United States onlyPOSITION SUMMARY
Leads and provides subject matter expertise in collaboration with client services, claims, implementations, clinical, Non-Clinical, and IT organizations to manage new and existing workflows. Monitors overall operations including review of internal reports and ad-hoc data analysis associated with operational workflows. Identifies ways to improve or enhance operational performance.
RESPONSIBILITIES
• Gains an understanding for utilization management, claims operations, IT operations, and call center operations
• Develops operational specific expertise in becoming a subject matter expert in the technical and operational aspects of the company
• Provides subject matter expertise during the implementation of new clients by integrating workflows into current operations
• Assists with functionality and regression testing for program specific enhancements, implementations and code
• Provides operational expertise to client services and client operations managers in research and resolution of issues and requests
• Builds presentations and completes analyses to assist the program lead in communications to senior management
• Manages designated special projects, process improvements and project plans
• Create reports using Microsoft SQL; write SQL queries against SQL server database to validate reports; and provide performance tuning and maintenance of existing reports.
• Translates business request into system rules; evaluates existing functionality for operational efficiencies and maintains historical record of system development
• Documents and maintains business workflows, requirements or supports central teams that manage these functions
• Coordinates with key leaders to execute projects
• Assist in preparing internal and external training and direction for clinical and Non-Clinical staff
QUALIFICATIONS
• High School diploma required
- Must have proficiency with MS Word, Excel and MS PowerPoint (Visio preferred as well)
• Ability to manage multiple priorities independently
• Ability to learn basic SQL queries as needed
• Ability to collaborate with various business partners & organize effectively
• Strong verbal and written communication skills
• Understanding of requirements creation and development
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 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: [email protected] for support. Do not email [email protected] 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.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
