Position Overview: The Clinical Integration Services Portfolio Lead role is responsible for bringing together multiple key players across complex solutions and programs in order to meet delivery commitments and excel at growth opportunities. This role promotes collaboration and open communication to deliver on the technology portfolio aligned to Care Delivery business strategy, specifically around the Direct Health Portfolio. The ideal candidate has exceptional organizational, communication and planning skills, is passionate about healthcare and technology and is looking to further their knowledge and expertise. This role requires someone who is comfortable developing and managing a plan, executing against tasks that are occasionally ambiguous, works independently to solve problems and proactively seeks to bring together teams and information to align to a common solution and timeline. Key Responsibilities: Facilitates integration with delivery partners to manage...

Remote, Work from home, United States Join us! We are looking fortalentedIT professionals with hands-on experience infunctional and automation test design and execution forawide variety of projects. This team player must have the ability to engage in requirementsanalysisand test approach discussions with delivery and business teams. They should also be able to self-organize and work independently withintheir specific area of responsibility. Key Responsibilities: Understands various back-end and front-end architecture components required to formulate test strategies Works with both onsite (Scrum Master, Product, QA and Developers) and offshore QA team members in properly defining testable scenariosbased on requirements/acceptance criteria Helps define test data criteria and partners with Data team to obtain the data Participates in sprint-level,integration and regression test planning andexecution Designs and develops scripts to run automated tests to ensure...

This position is responsible for designing, delivering and maintaining the Long Term demand forecasting and supply planning needs, enabling the Customer Organization achieve business goals by optimizing operational performance. It will develop a formal outlook process that will aid in identifying, in advance, excess/shortfalls in staff. Accurate demand forecasts are essential for managing the cost and quality of the service we provide to our customers. As the Resource Planning Lead Analyst, you are responsible for long range forecasting, project analysis, consolidation of actual volume and cost information and ad hoc analytical support. The Resource Planning Advisor collaborates with finance, operations partners and others to ensure the accuracy of our financial results, variance drivers, and risk mitigation plan. Responsibilities include identifying, reengineering, and implementing capacity planning and forecasting outlook improvements to optimize business outcomes, operational...

Summary The Account Management Senior Associate will provide support to the Account team of their assigned Coalition(s).The Senior Associate will provide client facing support, non-standard reporting, submit client access requests, and assistwith benefit set up and project support as requested. The primary focus for the position is executing client-specific operational deliverables, identifying service trends, supporting operational needs and issue resolution. In order to function effectively in the model, the Senior Associate must collaborate with the Account Manager, Account Executive, and Clinical Account Executive to successfully service the entire Book of Business. The primary measure of the Senior Associate's performance is by way of both the Account Team and client satisfaction. Essential Functions Manages day-to-day client requests. Assists the Account Management team by providing client facing support. Maintains ownership for assigned service/operational deliverables and...

This position is responsible for designing, developing, and maintaining automation and analytics to support the Workforce Management team and Service Operations. This role will create data flows in Alteryx, dashboards in Tableau, automating of existing reporting, and conduct adhoc business analysis as needed. Business Analytics Lead Analyst role will also support reviewing data sources for data quality/consistency and creating/blending data sources required for automation, reporting, and analytics. Another key function of the role is to review current reporting and analytics processes for efficiency improvements, accuracy, and providing business value. This position has exposure to cross-functional teams and provides WFM data to drive incremental revenue and margin. Responsibilities: Design, development, testing and deployment of Tableau Dashboards. Leverage advanced Tableau functionality (parameters, actions, tooltip modifications, API, etc.) to create analytical dashboards....

Remote, Work from home, United States US Medical Integration Solutions (USM-IS) seeks an individual to create and drive simple, modern, and composable cloud-first architectures across an extensive portfolio of integrated business products. Individuals in this role are directly responsible for the design of products and portfolio initiatives. Additionally, this individual will collaborate within a solution architecture community to define the execution and governance principles for solution architecture best-practices. The Solution Architecture Senior Advisor balances the needs of product owners, business leaders, delivery teams, enterprise strategy, and budget to define, refine, and deliver upon a multi-year USM-IS Technology Strategy. This is a senior technical role, requiring an individual capable of providing thought leadership and architectural oversight for multiple USM-IS delivery teams while managing relationships with IT and business leaders. Key Responsibilities...

**Remote, Work from home** The HEDIS Intake and Retrieval Manager is responsible for the supervision of the Medical Record Intake and Retrieval Team as a key element of the HEDIS team within the Cigna Medicare Quality Organization. This position currently reports to the Director of Quality Improvement and Population Health Management Oversight. The Manager develops strategy, workflows, and training materials during the HEDIS Planning Season in preparation for HEDIS MRR. Will assess, plan, monitor, evaluate and report on project plans. Participates in and/or facilitates the design, development, and implementation of new operational controls, performance metrics, information management systems, and automated processes. **KEY RESPONSIBILTIES:** + The manager recruits, trains, and supervises a team of 15 - 20 temps during MRR, ensuring timely and efficient processing of records into the HEDIS MRR Project and fax requests to providers for record retrieval. + The manager also is...

