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Cigna Digital is in search of a Senior Software Engineer to join our engineering team.
The role will collaborate with a small team within Cigna Digital to maintain and enhance Cigna's Monorepo.
This role requires a solid understanding of Angular and/or React and experience with creating CI Pipelines to contribute to the underlying work that supports Cigna's Monorepo.
The primary responsibility of this team is to improve the software engineering velocity of all the teams who we serve.
This includes creating custom developer tools, performing React / Angular / Nx upgrades , maintaining core modules, improving the overall CI/CD pipeline, creating Nx generators, improving code quality conventions, and providing mentorship and onboarding to the Monorepo.
The position requires hands-on development of React, Angular, Nx, and Gitlab CI.
Our team is extremely collaborative.
Interested candidates must love to write code, be self-motivated, willing to learn, and willing to share new ideas to improve our team and processes.
Required Qualifications:
* Extensive Experience with React or Angular 2+
* Extensive Experience with implementing and configuring CI/CD pipelines in Gitlab CI or Github Actions
* Experience with Helm, Openshift or Kubernetes
* Experience with scripting languages such as Typescript (preferred), or JavaScript
* Solid understanding of Typescript/JavaScript, HTML and CSS
* Solid understanding of OOP, Design Patterns, Data Structures and Web Standards
* Experience with cloud infrastructure (AWS, Google App Engine, or Heroku)
* Strong understanding of parallel processing, concurrency and asynchronous concepts
* Experience with RESTful web services
* Strong experience with enterprise level N-tier web applications
Desired Qualifications:
* Experience with NRWL Nx
* Experience supporting a Monorepo
* Experience with NestJS or Express
* Experience with Testing frameworks such as Jest and Cypress
* Experience with Webpack
* Experience in architecting and designing distributed systems that are highly available and security focused
* Experience with designing event-based systems
* Experience in SSO (SAML, OPENID)
* NoSql Database - DynamoDb, MongoDB, Cassandra
* Experience with Linux
* Experience in writing native SQL queries
* Relational Database - experience using Oracle, MySQL/MariaDB, Postgres, or SQLServer
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an annual salary of 123,400 - 205,600 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure.
T...
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Type: Permanent Location: Santa Monica, US-CA
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:21
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Location: Remote Opportunity - Must live in Arizona, Florida, Indiana, Georgia, Pennsylvania, or Texas.
Summary: Are you passionate about assisting others and thrive in a dynamic virtual environment? Join our team at Accredo by Evernorth, a leading specialty pharmacy serving patients with complex health conditions.
As a Customer Service Associate Representative, you'll play a crucial role in delivering exceptional patient care and support while representing Accredo with professionalism and empathy.
Key Responsibilities:
* Assist patients and prescribers through inbound/outbound phone calls or web support.
* Handle various inquiries including scheduling medication orders, order status updates, explaining patient benefits, resolving account issues, and billing inquiries.
* Serve as a liaison between patients and internal expert teams.
* Participate in extensive paid training to ensure proficiency in Accredo/Cigna systems and procedures.
* Maintain high call volume productivity, handling an average of 30-50 calls daily.
* Adhere to scheduled work hours and meet performance metrics.
Role Summary: Our Customer Service Associate Representatives are integral to our mission of elevating patient care.
With a focus on empathy and attention to detail, you'll anticipate patient needs and provide solutions proactively.
This role requires a commitment to excellence in customer service and the ability to thrive in a fast-paced virtual environment.
Qualifications:
* High School Diploma or equivalent required.
* 1+ years of customer service experience.
* Proficient in Microsoft Office Suite and navigating multiple systems simultaneously.
* Ability to excel in a high-volume call center environment.
* Strong communication skills, both written and verbal.
* Organized with excellent time-management abilities.
* Customer-oriented with the capacity to adapt to various patient perspectives.
* Must be available to work within Contact Center hours: Monday through Friday, 8:00 am to 11:00 pm EST, and Saturday, 8:00 am - 5:00 pm EST.
* Reliable internet connectivity and a dedicated workspace free of distractions required.
* Must attend 100% of training within the first 90 days of employment.
Join Our Team: Embark on a rewarding career with Accredo by Evernorth, where your dedication to exceptional customer service will make a difference in the lives of patients.
We offer comprehensive training, career development opportunities, and a supportive virtual environment.
Apply now to be part of a team committed to transforming healthcare and improving patient outcomes.
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 pharmac...
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Type: Permanent Location: Tampa, US-FL
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:20
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Cigna Digital is in search of a Full Stack Engineer to join our digital engineering team.
This team is responsible for the engineering assignments on Cigna's digital assets.
The role will closely collaborate with the digital analysts, product owners, architects, quality engineers, and other delivery teams/personnel within Cigna Digital to develop and deploy solutions for Cigna's customer and client facing web and mobile applications.
The candidate may also be asked to contribute to other front, middle, and backend development efforts as strategic priorities and work evolve.
The ideal candidate is a motivated, self-starter that brings a fresh perspective and passion to solve complex business and technical challenges in a fast-paced and team-oriented environment.
Key Responsibilities:
* Collaborate with Cigna Digital peers to develop and deploy changes on Cigna Digital's web and mobile applications
* Participate in design and product requirement sessions in order to come up with new solutions or modify existing solutions, delivered in an agile manner
* Be involved in all phases of the software development process all the way to production deployment and development support
* Work in a large-scale application environment with multiple teams on a shared code base
* Contribute to larger Cigna Digital community of engineering best practices and code reviews
* Be part of a fast-moving team, working with the latest tools and open source technologies
Required Qualifications:
* Experience with scripting languages such as Python, JavaScript and TypeScript
* Experience with React, or React Native, and styling engines such as Tailwind
* Web application development experience with compiled languages such as Java, or Go
* Experience with single-page applications
* Understanding of client side (mobile app and web) debugging tools
* Experience with Node.js
* Ability to multitask with diverse types of work and adapt as priorities change
* Motivated self-starter with a passion to learn and share emerging technologies independently
* Experience working in an Agile or continuous delivery development life cycle
Desired Qualifications:
* Experience with developing RESTful web services
* Understanding of modern web/mobile technology stack - BFF (backend for frontend), microservices, and cloud based/containerized application solutions (Kubernetes/OpenShift)
* Experience with cloud infrastructure (AWS, Red Hat, Kubernetes)
* Relational database experience using Oracle, MySQL/MariaDB, Postgres, or SQLServer
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...
....Read more...
Type: Permanent Location: Morris Plains, US-NJ
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:19
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Location: Remote Opportunity - Must live in Arizona, Florida, Indiana, Georgia, Pennsylvania, or Texas.
