Category Management Lead Analyst - Claim Intake/ Operations Support - Hybrid - The Cigna Group
Nashville, TN
About the Job
Reports To
_Category Director, Pharmacy & Enterprise Operations_
Role Summary
Accountable for sourcing activities and associated strategies across the Claim Intake/ Enterprise Operations Commodity as it relates to the identification, negotiation and procurement of the various products and functions associated with the Medical (and Dental) claim life cycle services which include, but are not limited to, Direct to Consumer Sales, Electronic Data Interchange (“EDI”), Claims Call Center, Language Translation Services, and other claims support products and services. This includes leading sourcing projects of various sizes and complexities and supporting larger projects. This role will involve the creation, market analysis, strategic development, negotiation, and maintenance for activities around identifying a supplier, managing the competitive process and recommending a supplier that best meets the business objectives. This resource must have experience in dealing with dynamic requirements that are tied to strategic level business and claims operations services In order to effectively engage suppliers, this resource must have experience dealing at various management levels to achieve desired outcomes through sourced engagements.
Responsibilities
+ Identifies opportunities to improve the sourcing approach and procurement process which could have significant financial impact on the organization.
+ Ensures that contracted relationships have enabled supplier performance measurement and reporting function.
+ Analyzes overall business requirements, supplier relationship structures and processes to improve performance and overall value.
+ Analyzes industries, supply, markets, and sourcing best practices to define alternative supplier relationship structures to meet enterprise-wide requirements, manage costs, and maximize value for dollars spent.
+ Manages execution and implementation of sourcing initiatives within assigned commodity.
+ Develops timelines and organizes matrix teams to implement sourcing strategies and initiatives.
+ Manages day-to-day execution of sourcing and contracts process and facilitates involvement of expert resources.
+ Collaborates with business staff and manages development of RFPs and other selection and supplier evaluation tools.
+ Works with Category Lead to develop negotiation strategies and conducting detailed financial analysis to determine market and world class costs for specified products and services.
+ Prepares negotiation and facilitates negotiation strategy in conjunction with the Business Staff and Supply Chain Management leadership where appropriate and able to lead negotiations.
Qualifications
+ BA / BS strongly preferred, ideally in Business, Supply Chain, Claim Operations or related field.
+ 2-3 years-experience in procurement activities
+ Excellent project management skills.
+ Prior military and or law enforcement experience is a plus.
+ Strong communication, facilitation and leadership skills with a proven ability to lead, influence and motivate others.
+ Needs to possess the ability to think multi-dimensionally to identify the optimal, preferred and least acceptable project outcomes and develop supporting strategies for each.
+ Strong time management skills; highly organized and detailed oriented
+ Strong analytical, cross - functional communication skills, teamwork and interpersonal skills.
+ General financial analysis skills and experience.
+ Structured problem solving and decision-making skills.
+ Ability to influence and lead a diverse negotiation team without direct authority.
+ Highly collaborative and collaborates with appropriate experts to solve issues.
+ Makes decisions and takes action to solve a problem for a team or a unit in the organization.
+ Ability to work well in a dynamic and rapidly changing environment, with periods of ambiguity.
+ Articulates potential solution(s) effectively to key executives.
+ Ability to apply fact - based negotiation principles and tactics.
+ Able to perform procurement - related economic and financial analyses.
+ Ability to perform total cost analysis.
+ Ability to provide fact-based advice to decision makers and oversee development of market and industry analysis.
+ Understands strategic and sourcing implications of key industry trends and developments.
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 The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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:_ _SeeYourself@cigna.com_ _for support. Do not email_ _SeeYourself@cigna.com_ _for an update on your application or to provide your resume as you will not receive a response._
_Qualified applicants with criminal histories will be considered for employment in a manner_
_consistent with all federal, state and local ordinances._
_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._
_Category Director, Pharmacy & Enterprise Operations_
Role Summary
Accountable for sourcing activities and associated strategies across the Claim Intake/ Enterprise Operations Commodity as it relates to the identification, negotiation and procurement of the various products and functions associated with the Medical (and Dental) claim life cycle services which include, but are not limited to, Direct to Consumer Sales, Electronic Data Interchange (“EDI”), Claims Call Center, Language Translation Services, and other claims support products and services. This includes leading sourcing projects of various sizes and complexities and supporting larger projects. This role will involve the creation, market analysis, strategic development, negotiation, and maintenance for activities around identifying a supplier, managing the competitive process and recommending a supplier that best meets the business objectives. This resource must have experience in dealing with dynamic requirements that are tied to strategic level business and claims operations services In order to effectively engage suppliers, this resource must have experience dealing at various management levels to achieve desired outcomes through sourced engagements.
Responsibilities
+ Identifies opportunities to improve the sourcing approach and procurement process which could have significant financial impact on the organization.
+ Ensures that contracted relationships have enabled supplier performance measurement and reporting function.
+ Analyzes overall business requirements, supplier relationship structures and processes to improve performance and overall value.
+ Analyzes industries, supply, markets, and sourcing best practices to define alternative supplier relationship structures to meet enterprise-wide requirements, manage costs, and maximize value for dollars spent.
+ Manages execution and implementation of sourcing initiatives within assigned commodity.
+ Develops timelines and organizes matrix teams to implement sourcing strategies and initiatives.
+ Manages day-to-day execution of sourcing and contracts process and facilitates involvement of expert resources.
+ Collaborates with business staff and manages development of RFPs and other selection and supplier evaluation tools.
+ Works with Category Lead to develop negotiation strategies and conducting detailed financial analysis to determine market and world class costs for specified products and services.
+ Prepares negotiation and facilitates negotiation strategy in conjunction with the Business Staff and Supply Chain Management leadership where appropriate and able to lead negotiations.
Qualifications
+ BA / BS strongly preferred, ideally in Business, Supply Chain, Claim Operations or related field.
+ 2-3 years-experience in procurement activities
+ Excellent project management skills.
+ Prior military and or law enforcement experience is a plus.
+ Strong communication, facilitation and leadership skills with a proven ability to lead, influence and motivate others.
+ Needs to possess the ability to think multi-dimensionally to identify the optimal, preferred and least acceptable project outcomes and develop supporting strategies for each.
+ Strong time management skills; highly organized and detailed oriented
+ Strong analytical, cross - functional communication skills, teamwork and interpersonal skills.
+ General financial analysis skills and experience.
+ Structured problem solving and decision-making skills.
+ Ability to influence and lead a diverse negotiation team without direct authority.
+ Highly collaborative and collaborates with appropriate experts to solve issues.
+ Makes decisions and takes action to solve a problem for a team or a unit in the organization.
+ Ability to work well in a dynamic and rapidly changing environment, with periods of ambiguity.
+ Articulates potential solution(s) effectively to key executives.
+ Ability to apply fact - based negotiation principles and tactics.
+ Able to perform procurement - related economic and financial analyses.
+ Ability to perform total cost analysis.
+ Ability to provide fact-based advice to decision makers and oversee development of market and industry analysis.
+ Understands strategic and sourcing implications of key industry trends and developments.
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 The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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:_ _SeeYourself@cigna.com_ _for support. Do not email_ _SeeYourself@cigna.com_ _for an update on your application or to provide your resume as you will not receive a response._
_Qualified applicants with criminal histories will be considered for employment in a manner_
_consistent with all federal, state and local ordinances._
_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._
Source : The Cigna Group