Remote, Work from home, United States The Technical Product Manager is Market/Customer focused and acts as a conduit between the business, solution architects and Agile Team(s). The Technical Product Manager is responsible for defining the vision, scope, and priority of the program backlog to be delivered by the ART. The Technical Product Manager will work closely with stakeholders ( business and IT ) across the organization to define strategy, scope and create roadmaps and requirements to deliver on-time and high quality software products that align with business goals. The Technical Product Manager needs to use their technical background to bridge the gap between the product and technical side of the product development by working side by side with the business, solution architects and solution train experts. This individual will work with business, technology, and solution teams to define Epics and Features and prioritize the Program Backlog. This individual must...

The **Technical Writer/Technical Training Lead Analyst** role is responsible for the research, authoring, publishing, and maintenance of procedures and curriculum using various authoring tools (KMS, Word, PPT, Flare, etc.). This position will work closely with various departments and related groups, Business Owners and SMEs to document procedures and related content, including the translation of business needs into user instructions and training content. The Technical Training Lead Analyst will provide support on a variety of projects including systemic improvements and enhancements to existing documentation flow and storage. **ESSENTIAL FUNCTIONS** + Writes, edits and formats task-level documentation to include but not limited to: Procedures, Job Aids, Participant and Facilitator Resources, Forms, and Client Pages + Works with a variety of departments and related business owners/approvers to document process, procedures and related training content + May lead several projects in...

Head of Government Digital Strategy-Work From Home- CT **_ABOUT EVERNORTH DIGITAL_** Evernorth is built on the recognition that health makes progress possible. Our health services are designed to redefine health care as we know it, and the Evernorth team is unified in the belief that we are responsible for the future of healthcare. This means that our products must inspire change in people that leads to positive pathways: pathways that lead to health, to healing, to preventative wellness and ultimate vitality. The Evernorth Digital team is like few in comparable Technology companies today: we are a collective of carefully curated, specialized disciplines that, when whole, imagines, plans, defines, tests, instruments, measures, builds, deploys, monitors and optimizes end-to-end experiences that represent the health services suite of product offerings. We are united by our mission to improve life and health outcomes towards aspirational vitality, but we practice our crafts in a...

POSITION SUMMARY The Senior CAE l is assigned a set of complex / sophisticated clients carrying a heightened strategic project management role. They serve clients as the primary contact for all clinical, formulary related initiatives, financial /rebate and clinical modeling, trend evaluation, clinical business plan development consultation-presentation, implementation and oversight, results evaluation, and follow-up related to the comprehensive management of clinical programs and services issues and initiatives regarding programs and up-sell. ESSENTIAL FUNCTIONS + Leads the up-sell and implementation of clinical program solutions and formulary related programs to clients thru consultative methods and processes (e.g. Client P and T presentations, quarterly/ annual reviews, modeling/ report reviews, etc) in accordance with client business plans and upon collaboration and coordination with account management team members regarding operational details. + Continually reviews to detect...

If you're looking to add value and make an impact, in a fast-paced environment, starting your career within the Underwriting & Analytics team at Evernorth will allow you to do all this and more. As part of our Underwriting Operations team, you will directly impact our business on a daily basis, protecting Cigna's sound financial position which enables us to meet our financial commitments to our customers.The Enablement & Operations Senior Analyst role will be responsible for client implementation and contracting for renewing and new sales Commercial clients.The role's main focus will be client implementation which includes pricing set-up and contract approval responsibilities. Other functions may include ensuring data repositories are updated in a timely and accurate manner, improving capture of key data elements, and accuracy of intended pricing into ESI systems. The Senior Analyst will ultimately perform tasks related to set-up and ongoing maintenance of client pricing...

Member of Special Investigations referral and case enhancement team that works closely with analysts, investigators, advanced IT specialists, and management. The primary responsibility of the position is to perform a comprehensive in depth review on suspected claims fraud referrals received from sources outside of SIU or identified proactively. Effectively integrates claims fraud investigation experience and industry knowledge with the use of data analytics. Responsible for efficiently and accurately assessing referrals submitted to the SIU for investigation to determine if there is merit in the allegation and a matter that should be addressed by SIU. Conducts a comprehensive review to identify highly suspect billing behaviors and trends, potential overpayments and formulates specific investigative next steps. The finished product should be packaged in a manner that allows the investigator to fully understand what actions should be taken to mitigate patient harm and financial risk...