Job Title: Customer Service Representative - Remote
Location: Remote Opportunity - Must live in Arizona, Florida, Indiana, Georgia, Pennsylvania, or Texas.
Hours: Mon- Fri, 8:00 am to 11:00 pm EST, and Saturday, 8:00 am - 5:00 pm EST.
(You will work a 8 hour shift in that window)
Summary: Are you passionate about assisting others and thrive in a dynamic virtual environment? Join our team at Accredo by Evernorth, a leading specialty pharmacy serving patients with complex health conditions.
As a Customer Service Associate Representative, you'll play a crucial role in delivering exceptional patient care and support while representing Accredo with professionalism and empathy.
Key Responsibilities:
* Assist patients and prescribers through inbound/outbound phone calls or web support.
* Handle various inquiries including scheduling medication orders, order status updates, explaining patient benefits, resolving account issues, and billing inquiries.
* Serve as a liaison between patients and internal expert teams.
* Participate in extensive paid training to ensure proficiency in Accredo/Cigna systems and procedures.
* Maintain high call volume productivity, handling an average of 30-50 calls daily.
* Adhere to scheduled work hours and meet performance metrics.
Role Summary: Our Customer Service Associate Representatives are integral to our mission of elevating patient care.
With a focus on empathy and attention to detail, you'll anticipate patient needs and provide solutions proactively.
This role requires a commitment to excellence in customer service and the ability to thrive in a fast-paced virtual environment.
Qualifications:
* High School Diploma or equivalent required.
* 1+ years of customer service experience.
* Proficient in Microsoft Office Suite and navigating multiple systems simultaneously.
* Ability to excel in a high-volume call center environment.
* Strong communication skills, both written and verbal.
* Organized with excellent time-management abilities.
* Customer-oriented with the capacity to adapt to various patient perspectives.
* Must be available to work within Contact Center hours: Monday through Friday, 8:00 am to 11:00 pm EST, and Saturday, 8:00 am - 5:00 pm EST.
* Reliable internet connectivity and a dedicated workspace free of distractions required.
* Must attend 100% of training within the first 90 days of employment.
Join Our Team: Embark on a rewarding career with Accredo by Evernorth, where your dedication to exceptional customer service will make a difference in the lives of patients.
We offer comprehensive training, career development opportunities, and a supportive virtual environment.
Apply now to be part of a team committed to transforming healthcare and improving patient outcomes.
If you will be working at home occasionally o...
....Read more...
Type: Permanent Location: Whitestown, US-IN
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:19
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General Summary:
Full stack developer who has experience developing client facing web/mobile applications using the technologies listed above.
They are expected to work closely with developers, technical project managers, principle engineers and business stakeholders to ensure that application solutions meet business/customer requirements.
Essential Functions:
* Candidates will need to have experience with medium-to-large-scale web development.
* Ability to develop within "full" technology stack
* Be part of a fast moving team, working with the latest tools and open source technologies
* Design and develop our next generation of RESTful APIs and Event driven services in a distributed environment
* Use advanced, distributed technologies to process, store, and quickly retrieve huge volumes of data
* Work on a development team using agile methodologies
Qualifications:
* 7-10 years of work experience in application engineering
* Experience with scripting languages such as JavaScript, Typescript
* Experience with React (preferred), React Native (preferred), Angular 2+, or Ember.
* Solid understanding of OOP, Design Patterns, Data Structures and Web Standards
* Solid understanding of JavaScript, HTML and CSS
* Strong understanding of parallel processing, concurrency and asynchronous concepts
* Strong experience with enterprise level N-tier web applications
* NoSql Database - DynamoDb, MongoDB, Cassandra
* Caching - Redis, Memcached
* Experience with cloud infrastructure (Preferred - AWS, Google App Engine, or Heroku
* Experience with Application Monitoring Tools (Splunk, Cloudwatch, Dynatrace etc)
* Strong experience with Continuous Integration/Deployments (Jenkins/Terraform/Git Lab Runners)
Nice-to-haves
* Experience with Node
* Experience in SSO (SAML, OPENID)
* Knowledge of search solutions such as Lucene, Solr, or ElasticSearch
* Experience in architecting and designing distributed systems that are highly available and security focused
* Experience with designing event-based systems
* Understanding Queue/Messaging services- JMS, Amazon SQS, MS MQ, etc.
* Experience with single-page applications
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an annual salary of 123,400 - 205,600 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure.
That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health.
Starting on day one of your employment, you'll be offered several health-related benefits includ...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:18
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Cigna Digital is in search of a Senior Software Engineer to join our engineering team.
The role will collaborate with a small team within Cigna Digital to maintain and enhance Cigna's Monorepo.
This role requires a solid understanding of Angular and/or React and experience with creating CI Pipelines to contribute to the underlying work that supports Cigna's Monorepo.
The primary responsibility of this team is to improve the software engineering velocity of all the teams who we serve.
This includes creating custom developer tools, performing React / Angular / Nx upgrades , maintaining core modules, improving the overall CI/CD pipeline, creating Nx generators, improving code quality conventions, and providing mentorship and onboarding to the Monorepo.
The position requires hands-on development of React, Angular, Nx, and Gitlab CI.
Our team is extremely collaborative.
Interested candidates must love to write code, be self-motivated, willing to learn, and willing to share new ideas to improve our team and processes.
Required Qualifications:
* Extensive Experience with React or Angular 2+
* Extensive Experience with implementing and configuring CI/CD pipelines in Gitlab CI or Github Actions
* Experience with Helm, Openshift or Kubernetes
* Experience with scripting languages such as Typescript (preferred), or JavaScript
* Solid understanding of Typescript/JavaScript, HTML and CSS
* Solid understanding of OOP, Design Patterns, Data Structures and Web Standards
* Experience with cloud infrastructure (AWS, Google App Engine, or Heroku)
* Strong understanding of parallel processing, concurrency and asynchronous concepts
* Experience with RESTful web services
* Strong experience with enterprise level N-tier web applications
Desired Qualifications:
* Experience with NRWL Nx
* Experience supporting a Monorepo
* Experience with NestJS or Express
* Experience with Testing frameworks such as Jest and Cypress
* Experience with Webpack
* Experience in architecting and designing distributed systems that are highly available and security focused
* Experience with designing event-based systems
* Experience in SSO (SAML, OPENID)
* NoSql Database - DynamoDb, MongoDB, Cassandra
* Experience with Linux
* Experience in writing native SQL queries
* Relational Database - experience using Oracle, MySQL/MariaDB, Postgres, or SQLServer
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an annual salary of 123,400 - 205,600 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure.
