Job Summary: The Clinical Account Executive (CAE) position is an exciting opportunity for a pharmacist who is looking to leverage their pharmacy and healthcare expertise to meet the Health Plan clients strategic goals and drive improved clinical and financial outcomes for their membership. In this role the CAE will use their deep understanding of the pharmacy/healthcare landscape and pipeline, as well as strong clinical, analytical, financial, and business skills to develop and present a comprehensive strategy aligning and supporting to the clients strategic goals. The strategic plan should address critical business metrics such as member and client satisfaction, clinical support and clinical solution program adoption with a goal to deliver lower healthcare costs and optimal clinical outcomes. This role requires the CAE to think forward into the future as the healthcare landscape continues to evolve, be comfortable with a wide variety of data elements, have an ability to draw...

Remote, Work from Home, United StatesThe incumbent will be a member of the Network Solutions & Delivery team; responsible for leading and delivering on all aspects of Medicare network solution implementations, including designing network configurations and managing the provider data implementation for across Network Solutions and Operations (NS). The Network Manager is the primary point of contact for NS and works extensively with field contracting, Provider Relations & Solutions Management (PRMS), Market Deployment Managers (MDM's) and Strategic Solutions/Product to ensure networks solutions are effectively implemented. The Network Manager also works extensively with Network Operations partners and other matrix partners to ensure solution designs meet operating efficiency expectations. RESPONSIBILITIES:Design network solutions using networks within business and operational guardrailsResponsible for configuring the data to meet the requestor's need using operational...

Do you want the rare opportunity to create functional digital products that will help reduce administrative burdens and introduce new capabilities for Cigna's healthcare professionals?We are embarking on a Digital Solutions Renovation to help increase our digital capabilities on the Cigna for Healthcare Professionals website. We're using Agile methodology and user-centered design focus to build capabilities that will improve our provider experience.We are currently hiring aDigitalProduct Designer(UX/UI Designer)who is passionate about improving user experience in technology used by healthcare professionals around the world. You will drive and own the design process from start to finish working directly with the Product Manager, developing the design plan and acting as the design authority.Responsibilities will include:Collaborating with Experience Owner, Product Manager, Product Owner, and Usability Specialists to conduct research, analyze findings, inform the development team of...

This is a position. Please review required qualifications for this position. POSITION SUMMARY The Instructional Designer/ e-Learning Designer works collaboratively with internal clients to assess needs, coordinate, design, develop, and deliver interactive learning solutions through a variety of mediums in support of the overall strategy and goals of Accredo business areas.Learning interactions will focus on competencies such as skill and knowledge transfer in soft skills and process and procedural knowledge.Candidate must have a solid understanding of adult learning concepts and in-depth knowledge and experience in the Instructional Design process, to include the ability to: Understand and have in-depth experience with the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model to create effective training solutions to meet business needs Conduct needs assessment and other types of analysis to identify gaps in employee performance or knowledge Demonstrate...

The Diversity, Equity and Inclusion, Recruitment Strategist will be responsible for leading and implementing enterprise talent acquisition strategies in partnership with key business and HR leaders across our global business. In this highly visible role, this individual will have the opportunity to consult with the broader Talent Acquisition organization to create and implement best in class diversity and inclusion recruitment strategies. This position is a critical role within the Early Career and Diversity recruitment team; and will lead partnerships with organizations, universities, and initiatives to broaden the candidate reach and drive intentional inclusion.The Diversity, Equity and Inclusion, Recruitment Strategist will have key relationships with leaders across the company to inform and consult on talent acquisition strategies. They will represent Cigna at various national, regional, and global conferences on the topic of D talent acquisition strategies. This individual will...

We are searching for aSenior Recruiter thatwill support professional level roles within the Technology Services organization.The Senior Recruiter will be responsible for turning the business strategy into an actionable recruiting strategy and building proactive recruiting plans to address critical talent gaps, helping the organization assess and select talent for both today's and tomorrow's business needs and ultimately creating competitive advantage in the business and talent marketplace. The position requires extensive proactive recruitment and sourcing strategies. This is a great opportunity to join Cigna's growing Talent Acquisition Organization!ResponsibilitiesConsult with senior business and HR leaders on critical talent gaps and drive an effective and efficient talent strategy in support of the business.Understand the US Technology Services business strategy, consult on the overall aligned talent strategy.Drive a strong talent assessment process and rigor.Proactively share...

After completion of application, be sure to complete the required assessment to continue in the hiring process.As an Intake Representative in eviCore healthcare's Non-Clinical Call Center, you will serve as the main point of contact for inbound callers as you manage their benefits needs from start to finish. This includes processing requests for service, speaking with physicians' offices and sites where the procedures will take place, as well as capturing and entering the necessary demographic and medical information in order to build the case file. You will also provide status updates and serve as a liaison to our clinical staff when needed.Upon joining us, you will attend 6 weeks of in-depth training to help ensure your success here at eviCore healthcare. After training, a mentor and supervisor will guide your performance as you take inbound calls from doctor's offices and/or diagnostic centers, through a computer generated system. The ability to multitask will be key, as you will...