**Japanese speaking required** **Role Summary:** Handle operations escalations and provide consultative service to Cigna Global Health Benefits clients and customers. Proactively engage business partners to facilitate and drive customer centric solutions to ensure a timely, high quality and positive client and customer experience. **Responsibilities:** + Deliver successful ongoing service experience for clients and customers + Own and effectively manage service inquiries from Cigna Global clients and Client Management. + Perform root cause analysis and drive for first contact resolution + Establish consultative and collaborative partnerships with Sales, Client Management, Underwriting, Operations and others as needed to drive client and customer solutions + Collaborate with Client Service Executive to develop and effectively present service solutions to clients and customers. + Prioritize tasks and deliverables ensuring solutions are achieved timely with high quality...

As a Pharmacy Program Management Sr Analyst, you will be working with internal matrix partners to maintain custom client relationships and solutions. You will work independently while fully supported by a phenomenal leadership team focused on providing exceptional service to our clients. Here's how you'll make an impact: Manage relationships related to specific pharmaceutical clients and programs Research, gather, and analyze data to create a clear picture of needs and potential solutions Manage client escalations as needed Present data externally with an ability to communicate to all levels Collaborate with other key areas of the business Complete day-to-day Business Operations tasks without immediate supervision, but have ready access to advice from more experienced team members Identify ways to streamline operational procedures between or within department What you need to do the job: High School Diploma or GED 3+ yrs healthcare or pharmacy related experience 2+ yrs client...

**Role Summary** This role will be an integral part in the Corporate Accounting SEC reporting team and be responsible for monthly accounting for the parent companies, management reporting for Corporate segment, as well as quarterly 10Q/10K reporting. **Role Responsibilities** + Lead monthly close for the parent companies. + Responsible for Monthly Operating Results (MOR) for Corporate segment, including analysis, reconciliations, and research of actual vs projection variances. + Support preparation of quarterly Statements of Cash Flow and related analysis. + Responsible for certain US GAAP financial reporting activities for Cigna Corporation, including disclosures supporting SEC Forms 10-Q and 10-K. + Ensure satisfaction of disclosure requirements listed per GAAP Disclosure Checklist. + Participate in special projects such as the adoption of new accounting guidance and associated restatement of prior period financials, debt transactions, etc. + Support SOX compliance and...

The Healthcare Vendor Implementations Specialist will be a member of 3rd Party Service Management team working directly with internal and external development teams. This person will act as the principal point of contact for coordinating communication between Business, IT, Compliance, and Vendor with the purpose of implementing changes or new functionality. They will be responsible for communication, documentation, change management, and transition to support.Requirements:3-5 years of Electronic Data Interchange (EDI)/file exchange implementation, required.Knowledge of Medicare and Medicaid industries, required.Application development and/or project management experience.Experience working in Agile and matrixed environments.Flexibility and experience working as an individual contributor and as a member of a team.Key Responsibilities: Coordinate/host meetings and assist with presentations.Gather requirements, communicate expectations, analyze designs, and construct and deliver...

**Role Summary** Position directs and supports the Clinical Measurement and Improvement team in activities of healthcare data collection, analysis and improvement through the execution of the Healthcare Effectiveness Data and Information Set (HEDIS®)*/Quality Rating System (QRS) quality programs. These activities include, but are not limited to, the management of a local HEDIS/QRS market(s), vendor relationships, regional and national project management, collection and submission of state specific HEDIS/QRS requirements, and development/execution of initiatives to improve customer quality outcomes. Position collaborates with matrix teams including contracting, provider experience, market medical executive, market facing clinical organization, IT, vendor, etc. Position also serves as a HEDIS/QRS subject matter expert, directing and supporting the HEDIS/QRS team to assure that Cigna customers achieve market leading results in clinical outcomes. **Major Duties** + Direct activities...

The Service Operations Change Manager is responsible for leading Change Management strategies for critical, high priority programs and strategic change initiatives across Operations. This individual will work in a highly matrixed environment to provide direct Change Management leadership and support for Operations stakeholders. Principal Responsibilities: Lead the development and oversight of delivery of Change Management strategies and plans to facilitate and enable change for programs and initiatives within Service OperationsPartner with program leaders, project managers, Stakeholders and enablement partners to drive strategies that promote faster adoption, utilization and proficiency of changes while minimizing impact of changes to Operations teamsWork closely with key business leaders and stakeholders to understand implications of change across multiple business unitsDrive engagement, awareness and preparedness for change through a robust stakeholder engagement strategyAlign...