T...
....Read more...
Type: Permanent Location: Santa Monica, US-CA
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:17
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This is a remote position.
Ideal candidates must reside and be licensed in one of the following states: Arizona, Florida, Ohio or Tennessee and preferably reside within an hour of our local sites.
The start date for this position is 6/24/2024.
During the training period, the hours will be Monday through Friday 9:00 am - 5:30 pm ET for all candidates.
Once training is completed, the following shift schedules will apply Monday through Friday:
* AZ - 11:30 am - 8 pm ET
* FL - 10:30 am - 7 pm ET
* OH - 10:30 am - 7 pm ET
* TN - 11:30 am-8 pm ET
There will also be 1-evening shift per week from 2:30 pm -11 pm ET and a Saturday rotation every 3-weeks.
When working a Saturday shift there would be a weekday off.
POSITION SUMMARY
The Staff Pharmacist interprets physicians' prescriptions, contacts doctors or other prescribers and/or patients to verify information on prescriptions and expedite processing of order.
The Staff Pharmacist will track order status and outstanding issues as well as consult with patients regarding the use of medications and potential drug interactions.
This individual will take calls from customers regarding lost orders or dispensing errors, maintain daily production, quality and service levels, vary work priorities and activities to accommodate business needs.
The Staff Pharmacist may also train less experienced pharmacists.
ESSENTIAL FUNCTIONS
o Consult with patients regarding the use of medications and potential drug interactions.
o Contact physicians for new and/or transfer authorization.
o Collaborate with physicians to convert prescriptions to generic or preferred drugs whenever possible.
o Interpret physicians' or prescribers' prescriptions.
o Contact doctors and/or patients to verify information on prescriptions such as drug strength, prescription sig., and drug name in order to expedite processing of orders.
o Provide oversight and quality assurance to pharmacy technicians.
o Verify and confirm validity of controlled substances.
o Verify prescription information entered in the system by data entry or order entry.
o Back up other pharmacists as needed, perform additional duties as assigned by management, or train less experienced pharmacists.
QUALIFICATIONS
o Current resident pharmacist license in good standing.
o Advanced problem-solving skills and the ability to work collaboratively with other departments to resolve issues.
o Good oral and written communication skills.
o Ability to read and interpret prescriptions.
o Strong focus on customer service, quality and accuracy.
o Ability to manage timelines and meet tight client deadlines.
o Ability to adapt in a changing environment.
o Ability to work a flexible schedule for peak volume times.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position,...
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Type: Permanent Location: Tempe, US-AZ
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:16
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Help us lead our future.
Get ready for a job that encourages you to think strategically yet stay connected with your teams.
Do you have problem-solving or technical experience? If so, prepare to innovate, create, and inspire.
The Technical Support Analyst demonstrates made up of Specialized Technology Services (STS), Global Deskside Services, Executive Support Services, Colleague Technology Experience, Technology Enablement Leader and Customer Support Center.
The Technology Solution Zone is under STS, where we support all colleagues of locations where we have a brick & mortar stores.
Must be a current contractor with Cigna, Express Scripts, or Evernorth.
Evernorth is a new business within the Cigna Corporation.
Responsibilities:
* Provide excellent colleague support for all technology products and services.
Resolve issues within a specified timeframe per our defined processes or refer unresolved issues and escalate problems to appropriate technical support groups identified in the Customer Support Process to ensure resolution is achieved.
* Troubleshooting colleague hardware issues including Windows.
MAC, and cellular devices
* Work with technical staff and provide input and solutions.
* Meet and greet colleagues to answer questions and resolve problems related to all LOB's to Cigna products and services.
* Works with customer to answer basic training and how-to questions.
* Follows up on all open tickets/issues within specified timeframe.
* Responsible for inventory of technology products and prizes.
Will create a forecast of how many Technology peripherals will be needed each month, based on usage and past delivery.
Ensure items are ordered in Ariba, delivered and ready for colleague purchases.
Qualifications:
* Associate degree in technology or an equivalent combination of 1-2 years of Technology/Customer Service work experience.
Aptitude for problem-solving
* Excellent client-facing/customer service skills
* Excellent written and verbal communication skills
* Experience to focus and follow-through to resolution of issues
* Experience to diffuse tension and work the issue at hand
* Experience communication and motivational skills.
* Ability to understand customer's issues and demonstrate real concern via customer centricity.
* Experience to greet our colleagues with a smile on your face.
* Experience to multi-task and foster working relationships with the team and lines of business in the Brick-and-Mortar location.
* Experience to use sound judgment, manage time and workload effectively which includes planning, organizing, and prioritizing with attention to details.
* Experience to manage conflict and empathize with colleague frustrations.
* Identify opportunities for process improvement and problem elimination.
Continually focus on learning new technologies to support rapidly changing and expanding environment.
* Must be able to pr...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:15
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hours - 5:30 AM - 3:30 PM Wednesday - Saturday
*
*subject to change based on business need
Our Pharmacy Technician Senior Representative is responsible for theaccurate and timely execution of all assigned tasks in accordance with standard operating procedures, work instructions and supervisor direction.
Distribution of workload and workflow for members of their assigned area to ensure assigned work is completed timely and accurately.
Serves as a resource to lead and supervisor and back up to team members.
Supports productivity, quality and safety efforts by accurately operating production equipment, assisting in troubleshooting and rectifying issues, and participating in development of policies and procedures.
ESSENTIAL FUNCTIONS:
* Ensure appropriate distribution of workload and workflow for assigned area including shifting resources and back filling as needed.
* Accurately and responsibly operates production equipment to include but not limited to changing labels, cleaning printers, monitoring production equipment, restocking materials; Ensure appropriate teams are informed of equipment malfunctions.
* Serve as the first line resource for questions/issues for team members in coordination with supervisor; Promote a positive work environment for team that supports high employee morale and job satisfaction.
* Identify and document issues impacting performance and productivity of team members; Raise issues to Lead and Supervisor for action; Provide input regarding solutions for same.
* Assist Lead and Supervisor in ensuring that established policies and standard operating procedures are being followed and that individual and team goals for productivity and quality are met/exceeded.
* Assist in the development and documentation of policies and procedures for technicians, including specific training materials and ensuring these documents are current and accurate; Assist in training and validating technician staff regarding procedures; Provide one on one training in addition to group sessions on an as needed basis; Provide tips on how to get the job done more efficiently and accurately; Ensure that all team members are cross trained to cover production functions.
* Other duties as assigned.
MINIMUM QUALIFICATIONS:
* HS diploma or equivalent working experience.