Remote, Work from home, United StateseviCore is hiring a Sr. Data Analyst to support data ingestion projects within the Enterprise Data Office. You will lead member eligibility and provider network data requirement sessions and create logical data designs for developers.Requirements:Bachelor's degree in Computer Science, Information Technology; or equivalent experience.5 - 7+ years' experience with systems analysis, data analysis and requirements gathering in Healthcare industry experience is required.Must have a thorough understanding of how to interpret customer data and business needs and translate them into technical designs for loading and extracting data considering all downstream impacts for member, provider look up, eligibility rules, program specifications, case build, to letter generation and authorization exports.Possess a solid knowledge of a query language, and understand software design principles.Solid understanding of data modeling design, data quality principles,...

Remote, Work from home, United StatesSummary:Lead and participate in medium to large scale projects by reviewing project requirements. Translating requirements into solutions, write code, unit tests, ensure code coverage, communicate status and issues across team while collaborating with product, project and cross-functional teams. Ensuring on-time delivery.Troubleshooting complex problems, identifying code defects and collaborating with other developers on defect fixes.Provide support to business by responding to and raising user story questions, concerns and issues. Identifying strategies to implement features and functionality in regular cadence with short and long term plan.Write technical documentation. Work on multiple projects with varying deadlines. Coordinate work with business, QA and other teams including offshore Development. Communicate with technical management and other departments, reporting statuses and risks.Work under minimal supervision. Will be provided with...

Job Summary: Help architect our future. Be a leader of leaders. Get ready for your perfect job, one that encourages you to think strategically yet stay connected with Cigna's cross-functional teams. Do you have Medicare product experience? If so, prepare to innovate, create, and inspire! In this role, you will be supporting our Part D product strategy efforts, including competitive intelligence, plan design, annual bid process, and bid quality control coordination. Core Responsibilities: Provide counsel and advice to top management on significant product strategy matters, often requiring coordination between organizations. Drive the development of product definition and solution plans to optimize the company's products and services portfolio. Evaluate business opportunities to define and optimize the product portfolio and solution alternatives through analysis and understanding of targeted markets, market trends, new technology, customer business issues and the...

Job Location: Remote, Work from home, United States Summary: The VP Supplemental Benefit Sales, Broker Channel within Cigna Supplemental Benefits (CSB) will be a critical team member responsible for making CSB a market leader in the Medicare Supplement and Supplemental Health markets. This individual will be part of a growth engine for the organization and will lead a team of Regional Vice Presidents and a portion of our broker partners. You will hire, train, and motivate a team that will deliver industry leading results by developing a best in class channel. Key responsibilities include: Develop the strategy and implementation of distribution items related to working in the Medicare Supplement and Supplemental Health markets. Lead a team of two Regional Vice Presidents that are responsible for cultivating relationships with National Marketing Organizations (NMO's) and their downline partners. Assess competitors' distribution capabilities and make recommendations on...

Work from home - Portland, OR (must be located in or near area) First 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. Travel - L ocally 75% (25% up to 150 mile radius) Reliable transportation, valid driver's license, and insurance required (mileage reimbursement provided) Valid Oregon Insurance license will be required Now let's talk about the role: SUMMARY: Responsible for the execution of the Cigna Medicare Advantage strategy for local topline sales agencies, directly contracted agents, and broker down-line sales within their market for the book of business they manage through training, relationship...

Work from home - South Florida: Dade, Broward or Palm Beach (must be located in one of these areas) Summary Owns the output of a key discipline within Medicare Network Operations and typically manages a team of Network Management job family roles. Responsible for the management of the physician, provider and/or institutional network, which may include network development, contracting, credentialing, provider relations, provider services, and operations. Develops programs to recruit, service, train, and reimburse physician and providers. Designs and implements programs to maintain positive relationships between the health plan, physician, providers, and practice manages. May also be responsible for providing policy administration for provider networks and ensuring contractual compliance with governmental regulations. Strong experience in contracting for managed care and/or integrated provider systems. Experienced in managed care, membership enrollment, claims and/or pharmacy benefits...

Must live in California to be considered for this position Responsibilities The Transplant Case Manager interacts with benefit specialist and claims staff for claim payment direction to ensure correct interpretation of transplant contracts and to apply payments accurately.Assists in service marketing and/or account management functions for service center-based customers, as assigned.Assists Sales Account Executive in communicating status and/or resolving issues for service center-based customers, as assigned.Participates on committees, task forces and other company projects, as assigned.Supports training initiatives or audits of case files, as assigned.Demonstrates sensitivity to culturally diverse situations, clients and customers.Any other assigned tasks as deemed necessary to meet business needs.Additionally the candidate will be responsible for the adoption and demonstration of the Consumer Health Engagement cultural beliefs. They will be responsible for role modeling the six...

