advance health outcomes and affordability.
* Evaluation of existing clinical programs with recommended design enhancements and quality improvements, consulting with and providing recommendations to the Product, Clinical Operations, Reimbursement and Collaborative Care team and other key stakeholders.
* Actively participate in clinical design advancement with a focus on trends including health disparities and literacy.
* Manage or key support for assigned current clinical programs and advance clinical development to assure clinical/health advocacy program integrity and results, supporting vendor integration through clinical program education, and process and workflow development.
(ex: Gaps in Care, Health Advocacy Programs).
* Exudes self-motivated ownership of clinical metric-driven results, continually acting with a sense of urgency to ensure that results are attained, if not exceeded and to champion perpetual change within Behavioral to ensure that we anticipate market trends and offer industry-leading products and services.
* Collaborating with Informatics/Analytics and other key matrix partners to understand results - advancing the performance of our programs and services
+ Service utilization patterns
+ Clinical...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:42
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POSITION SUMMARY
The Operations Lead Analyst will administer account installation and renewals.
Provides complete, accurate and timely responses to clients.
Develops relationships with clients.
Typically provides all service and account installation to assigned clients.
Supports and provides direction to colleagues where appropriate.
Works autonomously, only requiring "expert" level technical support from others.
Exercises judgment in the evaluation, selection, and adaptation of both standard and complex techniques and procedures for benefit setup.
Utilizes in-depth professional knowledge and acumen to develop models and procedures, and monitor trends, within Benefit Operations.
The Benefit Operations Lead Analyst is responsible for completion of assigned operational tasks using standard appropriate tools and for managing client specific requests related to product requirement across all business units.
May lead projects or project steps within a broader project or have accountability for ongoing activities or objectives.
This position manages and tracks requests to ensure adherence to timelines and proactively manages client specific performance guarantees through effective processing controls that are in place.
Ensure that production levels and targets are achieved and effective processing controls are in place.
The Benefit Operations Lead Analyst resolves differences in client's requirements and manages all requests to ensure high quality results are consistently met while mitigating financial and/or member disruption.
Primary Functions
* Provide operational support for assigned client benefit implementation, on-going plan changes and renewal activity without immediate supervision but with access to advice from colleagues
* Configure client requirements directly into appropriate systems.
* Review, analyze and verify intent of assigned benefit set ups as they relate to products and programs.
* Identify and communicate need for customization to support client benefit requirements.
* Attend client calls/meetings as needed.
* Attend internal validation meetings.
* Identify interdependencies with cross-functional programs.
* Run customized/scheduled reports, manage performance guarantee tracking and report distribution for internal/external customers as requested.
* Adhere to all organizational SOPs and Compliance standards.
* Provide subject matter input as it relates to checklists and SOPs.
* Assist with operation input related to new product development; identification, research and resolution of operational issues.
* Provide assistance to team members with issues needing technical expertise and client specific requirements interpretation.
* Forward planning and anticipation of needs/issues
* Provide support to assigned accounts by responding to inquiries or resolving complex issues using independent judgment and discretion.
* Preparation of plan materials such as ad...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:42
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This is a HYBRID role with on-site presence required.
Only local applicants will be considered.
JOB SUMMARY
This position will be responsible for interpreting client contracts to identify and set up of Performance Guarantees.
In addition, this position will assist in reconciliation reporting.
This includes gathering results and preparing reporting to present to Account Management for distribution to clients.
The position requires regular communication with cross functional areas in order to meet deadlines, including Client Pricing, Account Teams, IT, Audit, etc.
The ability to communicate requests, results and issues effectively with team members, management and cross functional areas is essential.
The successful candidate will also be expected to proactively contribute to driving and developing best practices across the Financial Client Operations team.
SCOPE OF JOB
Position will be involved in the support of over 6,000 active clients with regards to establishing rebate sharing arrangements, rebate payments and analysis, interpreting contractual financial guarantee exclusions, financial guarantee reconciliations and analysis, and performance guarantee set ups and reporting.
ESSENTIAL FUNCTIONS
* Works under minimal supervision, through established procedures, to ensure appropriate assessment of Performance Guarantees
* Recommends resolution of identified issues during assessment as well as efficiency process improvements.
* Work cross-functionally with business partners to research and analysis Performance guarantees.
QUALIFICATIONS
* Bachelor's degree in related field (Business, Finance, Economics).
* 1+ years relevant experience.
* Related work experience in PBM, Pharmaceutical, or Healthcare industry preferred.
* Strong SQL skills with an ability to work in multiple databases on a daily basis.
* Strong analytical, planning, problem identification and resolution skills required.
* Effective communication with internal and external individuals in various functional areas and at all levels of management.
* Experience with client benefits and formularies highly preferred.