* Two to three years of experience; experience in a dispensing pharmacy setting required.
* Pharmacy Technician license/certification/registration as required by state law.
* General PC knowledge and e-mail abilities.
* Knowledge of standard concepts, practices, and procedures within dispensing pharmacy, strong attention to detail with good organizational skills, good verbal and written communication skills, ability to adapt in a dynamic work environment, learn quickly, solve problems and make decisions.
Ability and desire to assist team members, Willingness to work a flexible schedule to accommodate heavy work volumes, ability to ...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:14
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This exciting leadership role needs an expert in Artificial Intelligence, especially Generative AI who will be responsible for designing Gen AI solutions that disrupt current business models and improve efficiency, provide data-driven decisions, personalization and Rapid prototyping and testing of new solutions.
This key leadership role leads product management, product design, and value measurement for AI Solutions for the enterprise.
This role reports to the leader of the AICOE and leads the designing of AI solutions and ensures that AI solutions are designed to meet the right business outcomes and maximize value.
This is a technical director role and will set the standards for AI solution design, ensure that the design meets business, security, explainability goals, working in partnership with business, AI Governance team and Solution Delivery teams.
This role is critical to design solutions that disrupt current business models and improve efficiency and pace, while ensuring security and reliability of the AI solutions.
The ideal candidate has a strong background in developing and managing AI-powered solutions and a proven track record of delivering innovative products from concept to market.
This role will:
* Define and execute our AI solutions product vision and strategy, ensuring alignment with overall business objectives.
* Own the product roadmap, prioritizing features and enhancements based on customer needs, market trends, and competitive analysis.
* Develop and maintain deep domain expertise in AI and the healthcare industry, staying up-to-date on relevant trends and technologies.
* Manage and mentor a team of product managers and analysts, fostering a culture of innovation, collaboration, and continuous improvement.
* Work with governance and business areas and define features that need to be built into the Enterprise AI Gateway platform
* Define the art of possible with new AI solutions and lead marketing to provide awareness and generate ideas for new products and solutions
* Identifies the needs across strategic areas such as Care delivery, Customer Experience, Finance to design AI solutions, define objectives and success metrics for the AI products
* Define features to build into our AI solutions, aligns stakeholders around the vision for the Product and designs seamless Human and AI interactions to support rapid scaling and adoption of AI solutions.
* Collaborate with cross-functional teams, including product managers, software developers, and AI designers, to design AI-powered products and services, ensuring fairness, transparency, and accountability in the design process and outcomes
* Stay up to date on new AI technologies and solutions and determine applicability of these solutions to solve the right business opportunities.
* Drive value tracking and measurement for AI solutions, using the existing value frameworks
* This is a key leadership role and will par...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:14
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need to update!!
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives.
At The Cigna Group, we're dedicated to improving the health and vitality of those we serve.
Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients.
Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support.
Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible.
Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment.
These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
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Type: Permanent Location: Morris Plains, US-NJ
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:13
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Work Location: Remote
Must have a Maryland Counseling License
Evernorth Behavioral Health
Job Title: Case Management Lead Analyst (Licensed Telephonic Counselor)
ROLE SUMMARY:
A great opportunity to help military members and their families!
This position is responsible for providing confidential behavioral health consultations and 1-12 fifty minute sessions of non-medical counseling (EAP) to members of the military and their family.
Non-medical counseling is focused on a specific issue or concern and includes developing strategies and solutions, building on the participant's strengths, accessing support systems, and utilizing community resources.
Sessions are provided telephonically, via video or secure chat and are intended to be solution focused and short-term.
Non-medical Counseling topics are varied but often include the following issues:
* Stress
* Transition/Relocation
* Grief and loss
* Employment issues
* Marital/couple conflict or communication
* Parent-Child Relational Problems
* Academic or Educational problems
* Problems related to Primary Support
The successful candidate will have demonstrated excellence with solution focused therapy with a passion to deliver a service experience that exceeds the participant's expectation.
The team works in a fast-paced environment, on a queue, taking non-medical counseling calls in the moment, as well as through scheduled appointments.
The team is staffed 24/7 in support of the schedules of military members around the world.
This role offers a great salary with an excellent benefits package that starts your first day of employment including a continuing education program with funding and extra leave time.
Duties and Responsibilities:
* Provide participants with confidential, non-medical counseling services
* Assess the participant's immediate risk and biopsychosocial needs
* Provide appropriate referrals for resources and treatment
* Use clinical expertise, professional judgment and best practices
* Execute duty to warn/mandated reporting processes
* 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 work process.
* Deliver excellent clinical judgment and interpersonal communication skills
* Understand confidentiality and privacy regulations
* Demonstrate excellent verbal and written communication
* Display knowledge and understanding of the military lifestyle and culture while maintaining the highest degree of sensitivity, compassion and respect for Service Members and their families.
Qualifications:
* Must be a U.S.
Citizen
* Master's degree or PhD from an accredited graduate program in a mental health related field such as social work, psychology, marriage/family therapy, or counseling
* Current, valid, unrestricted counseling license/certification ...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:12
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This Chief Technical Product Owner (CTPO) role will lead a team of TPOs for products that create and/or consume clinical and financial opportunities, including Opportunity Management System (OMS) and HealthConnect 360 (HC360).
The role will have direct management responsibility for a team of TPOs supporting the OMS and HC360 products through the entire Agile value delivery cycle, including close collaboration with business partners to create market-driven roadmaps, quarterly program increment planning, supporting the bi-weekly sprint cadence, assisting in design and testing, and supporting releases and production support.
Responsible for managing the work of the team, as well as resource planning and career management.
Must be comfortable working with a high amount of ambiguity and demonstrate strong collaboration skills with all partners, peers, and staff.
Responsibilities
* Cultivates a close working relationship with Business Product Owners (BPO) and other stakeholders to create a product roadmap that maximizes value, drives earnings growth, and improves customer outcomes.
* Fully understands customer needs (proposes, influences and shapes market research, can turn customer insights into action), external environmental influences, and competitive offerings and provides key input to the feature roadmap.
* Supports discovery, ideation, estimation and value analysis for potential new product features, in partnership with the BPOs, Architects, Engineering leaders, and other stakeholders.
* Provides oversight of intake activities and supports the creation of estimates when needed.
* Independently manages and influences cross-functional relationships, as required for features within the program backlog.
* Provides guidance and mentorship to direct reports and other TPOs, and provides input into their features and/or user stories as needed.
* Leads TPOs in Story Mapping, adoption and utilization of Agile best practices to decompose work from themes, p-epics, epics/features and stories.
