The Cigna Group
Product Management Senior Advisor, Claims Transactions and Adjustments - Express
The Cigna Group, Saint Louis, Missouri, United States, 63146
Overview
The job profile for this position is Product Management Senior Advisor, which is a Band 4 Senior Contributor Career Track Role.
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.
Description of Position The Product Management Senior Advisor is responsible for supporting Claim and Adjustment data that is provided to our clients. To help educate clients on methods of delivery, interpreting the data and best practices for using the data within their systems. The position will also support internal stakeholders and account teams as a subject matter expert on claim and adjustment data. This position will ensure responsibility in establishing a working partnership and process flow between the client, account management, finance and data analytics team(s). Support on client calls providing overview of the processes, expectations, education and answering client questions as needed.
Position Details
Serve as the Regulated Markets business owner for Claim and Adjustment data that is provided to our clients
Meet with account teams and clients, educating how data claim and adjustment data is provided and how to understand and use the data
Understanding project changes due to new or changing regulations and the impact to data and files provided internally and to clients
Establishing a working partnership and process flow between the client, account management and data analytics team(s)
Responsible for gathering business requirements and define alignment on functional requirements and rules.
Analyze trends and data to develop recommendations to ensure client needs, compliance metrics, and/or internal support is met
Ensure internal/external policies and procedures are documented, maintained, and followed
Understand and use system tools to research and resolve issues and concerns
Cross-train and support other team initiatives where appropriate
Exhibit problem solving capabilities in a complex environment
Participate in cross-functional projects or work teams
Ability to appropriately interact with clients/account teams including:
Communicate information about their area of expertise
Meet with clients to educate and also help troubleshoot concerns
Manage account team expectations and ensure appropriate follow-up
Qualifications
College degree or equivalent experience preferred.
5 or more years work experience, preferably in business analysis.
Regulated Markets experience preferred
Familiarity with pharmacy adjudication and other PBM operations
Proficient in collecting and analyzing large data sets
Strong strategic, analytical, problem solving, and project management skills required
High attention to detail and proven ability to manage multiple, competing priorities simultaneously.
Internal and External Customer focused in all activities
Excels working cross functionally, at all levels of the organization to own, drive, manage and continuously improve the processes, perform root cause analysis, and develop reporting, and communication processes
Knowledge of PBM/healthcare industry or specialized business area
Ability to see business needs outside of one’s own work area
Ability to execute tactics under a strategic vision
SQL skills are highly desirable
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.
For this position, we anticipate offering an annual salary of 110,700 - 184,500 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
Benefits and Additional Information We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna.
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.
Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this site.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
We look forward to reviewing your application.
#J-18808-Ljbffr
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.
Description of Position The Product Management Senior Advisor is responsible for supporting Claim and Adjustment data that is provided to our clients. To help educate clients on methods of delivery, interpreting the data and best practices for using the data within their systems. The position will also support internal stakeholders and account teams as a subject matter expert on claim and adjustment data. This position will ensure responsibility in establishing a working partnership and process flow between the client, account management, finance and data analytics team(s). Support on client calls providing overview of the processes, expectations, education and answering client questions as needed.
Position Details
Serve as the Regulated Markets business owner for Claim and Adjustment data that is provided to our clients
Meet with account teams and clients, educating how data claim and adjustment data is provided and how to understand and use the data
Understanding project changes due to new or changing regulations and the impact to data and files provided internally and to clients
Establishing a working partnership and process flow between the client, account management and data analytics team(s)
Responsible for gathering business requirements and define alignment on functional requirements and rules.
Analyze trends and data to develop recommendations to ensure client needs, compliance metrics, and/or internal support is met
Ensure internal/external policies and procedures are documented, maintained, and followed
Understand and use system tools to research and resolve issues and concerns
Cross-train and support other team initiatives where appropriate
Exhibit problem solving capabilities in a complex environment
Participate in cross-functional projects or work teams
Ability to appropriately interact with clients/account teams including:
Communicate information about their area of expertise
Meet with clients to educate and also help troubleshoot concerns
Manage account team expectations and ensure appropriate follow-up
Qualifications
College degree or equivalent experience preferred.
5 or more years work experience, preferably in business analysis.
Regulated Markets experience preferred
Familiarity with pharmacy adjudication and other PBM operations
Proficient in collecting and analyzing large data sets
Strong strategic, analytical, problem solving, and project management skills required
High attention to detail and proven ability to manage multiple, competing priorities simultaneously.
Internal and External Customer focused in all activities
Excels working cross functionally, at all levels of the organization to own, drive, manage and continuously improve the processes, perform root cause analysis, and develop reporting, and communication processes
Knowledge of PBM/healthcare industry or specialized business area
Ability to see business needs outside of one’s own work area
Ability to execute tactics under a strategic vision
SQL skills are highly desirable
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.
For this position, we anticipate offering an annual salary of 110,700 - 184,500 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
Benefits and Additional Information We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna.
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.
Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this site.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
We look forward to reviewing your application.
#J-18808-Ljbffr