Remote, Work from home (Memphis, TN) with 50% travel in the Southeastern US. Clinical Pharmacy Consultant (Clinical Account Manager) As part of Cigna Pharmacy Management, the Clinical Pharmacy Consultant serves as the primary pharmacy benefits subject matter expert in an assigned geographic market and support role with Medical Sales to provide retention and renewal activities for an assigned book of business. The Pharmacist in the Clinical Pharmacy Consultant position will be responsible for developing and maintaining relationships with internal stakeholders, brokers/consultants and external Clients to advance the Cigna Pharmacy Management Client retention and growth strategies. The primary role of the Clinical Pharmacy Consultant include: Retain the assigned book of business Be present to educate and consistently advance the knowledge of pharmacy within the Cigna Medical sales organization Partner with the Medical Sales teams, client and broker/consultants to optimize the...

We are searching for a Senior Recruiter to support professional level roles within the U.S. Commercial Business (Sales and Network Contracting) 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. This is a fantastic opportunity to join a best in class recruiting organization! In this role you will: Consult 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 U.S. business strategy, consult on the overall aligned talent strategy. Drive a strong talent assessment process and rigor. Proactively share market and competitive intelligence to inform talent,...

Remote, Work from home, United States As part of the Data Strategy team, this individual plays a key role in defining data technology solutions and guiding others to align their solutions t..

Delivers specific delegated Customer Service tasks assigned by a supervisor. Receives requests by mail, telephone, or in person regarding insurance claims/policies. Responds to inquiries from polic.. by Jobble

**Remote, Work from home - United States**Internal Title: Business Analytics Senior AnalystExternal Title: Business Analyst**Summary:**Cigna's Medicare Advantage (MA) business is a key driver of the company s overall growth. Analytics is a critical enabler of MA growth, and we continue to work with our partners to build tools and capabilities to enable our leadership team to make data-driven business decisions that support our growth strategy. The MA Sales Analytics team partners closely with a range of business leaders, using data and insights to inform a wide variety of decisions, including market expansion, customer retention, Marketing effectiveness and the sales distribution strategy.The ideal candidate for the Business Analyst role will have a deep analytics background, familiarity with Medicare businesses, and experience partnering with all levels of leadership. They must be comfortable working in a fast-paced, changing environment, and be comfortable with ambiguity. The...

After completion of application, be sure to complete the required assessment to continue in the hiring process.As an Intake Representative in eviCore healthcares 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...

Software Engineer: Express Scripts is looking for Multimedia expert to develop voice, text and chat solutions in the contact centers. This includes support of all the outbound multimedia applications, corresponding business transactions and production support. ESSENTIAL FUNCTIONS: Define multimedia requirements with the business. Build, configure and implement multimedia applications utilizing conversational AI. Devise and present solutions to larger audience to ensure buy in by both business and technical teams. Troubleshoot and resolve issues related to multimedia products as a result of alerts or customer complaints. This includes identification of root cause and prevention measures. Participate in implementation and support expansion of new conversational AI initiatives. Interface with QA and business users on need basis for any issues/challenges. Work closely with onsite and offshore team in delivering best in class solution in Contact center space. Participate in 24X7...

Job Location: Remote, Work from Home, United StatesSummary:The Agile Product Owner Senior Advisor represents the "voice of the customer" at the team level, maintaining and prioritizing the Product Backlog, to ensure that the team is working on stories that maximize business value and deliver necessary fixes and functionality to all customers. You must have strong business skills and experience with either past experience working with technology teams, or the ability and interest to learn how to work with technology teams.You will provide expert content/professional leadership on complex assignments/projects. Exercises considerable creativity, foresight, and judgment in conceiving, planning, and delivering initiatives. Uses deep professional knowledge and acumen to advise functional leaders. Focuses on providing thought leadership but works on broader projects, which require understanding of wider business. Recognized internally as a subject matter expert.The Agile Product Owner...

Are you looking to hire game changers for Cigna? Do you have experience recruiting data and analytic professionals? This position may be calling your name!We are searching for a Senior Recruiter that will support professional level roles within the Global Data & Analytics (GDA) 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.Responsibilities Consult 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 GD business strategy, consult on the overall aligned talent...

POSITION MISSION - FUNCTION The CAC Embedded Care Coordinator (RN) is a member of a team of nursing professionals who supports discharge planning from acute and skilled nursing facilities. This role supports assigned Medical Groups and clinicians with coordination of care and community services for high-risk patients in the outpatient setting. This role supports efforts to improve the delivery of care the assigned Medical Group's patients with Cigna coverage, and to enhance the organization's overall performance. RESPONSIBILITIES: [Key position functions which support the critical success factors] * Identifies and refers appropriate patients to eligible programs within assigned Medical Groups and Cigna, such as diabetes and nutrition services, personal health team, health advisors, and complex case management. * Coordinates care of the high-risk targeted population in an appropriate, efficient, and cost-effective manner. * Assists with developing and updating the Key Focus Action...

After completion of application, be sure to complete the required assessment to continue in the hiring process.As an Intake Representative in eviCore healthcares 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...

POSITION SUMMARY The Software Engineering Senior Advisor uses in-depth knowledge and experience to implement transformational solutions that involve .net, entities/api and React UI. Creates detailed specifications, implement enhancements, conduct quality assurance reviews of peer's application programming, and act as a resource for team members with less experience.Provides counsel and advice to top management on significant Application Development matters, often requiring coordination between organizations. Acts as the designer for complex major systems and their subsystems utilizing a thorough understanding of available technology, tools and existing designs. Provides comprehensive consultation to business unit and IT management and staff at the technical level on all phases of application programming and processes for diverse development platforms, computing environments (e.g., host based, distributed systems, client server, software, hardware, technologies and tools, etc.). JOB...