* Partners with and supports Architects and Engineering leaders in the development of solution options, identification and prioritization of enablers and dependencies, and the identification of constraints, guidelines, and non-functional requirements as they relate to features within the program backlog.
* Partners with Delivery Manager in scope management, risk management, communication management, dependency management, and PI Planning and execution.
* Resolves escalated issues related to feature and user story issues when appropriate.
* Provides comprehensive consultation related to p-epics, epics/features and stories to Business and Technology partners and leadership, on all phases of the value delivery cycle.
* Participates in resource and capacity planning.
* Provides regular and ongoing leadership, coaching, mentoring, and guidance to TPO direct reports, including weekly 1:1s, quarterly check-i...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:11
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WORK LOCATION: This is a REMOTE work position.
Preferred locations within the West Coast Region: CA, OR, AZ, WY, NV, WA, Alaska
The Competitive Unit Cost Advisor has as its main focus the analysis of competitive unit cost information, validation of internal information and the development of actions and tools to improve Cigna's competitive unit cost position.
Partners closely with peers and management in Network Development & Competitive Insights, as well as matrix partners in Contracting, Sales, Network Analytics/Medical Economics, Underwriting and Pricing to accurately understand and represent Cigna's competitive unit cost position by area and product and to help drive improvements.
Support the generation of actionable reports to assist Contracting.
This position is responsible for Local Market Affordability/TMC support, including analysis of discount information, Risk Adjusted PMPM, Coordination of Benefits (COB) information, and other internal and external data sources to most accurately portray historic and projected competitive unit cost positions at both the market level and the provider level.
This position will evaluate cost trend projections compared to budgeted plan trends by product, by area and by provider to determine root causes of variances to plan and to identify opportunities for improvement.
This individual will obtain competitive data points from many sources and produce actionable reporting based on the data.
This position is responsible for working in a highly matrixed organization in a collaborative manner and exhibiting behaviors, attitudes and actions that demonstrate a high level of teamwork.
DUTIES AND RESPONSIBILITIES:
* Support COB, Onpoint, UC Plan, Hospital Transparency Analytics, NS&E updates, Local Market Affordability reviews, Market/Provider Triangulations, and Event Planning as needed.
* I ndependently present to Contracting & other customers competitive insight analyses in support of market discount and unit cost improvement initiatives.
* Evaluate discounts by product by area by component of medical expense to identify trends by payor, product or market.
* Validate internal roll ups of discount information inclusive of projected trends and ensure accurate representation of information to internal and external customers.
* Review of the current market's unit cost position and consult with the Regional Unit Cost Lead to recommend opportunities for medical cost improvements.
* Assessment of current unit cost position compared to competition and creation of reports to display competitive position.
* Partner closely with matrix partners to tap additional sources of competitive data and plot market trends.
* Partner with Pricing, Underwriting and Sales to help create accurate portrayal of unit cost within Pricing assumptions and in build up of employer specific medical expense.
* Determine competitive unit cost positions for top priority markets.
* Create and/...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:11
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POSITION SUMMARY
Join one of the fastest growing business segments at Cigna.
As a Product Management Lead Analyst you will support the development and implementation of product strategies to maximize profitable growth and membership targets within Cigna's Individual and Family Plans (IFP), a key business within Cigna's Government Business segment.
As part of the IFP Product Team, you will be responsible for market and segment analysis, product definition, competitive assessment, product design and price positioning strategies, and ensuring our products deliver superior value to customers who buy their own individual health insurance.
JOB DESCRIPTION
The Product Management Lead Analyst will develop and implement health insurance plans for specific market areas and provide in-depth SME support of key initiatives and projects.
A successful person in this role has or will rapidly become a functional expert in the individual business segment.
Success will be achieved through strong, proactive partnerships with areas/individuals such as IFP Market Managers, Pricing, Risk Management, Sales/Distribution, Network/Provider Contracting, Service Operations and IT.
Individuals with experience in developing benefit & plan design strategies and/or health related products for the individual health insurance industry are preferred.
Intellectual curiosity & analytical acumen are highly desirable.
DUTIES AND RESPONSIBILITIES
* Evaluate, develop and refine market level product portfolios through analysis and understanding of targeted markets, market trends, new technology, customer business issues and the competitive environment
* Partner with matrix partners/organizations such as Network/Provider Contracting, Segment Market and distribution managers, Network, IT, Pricing, Analytics, and Service Operations to identify and implement new product and/or enhancements that will result in increased membership/earnings
* Independently gather and summarize competitor information from publically available sources
* Identify tactics to maximize product advantages while aligning with the profitability and growth goals of the IFP segment
* Guide development of and utilize performance metric reports to monitor, communicate and positively influence areas of opportunity
* Project manage the annual product portfolio process, organize key meetings, document progress & key milestones, and manage key product artifacts
* Collaborate with the Mental Health Parity team to ensure products meet or exceed regulatory guidelines
* Help to manage IFP Product's source-of-truth product data management system, and improve/expand the processes to leverage and socialize the data.
* Identify potential issues and roadblocks from a benefits/product perspective and works to mitigate risks to ensure success.
* Maintain and/or update product policies, procedures and practices
POSITION REQUIREMENTS
* 3+ years minimum product management experienc...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:08
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Do you crave an intellectually stimulating job that allows you to leverage your clinical expertise while developing new skills and improving the lives of others? Then look no further! As a Medical Oncology Medical Director at eviCore, part of Evernorth Health Services, a division of The Cigna Group, you'll use your clinical know-how to provide evidence-based medical reviews for patient care.
Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases.
This role offers you the opportunity to build new skills while enhancing the health and vitality of others.
We're seeking a detail-oriented individual with good communication, technology, and typing skills, as well as strong clinical judgment.
Drive growth in your career with our innovative team.
How you'll make a difference:
* You'll start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success.
* Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on eviCore's case management software.
* Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence-based medical necessity and appropriateness of the requested service or treatment.
* Leverage your clinical expertise to recommend alternative services or treatments as necessary.
* Work collaboratively with over 500 eviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making.
What you'll enjoy about working here:
* Benefits start on day one
* Predictable work schedules
* 100% work from home
* 8 Paid Holidays + 23 PTO Days
* 401(K) with company match
* Reimbursement for continuing medical education
* Career growth opportunities across the enterprise
* Networking with peers across multiple medical specialties
Requirements:
* M.D.
or D.O.
with a current, active, U.S.
state medical license and board certified in Medical Oncology , recognized by the American Board of Medical Specialties, or American Osteopathic Association
* Eligible to acquire additional state licensureas required
* 5 years of relevant clinical experience post residency/fellowship
* Knowledge of applicable state federal laws
* Utilization Review Accreditation Commission and National Committee for Quality Assurance standards is a plus
* Ability to commit to a set, weekly work schedule (Monday through Friday)
* Strong computer skills: ability to work autonomouslywith automated processes, computer applications, and systems
* Meet physical demands of the role including, but not limited to, typing, speaking, and listening 100% of time
* In accordance with our HITECH Security Accreditation, company provided encrypted-workstation is required to be hard-wire connected to a modem or router.
