Product Management Lead Analyst - Express Scripts - Hybrid - The Cigna Group
Bloomfield, CT
About the Job
The Regulated Markets Services team is responsible for ensuring the execution of key operations accountabilities associated with all regulated lines of business including Medicare, Medicaid, and Marketplace (Exchange / Health Care Reform). The team supports Pharmacy Benefit Management (PBM) delegated responsibilities associated with Call Center and Grievances oversight, regulatory audit support, issue management and analytics.
The Lead Analysts’ primary role will be to support Call Center and Grievance functions as it relates to the Medicare Prescription Payment Plan (M3P) supporting initiatives to ensure member/client and internal satisfaction and alignment with both regulatory and client contractual support. When necessary the analyst will also provide functional SME support to client facing discussions.
Key Responsibilities:
+ Provides advanced professional input to complex assignments/projects.
+ Works autonomously, only requiring “expert” level technical support from others.
+ Facilitates the intake, triage, root cause analysis, mitigation, impact analysis and closure of all client issues associated with regulatory compliance of Call Center and Grievances
+ Promotes the tracking and documentation of all team activities in associated systems
+ Supports the M3P Product Team and Account Teams with function specific communications needs via account team/client inquiry requests, Field Alert development, deliverable reports and presentations
+ Compiles and evaluates data on the functional performance. Utilizes in-depth professional knowledge and acumen to develop models and procedures and monitor trends.
+ Exercises judgment in the evaluation, selection, and adaptation of both standard and complex techniques and procedures.
+ May assist, coordinate or lead portions of mid-size projects. Supports and provides direction to more junior professionals.
+ Exhibits proven ability to work cross-functionally in development and execution of operational plans aligned to enterprise goals and in support of the needs of our clients.
+ Exercises considerable creativity, foresight, and judgment in conceiving, planning, and delivering initiatives.
+ As necessary, follows audit support processes to notify to Express Scripts of client audit needs, facilitate Client/Express Scripts preparation and support for audit scope and document completion of all audit deliverables and findings
Ideal Candidates will offer a combination of the following:
+ Bachelor’s Degree with a preferred focus of Health Care Administration or Business
+ At least one year experience in a health plan or PBM setting. Medicare, Medicaid and Marketplace experience a plus.
+ Able to balance high priority, long-term projects with short-term, immediate deadlines
+ Creative thinker and exceptional problem solving skills
+ Ability to follow processes and document information consistently and timely to meet obligations
+ Able to translate technical data concepts to business partners for understanding and alignment
+ Proven ability to function in a heavily matrixed environment.
+ Extensive knowledge of Microsoft Office products (particularly Excel, Word, Power Point, etc.).
+ Experience leading projects and working with cross functional teams, especially Business and Marketing communications teams
Other Essential Skills:
+ Excellent process mapping and analysis skills
+ Open communicator; excellent oral and written communication skills
+ Ability to work effectively in dynamic, rapidly changing, team-based environment across multiple functions and in support of diverse regulatory obligations.
+ Critical thinker and creative problem solver, who exercises good judgment in resolving difficult situations, prioritizes and can balance needs with enterprise objectives
+ Ability to work in a fast-paced deadline-driven environment, and juggle multiple, sometimes competing, priorities and requirements
+ Ability to motivate, influence and connect others
+ Ability to influence direction and action; build and leverage internal relationships
+ Goal oriented and personally accountable; resourceful and self-directed
+ Adaptable and flexible; open minded, innovative and creative – seeks ‘out of box’ solutions
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:_ _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._
The Lead Analysts’ primary role will be to support Call Center and Grievance functions as it relates to the Medicare Prescription Payment Plan (M3P) supporting initiatives to ensure member/client and internal satisfaction and alignment with both regulatory and client contractual support. When necessary the analyst will also provide functional SME support to client facing discussions.
Key Responsibilities:
+ Provides advanced professional input to complex assignments/projects.
+ Works autonomously, only requiring “expert” level technical support from others.
+ Facilitates the intake, triage, root cause analysis, mitigation, impact analysis and closure of all client issues associated with regulatory compliance of Call Center and Grievances
+ Promotes the tracking and documentation of all team activities in associated systems
+ Supports the M3P Product Team and Account Teams with function specific communications needs via account team/client inquiry requests, Field Alert development, deliverable reports and presentations
+ Compiles and evaluates data on the functional performance. Utilizes in-depth professional knowledge and acumen to develop models and procedures and monitor trends.
+ Exercises judgment in the evaluation, selection, and adaptation of both standard and complex techniques and procedures.
+ May assist, coordinate or lead portions of mid-size projects. Supports and provides direction to more junior professionals.
+ Exhibits proven ability to work cross-functionally in development and execution of operational plans aligned to enterprise goals and in support of the needs of our clients.
+ Exercises considerable creativity, foresight, and judgment in conceiving, planning, and delivering initiatives.
+ As necessary, follows audit support processes to notify to Express Scripts of client audit needs, facilitate Client/Express Scripts preparation and support for audit scope and document completion of all audit deliverables and findings
Ideal Candidates will offer a combination of the following:
+ Bachelor’s Degree with a preferred focus of Health Care Administration or Business
+ At least one year experience in a health plan or PBM setting. Medicare, Medicaid and Marketplace experience a plus.
+ Able to balance high priority, long-term projects with short-term, immediate deadlines
+ Creative thinker and exceptional problem solving skills
+ Ability to follow processes and document information consistently and timely to meet obligations
+ Able to translate technical data concepts to business partners for understanding and alignment
+ Proven ability to function in a heavily matrixed environment.
+ Extensive knowledge of Microsoft Office products (particularly Excel, Word, Power Point, etc.).
+ Experience leading projects and working with cross functional teams, especially Business and Marketing communications teams
Other Essential Skills:
+ Excellent process mapping and analysis skills
+ Open communicator; excellent oral and written communication skills
+ Ability to work effectively in dynamic, rapidly changing, team-based environment across multiple functions and in support of diverse regulatory obligations.
+ Critical thinker and creative problem solver, who exercises good judgment in resolving difficult situations, prioritizes and can balance needs with enterprise objectives
+ Ability to work in a fast-paced deadline-driven environment, and juggle multiple, sometimes competing, priorities and requirements
+ Ability to motivate, influence and connect others
+ Ability to influence direction and action; build and leverage internal relationships
+ Goal oriented and personally accountable; resourceful and self-directed
+ Adaptable and flexible; open minded, innovative and creative – seeks ‘out of box’ solutions
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:_ _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