US Remote, Work from homeResponsible for directing all aspects of new client implementations, client expansions and existing clients implementing new programs/features . Maintains ultimate responsibility for the successful completion of an implementation and the quality of the deliverables provided by the implementation team. This position produces project schedules, manages issues and risks, manages the change control process, organizes tasks and resources, reports on progress and communicates directly with the client Project Manager.This position's duties include:Understanding client strategy and developing relationships within the client implementation teamInfluence stakeholders in a clear, confident and collaborative manner when articulating concepts, challenges, complexities in order to drive standards and best practices.Demonstrate and promote a genuine concern for the stakeholder, listen fully and actively to truly understand what others are saying, make decisions based on an...

Remote, Work from homeEPIC Certified Security and Access RequiredThe Epic Application Development Analyst will primarily be responsible for developing, supporting and maintaining Epic Security and Access. Qualified candidates must be certified in Epic Security and someone who works well in a fast-paced setting. In this position, you will have a major role in developing and maintaining Epic application solutions by investigating processes to understand data and communications flow with individual tasks and transactions within the organization's Integrated Delivery System. One or more Epic certifications and Badges are desirable in any of the following module: Epic Secuirty. Experience analyzing and interpreting customer requests and executes basic tasks in Epic Security access. Highly desire experience executing Epic Security modifications to increase operating efficiency, achieve long and short-term goals along with ensuring efficient integration with all Epic applications. Strongly...

Remote, Work from homeEPIC Certified Required for Cadence/Prelude Summary: The Epic Application Development Lead Analyst will primarily be responsible for developing, supporting and maintaining Epic's Cadence application with emphasis on innovations and analytics strategies. Qualified candidates must be certified in Cadence and Prelude.One or more Epic certifications are desirable in any of the following modules: Referrals, Canto/Haiku, RTE, and/or MyChart. You will participate in the planning, testing and scripting needed with Epic system updates, fixes and enhancements, as well as assist with completing assigned deliverables related to strategic technology initiatives and enduser training as needed. Desired candidate should possess strong analytical skills and have experience working with business partners and end-users. Responsibilities: Provide support of application incidents reported through the help desk including 24/7 on call coverage as requiredProvide analytical assistance...

After completion of application, be sure to complete the required assessment to continue in the hiring process.As an Intake Representative in eviCore healthcare's Non-Clinical Call Center, you will serve as the main point of contact for inbound callers as you manage their benefits needs from start to finish. This includes processing requests for service, speaking with physicians' offices and sites where the procedures will take place, as well as capturing and entering the necessary demographic and medical information in order to build the case file. You will also provide status updates and serve as a liaison to our clinical staff when needed.Upon joining us, you will attend 6 weeks of in-depth training to help ensure your success here at eviCore healthcare. After training, a mentor and supervisor will guide your performance as you take inbound calls from doctor's offices and/or diagnostic centers, through a computer generated system. The ability to multitask will be key, as you will...

Remote, Work from homeEPIC Certification required for HIM and Identity Summary: The Epic Application Development Lead Analyst will primarily be responsible for developing, supporting and maintaining Epic's HIM Module with emphasis on innovations and analytics strategies. Qualified candidates must be certified in Health Information Management and Identity.One or more Epic certifications are desirable in any of the following modules: Release of Information, Deficiency Tracking. You will participate in the planning, testing and scripting needed with Epic system updates, fixes and enhancements, as well as assist with completing assigned deliverables related to strategic technology initiatives and enduser training as needed. Desired candidate should possess strong analytical skills and have experience working with business partners and end-users. Responsibilities: Provide support of application incidents reported through the help desk including 24/7 on call coverage as requiredProvide...

Remote, Work from homeEpic Healthy Planet/CareEverywhere Certification highly preferredThe Epic Application Analyst III will primarily be responsible for developing, supporting and maintaining Epic's Healthy Planet module with emphasis on population health and analytics strategies. Qualified candidates certified in Healthy Planet/CareEverywhere highly preferred.One or more Epic certifications are desirable in any of the following modules: EpicCare Ambulatory and CareEverywhere. You will participate in the planning, testing and scripting needed with Epic system updates, fixes and enhancements, as well as assist with completing assigned deliverables related to strategic technology initiatives and enduser training as needed. Desired candidate should possess strong analytical skills and have experience working with business partners and end-users. Responsibilities: Provide support of application incidents reported through the help desk and on call coverageProvide analytical assistance...