Wireless connection is...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:07
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ROLE SUMMARY
The RFP Strategy & Operations Specialty (Pharmacy, EAP) Consultant supports the sales process by preparing, responding, and providing consultation to RFP questionnaires and other response documents, including client specifications, bid forms, requirements, finalist questionnaires, follow-up questions, etc.
The qualified individual uses his/her knowledge of Cigna's business and products, together with access to a library of pre-established content, internal resources and developed relationships with subject matter experts to craft strategically positioned responses and materials that support our win strategy.
The Specialty Consultant owns the end-to-end questionnaire response for integrated Pharmacy products and may also provide Q&A support for other specialty lines as needed to support the business (EAP).
The optimal candidate drives for better and faster ways to answer as much of the questionnaire as possible using existing resources and personal knowledge of Cigna's business and solutions.
This individual may interact with internal and external SMEs as needed.
The Specialty Consultant is part of Cigna's U.S.
Commercial RFP Strategy and Operations team.
This position supports all buyer segments (National, Middle Market, Select/U500, G&E, Allegiance/Payer) and may also be expected to provide cross-support to other business types as needed (Standalone).
ROLE COMPONENTS
With effective project and resource management, this individual collaborates closely with sales, presale, underwriting, content teams, and other matrix partners to support the bid process for both prospective and existing Cigna clients.
The Specialty Consultant owns the questionnaire response end to end, responding in a way that portrays Cigna's enterprise strategy as well as client-specific strategy.
This individual manages matrix partner relationships, sets timetables and deadlines, and communicates strategy to ensure the final questionnaire meets broker/client and sales specifications.
As a critical player in the RFP process, he/she also ensures the final product is of high quality, depicts Cigna's value proposition, and resonates with the audience.
The Specialty Consultant:
* Owns the end-to-end completion of questionnaires associated with integrated Pharmacy RFP, RFR, and RFI requests.
* Thinks critically about complex questions and new/unfamiliar topics, conducting thorough research and synthesizing cohesive responses from multiple sources as needed.
* Has a thorough and complete understanding of all buyer segment alignments and nuances, including the sales force structure and selling styles.
* Drive improvement to the RFP process and content by building stronger relationships with our matrix partners (Subject Matter Experts, Underwriting)
* Leverage all available resources to obtain information needed to support RFP's (Proposal Library, Knowledgexchange, Subject Matter Experts, Internet, etc.)
* Creates unique responses that...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:06
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This is a full-time Telephonic Clinical Dietitian working remote from home.
Employees must conduct business in a secure area in their home ensuring that discussions are confidential and cannot be overheard by others.
Position Scope:
* Provides 1:1 telephonic nutrition-related support to customers around behavior change to improve health status, reduce health risks and improve quality of life.
* Utilize nutrition care indicators, biometrics, and motivational interviewing techniques to establish health improvement plans, set personalized evidence-based goals, and support customer in achieving improved clinical outcomes
* Manages/coordinates an active caseload of telephonic cases.
* Establishes customer centric SMART goals and interventions to meet the customer's needs.
* Interfaces not only with the customer, but also with family members/caregivers, the healthcare team and the internal multidisciplinary team as needed via digital and telephonic communication.
* Builds solid working relationships with internal team members, matrix partners, key functional areas, customers and providers.
Major responsibilities and desired results:
* Assess readiness to change and implements actions to assist customers in reaching their goals.
* Empower customers to become an active participant in their own health outcomes
* Identify customer nutrition-related needs through targeted health assessments
* Provide customized diet based on diagnosis using the Nutrition Care Manual
* Be an active, motivated member on the interdisciplinary team; attend clinical rounds to discuss shared cases, establish next steps and accountable owners of action
* Collaborate with interdisciplinary partners through consults and referrals as appropriate
* Collaborate with internal and external matrix partners for care coordination
* Research and refer customers to community resources (Diabetes classes, food assistance programs, food desert support etc.)
* Completes training as required per role and demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate.
* Performs other related duties incidental to the work described herein.
Minimum Requirements :
* Registered Dietitian (RD)/ Registered Dietitian Nutritionist (RDN) with state licensure (as applicable)
* In good standing with the Commission on Dietetic Registration (CDR) required
* At least 3 or more years of direct nutritional care in a healthcare setting, providing health education and nutrition coaching
* Experience and/or familiarity with the Nutrition Care Process and Nutrition Care Manual
* Access to self-provided high-speed broadband wired internet with a modem/router.
Cannot support satellite-based internet or hot spots
Additional Qualifications Preferred:
* Active unrestricted Registered Dietitian license required in State of Residence a plus
* Strong computer...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:06
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340B Account Manager - Verity Solutions
Job Summary
Responsible for owning the ongoing account relationship and regular communications with a group of Verity Solutions accounts.
Educates, guides and set appropriate expectations with customers on maximizing Verity Solutions products for cost savings and compliance with 340B program guidelines.
Duties and Responsibilities
• Develop ongoing account relationships and serve as the key contact with assigned customers to understand their 340B program, compliance obligations, concerns and other pertinent data to develop clear service solutions.
• Consistently apply the client business review standards and expectations for consistent communication with assigned accounts, including frequency of scheduled contact and topics for review.
• Establish routines to review and analyze key savings metrics and account elements to maintain compliance and visibility to account performance including, but not limited to multipliers, ignores, unknowns, and savings reports.
• Educate and train customers on platform interaction specifics and new features/functions of all Verity products.
• Proactively report on findings for data anomalies to the appropriate team members and advise on next steps for resolution when possible.
• Use primary client management toolset (Salesforce) to manage and document all client interactions and projects as assigned.
• Respond timely and completely to customer cases as assigned, ensuring our service level standards are achieved.
• Support and promote the Verity Solutions performance standards and values through positive interactions with both internal and external stakeholders on a regular basis.
• Support occasional after-hours/weekend on-call support expectations
• Attend to other initiatives and goals as assigned
Experience, Skills and Qualifications
• BA or BS in Business or related field or equivalent work experience.
• 3+ years in a customer support, technical support or SaaS account management position.