Remote, Work from Home, United States The successful candidate will be responsible for all aspects of the credentialing and re-credentialing processes. The Coordinator will assess risk and perform sanctions monitoring to ensure compliance with Cigna's policies, NCQA, and standards for Medical, Behavioral and Dental businesses. Responsibilities: * Reviews credentialing and re-credentialing files to determine risk and prepares summaries of all risk files requiring National Credentialing Committee Review. * Reviews all newly identified sanctions and prepares summaries of all sanctions requiring National Credentialing Committee review. * Ensures documentation is prepared in time for committee packet mailing deadline. * Ensure timely and professional communication with internal/external customers as needed in order to expedite timely resolution via phone, email, and fax. * Correct any elements listed on the errors/quality reports as well as any other identified reports. * Consistently...

This role supports the Network Quality & Innovation organization and the associated functional processes within ConnectedCare Provider Operations. This position will conduct quality activities that measure and analyze the quality and consumption of provider data. Activities may include conducting focused audits, utilizing quality tools, analyzing root cause and performing analytical techniques. Along with these duties, this role improves the quality of the data, the process, and improvements in data consumption. The Business Analyst will also identify defects and will contribute to pinpointing the causes and offer recommendations for prevention. This role will maintain a strong focus on facts and data to understand the quality of our network, contracts, and demographics in Provider data.The Business Analyst should be proficient conducting sample audits, designing and maintaining audit procedures, implementing quality inspections, assisting in the development and enhancement of...

Remote, Work from home, United States The position requires strong financial and/or actuarial background and proven ability to work collaboratively with cross functional teams and business partners. Requires strong communication and project management skills to provide administrative support for the Medicare bid submission process. Performs actuarial analyses for Medicare Advantage business, including, but not limited to: medical expense analyses and projections, financial forecasts, Medicare Part C bid development, regulatory (CMS) bid submissions, actuarial modeling/analysis, ad hoc actuarial analyses/advice as needed. Will participate in strategic conversations and decision-making Medicare segment leadership as part of the process.Responsibilities:Primary responsibilities include Actuarial / Financial analysis and oversight, project management and strategic communication for Medicare bid submission process. Other responsibilities include: Provide project management support of key...

Remote, Work from homePRIMARY FUNCTION:This position is responsible for coordinating, documenting, and assisting in solving business problems that arise within the Stars and Risk Adjustment department. This position will collaborate with matrix partners across the organization to address business needs through operational, analytics, or otherwise solutions. MAJOR RESPONSIBILITIES Review intake requests and conduct relevant outreach to business owners for requirement gathering and next step documentationSuccessfully ideate on solutions and execute on the collaborate intervention techniques that are agreed upon between the business and the analystWork with matrix leadership across the organization to successfully prioritize and assist in the execution of business needsSeek to actively understand current processes to drive innovations for sustainable and scalable enhancementsMonitor the Stars and Risk Adjustment Enablement intake system including prioritization, assignment and...

This role is Flex /WFH which allows most work to be performed at home or on occasion at a Cigna office location . Employees must be fully vaccinated if they choose to come onsite. The Product Manager on the Pharmacy Product team will be responsible for leading the development and launch of new financial products and product enhancements.This Product Manager will manage a team of three FTEs and manage the development, launch and maintenance of pharmacy financial programs (e.g., SafeGuard for Cigna, Rebate Point of Sale, Rebate Enhancements, and Performance Guarantees). The role will be responsible for identifying high value financial programs for enterprise funding, developing/ writing detailed requirements, explaining complex financial instruments in easy to understand ways and effectively work with cross functional players to operationalize enhancements and net new innovations. This individual must have financial acumen, be detailed orientated, highly organized, a strong...

Job Description:The Patient Care Technician serves as a technical expert to call centerteams to assist with efficient resolution of member and client related issues. They provide direction and guidance to less experienced team members. Act as a liaison between pharmacists, pharmacy, account management, customer service and the patient to research and resolve problems that arise. Recognize and recommend improvements to processes and procedures. Uses full knowledge of the job to perform activities that support pharmacy management operations under general supervision in the administration of pharmacy benefit for lines of business. Typically a certified pharmacy technician.ESSENTIAL FUNCTIONS Translate prescriptions filled out by the prescriber and enter information in the patient's profile in accordance with state regulations.Quality assurance, prescriber and patient outreach and adverse event reporting.Research current and past prescription ordersManeuver through several different...

Have you heard? Express Scripts is now part of Cigna. Together, we've got big plans. How big, you ask? We want to change health care to make it more affordable, more personalized, and more focused on helping the whole person to achieve better health outcomes. And that's only the beginning. Read on to learn more about working with us.Transform healthcare and contribute to our industry-leading organization as a Customer Service Representative. Our Customer Service Representatives are dedicated team members who excel at customer service, helping us elevate our Patient Care to new heights. In this crucial role, you are on the front lines with patients, responding to phone inquiries and addressing each with care, detail, and most importantly, empathy.Here's a little more on how you'll make a difference:Help patients understand their pharmacy benefits better. Use the knowledge you gain from training, your problem-solving skills and support from your team answer patient calls...

We are searching for a Senior Recruiter to support professional level roles within the U.S. Commercial Business (Sales and Network Contracting) 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. This is a fantastic opportunity to join a best in class recruiting organization! In this role you will: * Consult 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 U.S. business strategy, consult on the overall aligned talent strategy. * Drive a strong talent assessment process and rigor. * Proactively share market and competitive intelligence to inform...