**Job Summary:** Remote Work from Home, United States the Claims Compliance Analyst will assist with supporting initiatives directly related to claim processing and adjudication functions. The claims compliance analyst ensures claims policies and procedures meet the standards of the company and are compliant with statutory, and regulatory guidelines. Other responsibilities include: monthly compliance reporting, implement and develop compliance auditing and monitoring policies. + Maintains statutory and regulatory compliance by researching regulations and provisions related to claim compliance + Monitor regulatory changes as they relate to each program and line of business + Support external client and/or health plan audits, market audits, and financial audits. + Support claims team with resolving issues and concerns from external audits + Maintains appropriate audit processes e.g. standardized audit samples, proper reporting of audit findings including recommendations for...

**Work From Home! Start dates are 10/17 or 11/7** The Clinical Reviewer will be responsible for: + All clinical certification activities, which include but are not limited to evaluating telephone, fax or WEB requests for authorization of clinical services from physician offices/and or imaging centers, comparing requests against established clinical protocols and authorizing services or referring requests for expert clinical review as appropriate. + Know and understand complex case specialties and case reviews. + Review clinical information submitted by providers to appropriate criteria and standards and makes decision to issue a review determination or to refer to physician review if criteria are not met. + Maintain current departmental standards related to productivity. + Train in clinical certification, utilization management, URAC and NCQA principles, policies, and procedures. + Prepare program correspondence as needed. + Serve as a resource for members calling for assistance. +...

Remote, Work from home United States. Must be able to work CST or EST hours. The duties of this role will revolve around the development, maintenance, and operation of data protection processes which run in both distributed and mainframe environments. This will include process improvement, increasing the efficiency and stability of these processes thru refactoring and automation. This role also supports and maintains reporting functionality for these processes. Additionally, the person filling this role will be responsible for the creation and maintenance of de-identification logic and processes. The technologies you will have the opportunity to work with are many and varied, in both mainframe and distributed environments. Qualified candidates will be a logical thinkers and problem solvers, and possess these skills Languages Python Perl Java JCL COBOL SQL Databases DB2 VSAM Oracle Other Technology Mainframe TSO Batch...

Remote, Work from home, United StatesFirst things first, we're a global health service company dedicated to helping people improve their health, well-being and sense of security. But we don't just care about your well-being, we care about your career health too. That's why when you work with us, you can count on a different kind of career - you'll make a difference, learn a ton, and share in changing the way people think about healthcare.**Now on to the good stuff... what you'll do:**The Technical Product Owner for Data and Analytics Portfolio (DAE) position is a hands-on role responsible for the end-to-end design, testing and development of machine learning models for Health Data Services. As a Technical Product Owner for Data and Analytics Porfolio (DAE), you will be responsible for managing the backlog within the Hadoop Foundation team.**What you need to do the job:**Big Data experience preferred (e.g., Hadoop, Teradata,).Agile methodology experience required, including managing...

Remote, Work from home, United States The objective of this position is to work with business and technical experts to implement software engineering best practices related that promotes the highest re usability across the US and Global. The individual must have superb analytical and technical skills coupled with the ability to drive project deliverables. The individual will be expected to participate in the collaborative concept definition, architectural refinement, software design and realization of products that support the strategic technology needs to support the organization. A full stack engineer is a person that has a breadth of knowledge in computer science, a problem solving mentality and a desire to learn. This person is comfortable working with in a technical capacity across many of the sectors including core development on platform, data processing and report generation. You will be working in a team that demands technical excellence and whose members are expected to...

Remote, Work from home, United States 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 strategy experience? If so, prepare to innovate, create, and inspire. You will work with business and product teams to influence solutions involving AWS Cloud, and distributed systems architecture. Responsibilities: Responsible for delivering or reviewing solutions for a specific application or a suite of applications. Provides technical expertise through a hands-on mentoring approach to teams and projects, developing capabilities via the use of new technology and products and maintaining a deep level of involvement with the agile development teams. Contributes to the organizations application roadmaps, and supports EA product and capability roadmaps which impact broadly across a group of systems and products. Supports engineering and delivery in building and maintaining...

Remote, Work from home, United States We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. Help us solve our future. Get ready for a job that encourages you to think strategically yet stay connected with your teams. Do you like solving problems in innovative ways? The Financial Tools & Data Engineering Team is embarking on a transformative effort to build enterprise applications and data products that connect both Cigna and Evernorth delivery solutions. Delivering improved experiences, enabling new product offerings, and empowering self-service insights & analytics. The Senior Manager will be responsible for engineering & data teams that build and support databases & applications for the technology delivery platform. This...