• Strong written business communication skills, including proven ability to deal with competing goals, ability to lead difficult conversations, and the ability to achieve compromise outcomes.
• Aptitude to analyze data issues and troubleshoot problems with customer data.
• Strong experience and comfort level with MS office products, especially Excel.
• Experience using a CRM toolset, preferably SalesForce.com
• Ability to professionally and calmly communicate in both written and verbal forms with all levels of customer staff and management.
• Ability to be a self-starter, including strong multi-tasking capability, track record of managing multiple client accounts with shifting priorities and details in a fast-paced environment.
• Passion for working with customers, proactive problem-solving, and embodying a culture to exceed expectations.
• Experience working in a goal oriented, delivery focused, and dynamic environment....
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:05
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At Cigna we are committed to providing our customers with employee benefits, expertise and services that improve the health, well-being and productivity of their employees.Cigna's people are the key to our success in a changing and increasingly competitive marketplace.The collective skills, behaviors and work experiences of all Cigna employees enable us to make a real difference in the lives of our members.
We seek the most talented and creative minds in the industry to develop innovative solutions our customers value and consumers expect.
Major Duties
This role is in the Global Risk Management (GRM) Department reporting into the Finance Division.
Primary responsibilities include:
* Supporting the GRM claims reporting system, Clearsight; responsible for ensuring all new claims and required information are captured in the system; establishing standardized reports in the claim reporting system, including Insurance Placement reports, Loss reports and Claim Audit reports.
* Support financial operations for GRM, including requesting payment of premiums, settlements, etc.; reconciling payment systems to ensure consistency; ensuring all payments are appropriately captured in Clearsight; expense projections and allocations; monopolistic state, excise, and surplus tax reporting.
* Coordinate data submission and reporting for annual reserve reviews; communicate and report results.
* Support management reporting function through quarterly GRM reviews and Business Insurance Overviews.
* Responsible for managing the Surety program, including managing broker and insurer relationships.
* Assist with Insurance placements and renewals, ensure all submission and policy data has been appropriately maintained; complete renewal checklists; maintain enterprise Schedule of Insurance.
* Act as Compliance Assistant, ensuring appropriate filings and or responses to requests: Sarbanes-Oxley reports, Insurance Department reviews, 1099 Reporting, Physician Credentialing, National Practitioner Database, MCARE and OSHA/Workers Compensation postings, and Certificates of Insurance.
* Developing written policies and procedures for GRM processes, including Requests for Proposals (RFPs), Claims Management, GRM Manual, Financial Reporting, etc.
with a focus on looking for efficiencies and improvement opportunities.
Requirements:
* Bachelor's degree in Finance, Business Administration, Risk Management or Accounting
* 2 - 3+ years of Risk Management experience preferred
* Knowledge of health services industry preferred
* Knowledge of insurance and finance concepts preferred
* Ability to interact with internal and external business partners to support GRM goals
* Priority setting, problem solving and drive for results: Demonstrates agility to perform multiple projects while completing daily and weekly workload requirements.
* Effective business acumen and written and verbal communication
* Demonstrate...
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Type: Permanent Location: Philadelphia, US-PA
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:04
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Pharmacy Inventory Operations Rep.
Hours: M-F 10-7 pm est
The Pharmacy Inventory Operations Representative will audit and maintain accuracy in perpetual inventory system through physical inventory counting and ensuring all paperwork is accurate and filed properly.
The Representative will also be responsible for the research / resolution of inventory variances, including but not limited to dispensing, receiving, stocking, and coordinate / assist with assigned recalls, new product launches and discontinued items.
The Representative will also monitor and maintain Safire (dispensing system) in support of the Pharmacy Fulfillment operation.
ESSENTIAL FUNCTIONS:
* Conduct daily counting of inventory correctly and accurately enter into the perpetual inventory system.
* Research discrepancies utilizing the perpetual inventory system and Safire Fulfillment system.
* Collaborate with the Inventory supervisor, lead or manager for resolution.
* Primary contact for resolving inventory issues: inventory discrepancies, damages, short-date product and recalls.
* Support the Fulfillment operation by locating inventory needed for orders, adding new medications to the Safire system, and troubleshooting setup issues with existing items.
* Work with Procurement, Materials Management, and Operations to research/resolve discrepancies in shipments/receipts/ site-to-site transfers.
* Make necessary adjustments with proper approvals to system and provide outcomes to Inventory supervisor, lead or manager.
* Monitor email communications and resolve any questions, issues, or requests as necessary
QUALIFICATIONS:
* High school degree or equivalent with 3-5 years relative work experience.
Pharmacy Inventory and/or pharmacy technician experience preferred.
* Working Knowledge of Microsoft Office Suite; including Excel, Outlook, Word and PowerPoint.
* General Understanding and Working knowledge of office equipment
* Professional work experience in Inventory, Receiving or Warehouse in any industry will be considered.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality.
We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people.
Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or famili...
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Type: Permanent Location: Warrendale, US-PA
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:04
-
Case Management Sr.
Analyst - Specialty Consultant
JOB TITLE: Case Management Sr.
Analyst - Specialty Consultant
JOB BAND: Low Band 3 with $500 CEU budget and 2 CEU days aligned
DEPARTMENT: Clinical Operations-Clinical
UNIT/SECTION: Military OneSource
REPORTS TO: Specialty Consultant Manager (Supervisor)
Role Summary:
A great opportunity to help military members and their families!
The Specialty Consultant works with members of the military and their families in providing confidential specialty and special needs consultations.
The Specialty Consultant is responsible for identifying the individual and/or family's most immediate needs and leveraging their behavioral expertise to recommend available services that meet those needs.
This key role provides participants with support, education, resources, as well as information regarding legal/educational entitlements they may be eligible for.
The Specialty Consultant will coach the participant to an individualized plan of action to best meet their needs.
Specialty topics are varied but often include the following issues:
* Adults and children with special needs
* Complex areas of Disability/Educational law & entitlements (will not provide legal advice)
* Special needs trusts/estate planning (will not provide legal advice)
* Adoption
* Eldercare
* The military health care system & TRICARE
* Building healthy relationships
* Support for new parents
* Pet Care
* Everyday resources
The team works in a fast-paced environment, on a queue, taking Specialty Consultant/Special Needs Consultant calls in the moment, as well as through scheduled appointments.
Consultations are available by telephone, and/or using web based applications including real-time audio/video and chat discussions.
Duties and Responsibilities:
* Ability to created individualized Action Plans based on the needs of the participant.
Leverage behavioral expertise in formulating recommendations that best meet participant goals.
* Provide 1:1 telephonic, video and chat specialty/special needs consultations to help the participant identify and meet their individualized needs.