* Understanding of and experience with quality and process improvement concepts, methodologies.
* Requires experience in business analysis and production testing.
* Proven ability to plan for and integrate multiple tasks concurrently as well as work independently.
ABOUT THE DEPARTMENT
If your niche is in financial reporting and analysis, underwriting, cash management, audit or investor relations, our Finance department may be a perfect fit for you.
Our teams within Finance work together to ensure that spending stays on track and that we remain a profitable industry leader.
We're always on the lookout for innovative people who will bring outside-the-box thinking to our team.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or ...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:39
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The Warehouse Associate Representativeis responsible for performing tasks related to receiving product, stocking and replenishment, and inventory control.
This includes safely unloading trucks and unpacking received product, comparing the purchase order to the product received for accuracy, counting quantities of product received and ensuring the quality of the product is at an acceptable level, and removing damaged or non-conforming product using data entry and retrieval devices to record receipt transaction (using scanners and computer input).
In addition, this position safely transfers material from receiving area to warehouse or dispensing locations and ensures proper stock rotation-utilizing PDAs to update the inventory system.
The Warehouse Associate Representative also audits shelf counts for accuracy, reviews inventory for short-dated and expired product, and reports discrepancies to the supervisor.
Work shift: 4am to 1pm, Monday to Friday
What you'll do:
* Safely unpack and evaluate incoming product for correct count and condition in comparison to purchase orders.
* Safe operation of material handling equipment and hand tools such as forklifts, pallet jacks (manual and electric), carts, dollies, box cutters, wire cutters, etc.-to unload trucks and stock the warehouse/pharmacy.
* Accurate data entry and retrieval using computers, and scanners (PDA).
* Bin and shelf inventory maintenance and stock rotation-including shelf counts, short shelf life and expired product audits.
* Communicate discrepancies or issues as they occur to the appropriate personnel.
* Maintain organization and cleanliness of assigned workstations and areas.
* Other duties as assigned.
What you need to do the job:
* 0-1 years relevant work experience.
* Ability to accurately compare two sets of data.
* Basic math, organization, computer, and communication skills.
* Ability to do repetitive bending, squatting, standing, walking, pushing, pulling and hand motions.
* Willingness to work a flexible schedule to accommodate heavy work volumes.
* Ability to walk/stand for full shift.
* Bend, stoop, and lift up to 50 lbs.
* Ability to read and differentiate small print.
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 ...
....Read more...
Type: Permanent Location: Memphis, US-TN
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:38
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Summary
This role will be responsible for leading marketing analytics and reporting within Cigna Healthcare's Individual and Family Plan business segment.
The ideal candidate will partner closely with the marketing team, agency partners and other key stakeholders to develop a measurement framework for assessing the impact of marketing efforts as well as delivering actionable insights to prove/disprove hypotheses and optimize marketing performance.
They will deliver insightful data visualizations and employ advanced analytics techniques to drive meaningful impact for the business and across the enterprise.
Primary Responsibilities:
* Collaborate with marketing leaders to identify analytics challenges and develop solutions.
* Partner with internal clients to leverage predictive analytics, reporting and advanced statistical techniques to drive strategic thinking and effective decision making.
* Develop and manage reporting and data visualizations/dashboards across all marketing and distribution channels including call center, online and broker.
* Lead the development of predictive models, segmentation, audience selection, experimentation and statistical analysis to improve the performance of marketing efforts.
* Lead learning agenda development, hypothesis formulation, test design (including A/B and/or multivariate), measurement and optimization of all marketing communications across acquisition, engagement, retention and broker communications.
* Develop overall marketing attribution models for measuring marketing's impact on business growth and sales funnel development.
* Ensure timely delivery of reporting and improve the communication of marketing performance across the enterprise.
* Ensure accuracy and consistency in data, marketing campaign tracking, and reporting.
* Identify gaps in data/processes, perform root cause analysis where needed and partner with key stakeholders on issue resolution.
* Develop and maintain sales and other forecasts as needed.
* Lead effort to automate reporting and analytics workflows and develop best practices.
* Assist Marketing and the IFP business with ad hoc analytics support as needed.
Ideal candidates will offer:
* 5+ years of relevant experience in marketing analytics, business analytics, data analytics and/or digital analytics; preferably focused on health insurance and/or healthcare analytics.
* MBA or Master's degree in Data Analytics, Statistics, Applied Mathematics, Business/Marketing Analytics or closely related field is highly desirable.
* Professional hands-on experience in designing and evaluating marketing campaigns and translating campaign outcomes into actionable insights and business value is a plus.
* Strong understanding of experimental approaches in marketing strategies and A/B and/or multivariate testing.
* A high level of skill with data modelling, data extraction, manipulation, and warehousing tools (S...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-10-29 07:39:38