Core Technology Engineering Solutions - Scrum Master Sr AdvisorThe Core Technology, Engineering and Solutions organization is seeking a Scrum Master Senior Advisor member for two teams that support multiple initiatives including legacy applications running on the mainframe, as well as the migration of components of existing applications and data to the public cloud. Beyond the scrum master service leader responsibility, the selected candidate will participate in the definition and implementation of best practices and standards with Value Stream and Platform Groups Lean Portfolio Management teams.Our people make all the difference in our success.Key ResponsibilitiesServes as the "servant leader" of the Scrum team by removing impediments and helping the team remain successful and on schedule.Provide expert content/professional leadership on complex assignments/projects.Exercise considerable creativity, foresight, and judgment in conceiving, planning, and delivering initiatives.Use...

Remote, Work from home, United States (EST hours)Come, grow your career with us.Join a team whose mission is to move forward in the methodology of site reliability engineering (SRE). SRE is a set of principles and practices that incorporates resiliency software engineering via automation. Enjoy creating and modify existing applications to provide early warning awareness of potential problems, which eliminate toil, and measure real service level objectives (SLO) using service level indicators (SLI)/service level agreements. Be a part of a team that drives a culture of continuous improvement, continuous development. Enjoy the benefits of supporting systems that are efficient and improve customer satisfaction. We are looking for candidates with delivery experience. Be a part of Cigna's future.The role requires a wide variety of strengths and capabilities, including+ Bachelor's degree or equivalent experience+ 3+ years of experience in Developer, Operations roles+ Knowledge of...

Responsibilities: Primary duties are to maintain the Claims phone queue by providing great customer service to all callers regarding billed claims, denied claims or pended claims Understand the processes involved in the adjudication of a claim Investigate and resolve issues for providers Escalate concerns, claim issues or payment errors to the appropriate team for handling by using our ticketing system Build solid foundation and expertise in the various platforms/systems utilized for both authorization lookup and claims processing (ISAAC, ImageOne, Plexis, MC400) Cross-train on other administrative duties as needed Ability to complete special projects or other duties as assigned Qualifications: High School graduate with diploma or equivalent required Minimum 6 months experience in call center or claims operation Previous patient eligibility/benefits experience preferred Exceptional communication skills (verbal and written) required Professional...

Senior Advisor- Data Visualization, Senior Designer-Work from Home - Evernorth- Anywhere in the US Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. Evernorth was founded in 2020 by Cigna Corporation in hopes to be an aggregator of our multi-brand products and services -- A new movement in Health care to innovate and evolve our Healthcare industry as we know it today. The mission of the Enterprise Design Systems Team is to set the bar for design system disciplines and define the processes, work output, platforms and tools that will bring efficiency and quality to product delivery. This team incubates new design patterns, design systems that represent the evolution of the brand in the digital...

Remote, Work from home, United States Help us architect 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 strategy experience? If so, prepare to innovate, create and inspire. The Infrastructure Engineering Senior Advisor provides counsel and advice to top management on significant Infrastructure matters, often requiring coordination between organizations. Serves as the lead technical consultant responsible for design, engineering and development of information technology solutions.The senior engineer, under the guidance of the architect, partners with business customers and provides a key role in helping to lead projects, designing solutions, and maintaining infrastructure lifecycle management path. ESSENTIAL FUNCTIONS Coordinate and facilitate meetings with application and system teams to determine dependency management, visualization and improved operations. Capture, document, analyze...

Goodbye long commutes, rigid schedules, and busybody managers. Hello, Liveops. Our well-known clients are seeking Independent Contractors to provide virtual services to their customers across a variety of industries including Retail, Healthcare, Licensed Insurance, Non-Licensed Insurance and Tax Support.  As an Independent Contractor, you have flexibility to choose  when and where to provide services. Login and provide services when it works for you as you are your own self-employed boss! Liveops ranked #4 in FlexJob’s 2020 Top 100 Companies with Remote Jobs As an Independent Contractor, you are self-employed and can: Work from home or any quiet place. Set your own schedule to work around your life. Enjoy the freedom and flexibility of being your own boss. Our Clients look for Independent Contractors who are comfortable: Conducting inbound and outbound customer service calls with customers. Creatively problem solving. Quickly assessing customer needs and providing...

Goodbye long commutes, rigid schedules, and busybody managers. Hello, Liveops. Our well-known clients are seeking Independent Contractors to provide virtual services to their customers across a variety of industries including Retail, Healthcare, Licensed Insurance, Non-Licensed Insurance and Tax Support.  As an Independent Contractor, you have flexibility to choose  when and where to provide services. Login and provide services when it works for you as you are your own self-employed boss! Liveops ranked #4 in FlexJob’s 2020 Top 100 Companies with Remote Jobs As an Independent Contractor, you are self-employed and can: Work from home or any quiet place. Set your own schedule to work around your life. Enjoy the freedom and flexibility of being your own boss. Our Clients look for Independent Contractors who are comfortable: Conducting inbound and outbound customer service calls with customers. Creatively problem solving. Quickly assessing customer needs and providing...