* Educate participants on applicable educational and disability law while coaching them to take steps towards legal entitlements they are most likely to be eligible for given their unique circumstances (no legal advice)
* Research and provide participants with a wide variety of civilian and military resources
* Execute duty to warn/mandated reporting processes as needed
* Contribute constructively in team meetings and with matrix partners in a manner to enhance relationships and to improve communication and procedures relevant to team functioning.
* Perform additional tasks/projects as needed, requested or assigned.
* Comply with all policies and Standard Operating Procedures.
* Maintain a minimum of 12 professional development hours per calendar year on topics related ...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:03
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Job Purpose
The PBM Operations Commercial New Client Implementation team is a group of client account support professionals responsible for successfully managing and delivering strategic implementation projects while driving client/customer focused problem resolution and influencing/leading process improvement.
As an Implementation Manager on the Commercial New Client Implementations team, you are responsible for end-to-end management of implementation project delivery with strong emphasis on project management, process and product knowledge and internal and external communications.
This role is involved in all aspects of implementations on a day-to-day basis including all client meetings and discussions, leading topics and guiding decision making with the client.
The role is tasked with achieving business results through consistent customer-centric service delivery, operational excellence, and effective partnership with cross-functional colleagues and external consultants, coalition partners and clients.
The role exists within a fast-paced and dynamic team of highly supportive implementation and operations specialists and leaders whose focus is to collaborate and empower each other to deliver complex setups on time and without issue in order to best position our clients, their members and those who support them for success.
Essential Responsibilities
* Lead or co-lead implementation of new client accounts including project plan management and status reporting, intent gathering, setup case submission, and overall client relationship management through project delivery and transition to the client service team.
The role is client facing.
* Work directly with clients, consultants, coalition partners, Sales, Client Service Teams, Operations and Product partners to ensure delivery of client contractual requirements and to manage expectations driving overall client satisfaction.
* Communicate status and risk to appropriate client and Express Scripts leadership.
* Represent New Client Implementations through the sales process including participation in Finalist opportunities to demonstrate to clients how their objectives are met through the implementation.
Finalist opportunities may be virtual or in-person at a client site.
* Support team development and effectiveness by engaging with peers and leadership in knowledge sharing, training and special projects.
* Demonstrate Cigna values - including teamwork and enterprise mindset - to support a high performance culture.
* Work with team leadership to identify opportunities for process improvement within the tools we use and the implementation processes including those coordinated with our internal partners.
Skills and Attributes For Success
* Critical thinker with project management experience and proven ability to lead and manage multiple projects simultaneously
* Demonstrated ability to coordinate resources cross-functionally to resolve complex issue...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:02
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Position Scope
Hours for the Position: 11:30am-8pm, or 12:30pm-9pm EST Monday- Friday.
Must be able to work evenings
Nurse Case managers are healthcare professionals, who serve as customer advocates to coordinate, support, and guide care for our customers, families, and caregivers to assist with navigating through the healthcare journey.
Additionally, the candidate will be responsible for the adoption and demonstration of the Care Solutions cultural beliefs.
They will be responsible for role modeling the six cultural beliefs to drive personal accountability and organizational results.
* Customer Strong: I deliver world-class experiences for all my customers.
* Me to We: I take accountability to trust, partner, and deliver.
* Own It: I see a need and deliver value because I care.
* Evolve and Adapt: I learn and adapt to meet evolving business needs.
* Be Bold: I pioneer and think broadly to solve challenges.
* Take Care: I prioritize self-care and act with compassion toward colleague.
Day in the Life Responsibilities
* Collaborates with customer in creation of care plan and documents plan in medical management system.
* Partners with each customer to establish goals and interventions to meet the customer's needs.
* Establishes plan of care in conjunction with the customer and provider then document into a medical management system.
* Utilizes motivational interviewing, behavior change, and shared decision making to help customers achieve optimal health and well-being.
* Empowers customers with skills to enhance interaction with their providers.
* Interfaces with the customer, family members/caregivers, providers, and internal partners to coordinate the needs of the customer through telephonic, email, text, and chat interactions.
* Collaborates with nutritionist, pharmacist, behavioral clinician, Medical Director and customer's provider and other Cigna Medical Management programs to provide whole-person health support.
* Tracks daily activities to trend volume and outcomes.
* Follows standard operating procedures.
* Toggles between multiple systems and applications.
* Research relevant topics in health promotion and disease prevention, as required for specific customers.
* Prioritizes work to meet commitments aligned with organizational goals.
* Understands and adheres to Case Management performance measures to deliver on key results.
* Completes training within the communicated time limit as required per role.
* Demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate.
Minimum requirements
* Active unrestricted Registered Nurse (RN) license in state or territory of the United States.
* Minimum of two years full-time direct patient care as an RN required.
* Must be flexible to work days or evenings based on business needs
Preferred requirements
* For non-standard s...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:01
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Summary
Conducts facility provider contract underwriting/analysis.
Partners with the Behavioral Health Network team to deliver unit cost results in line with trend/cost expectations to ensure competitive positioning within the marketplace.
Partners with Manager to streamline and enhance facility modeling tools, incorporate competitive insights, and evolve overall suite of tools and reports to best support dynamic Network goals and strategies.
This individual will possess technical and business knowledge to provide standardized, customized, and ad hoc modeling for provider negotiations.
In addition, there will be a technical component that is required with a thorough understanding of relational databases, the information warehouse, medical claims data, and query logic.
Responsibilities
* Analyze impact to trends for facility contract negotiations
* Effectively influence contracting in a strategic fashion and offer meaningful options during negotiations with a provider
* Provide ad hoc analysis and deep dives into data as appropriate to support negotiation and provide value to our contracting partners
* Summarize and explain findings and recommendations
* Proactively synthesize facility reviews to develop market profiles, understanding provider mix, impacts, and opportunities for trend mitigation
Qualifications
* 6+ years' of facilities contract analysis experience
* Financial and Medical Claims data fluency (CPT, revenue codes, claim level financials, ub v hcfa, etc)
* Strong analytical and data visualization skills; Skilled proficiency with tools such as SQL and/or SAS and Tableau highly preferred
* Advanced knowledge and experience extracting data and large data sets
* Exceptional communication and problem solving skills
* Experience with Microsoft Office software
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 95,200 - 158,600 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure.
That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health.
Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
For more details on our employee benefits programs, visit Life at Cigna Group .
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitm...
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Type: Permanent Location: Philadelphia, US-PA
Salary / Rate: Not Specified
Posted: 2024-05-11 08:47:01