POSITION SUMMARYThe Business Project Advisor is responsible for leading cross-functional projects that are in support of key initiatives that typically include work process productivity improvements, margin improvements, change management, and product or system changes. Partners with business leadership to provide support for project initiation and execution that ensures value realization from original concept through final implementation. Establishes a project team, sets project schedule, estimates project resource plans, and maintains status reports for all business resources and end users. The Advisor is expected to influence the outcome and delivery of project efforts as it relates to timeline. Identifies, analyzes, and tracks project issues and risks as well as remove barriers to success. Essential Functions• Manage multiple projects with cross functional teams.• Lead the planning and implementation of projects.• Facilitate the definition of project scope, goals and...

You will be part of a collaborative team that provides analyses to aid decision-making based on data, facts, and analytical findings across Risk Management and Underwriting. You will analyze and interpret collected data, spots trends, and make capacity-related recommendations to Senior Directors of Risk Management (SDRMs) and Directors of Risk Management (DRMs) to support Cigna's growth objectives. You will also use data to develop recommendations to drive efficiency across the Risk Management & Underwriting organization.Responsibilities:Lead a process that supports strategic staffing decisions, including the ability to establish / maintain the following:Required staffing levels by market and skillsetAllocation of existing staff to support Drive to 2025Employee development and growth opportunitiesHiring strategyRefine capacity models based on the following criteria:Staffing projection - project monthly headcount, including known changes (e.g. retirements, rotations) and unknown...

Position Overview:The Clinical Integration Services Portfolio Lead role is responsible for bringing together multiple key players across complex solutions and programs in order to meet delivery commitments and excel at growth opportunities. This role promotes collaboration and open communication to deliver on the technology portfolio aligned to Care Delivery business strategy, specifically around the Direct Health Portfolio. The ideal candidate has exceptional organizational, communication and planning skills, is passionate about healthcare and technology and is looking to further their knowledge and expertise. This role requires someone who is comfortable developing and managing a plan, executing against tasks that are occasionally ambiguous, works independently to solve problems and proactively seeks to bring together teams and information to align to a common solution and timeline.Key Responsibilities:Facilitates integration with delivery partners to manage cross-team...

**Role Summary** This role will be an integral part in the Corporate Accounting SEC reporting team and be responsible for monthly accounting for the parent companies, management reporting for Corporate segment, as well as quarterly 10Q/10K reporting. **Role Responsibilities** + Lead monthly close for the parent companies. + Responsible for Monthly Operating Results (MOR) for Corporate segment, including analysis, reconciliations, and research of actual vs projection variances. + Support preparation of quarterly Statements of Cash Flow and related analysis. + Responsible for certain US GAAP financial reporting activities for Cigna Corporation, including disclosures supporting SEC Forms 10-Q and 10-K. + Ensure satisfaction of disclosure requirements listed per GAAP Disclosure Checklist. + Participate in special projects such as the adoption of new accounting guidance and associated restatement of prior period financials, debt transactions, etc. + Support SOX compliance and...

Role Summary This role will be an integral part in the Corporate Accounting SEC reporting team and be responsible for monthly accounting for the parent companies, management reporting for Corporate segment, as well as quarterly 10Q/10K reporting. Role Responsibilities * Lead monthly close for the parent companies. * Responsible for Monthly Operating Results (MOR) for Corporate segment, including analysis, reconciliations, and research of actual vs projection variances. * Support preparation of quarterly Statements of Cash Flow and related analysis. * Responsible for certain US GAAP financial reporting activities for Cigna Corporation, including disclosures supporting SEC Forms 10-Q and 10-K. * Ensure satisfaction of disclosure requirements listed per GAAP Disclosure Checklist. * Participate in special projects such as the adoption of new accounting guidance and associated restatement of prior period financials, debt transactions, etc. * Support SOX compliance and external audit...

Does your **DREAM JOB** involve **WORKING FROM HOME** and **HELPING OTHERS?** **Join CIGNA!** We want to change health care to make it more affordable, personalized, and focused on helping the whole person. As a **Pri** **or Authorization Representative** you'll be part of a dedicated team which provides information regarding pharmacy benefits and drug coverage. This crucial role is on the front lines with patients, pharmacists and doctors' offices, responding and addressing each phone inquiry with care, detail, and most importantly, empathy. **How you will make a difference** + **Help patients understand their pharmacy benefits better. ** You'll research benefits coverage with pharmacist and doctors' office and provide guidance to patients about medication coverage. + **Help patients get the medication they need.** While managing a high call volume, you'll use your expert listening and data entry skills to get to the heart of a patient's question and accurately document all...

Looking for an intellectually stimulating role that will challenge you to use your current knowledge and build new skills? Join us as an Associate Medical Director at eviCore, where you'll be empowered to make a difference in the lives of patients by improving the quality of healthcare nationwide. **What you'll do:** + **Use your analytical mindset** **.** Providetimely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria.Reviewappeals for denied services related to relevant medical experienceand our evidence based guidelines,in accordance with appeal policies, if so delegated. + **Be a team player.** Work collaboratively with over 400 eviCore Physician Peers to help ensure patients receive proper care via evidence based decision making. Providetimely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. + **Create new knowledge with...