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If you are an RN and looking for a Telephonic role, this opportunity is for you! Read on to learn more.
How you'll make a difference:
Take ownership of patient experience via telephone: Provide telephonic education that includes (but not limited to) disease and drug specific education to both patients and caregivers.
Follow clinical protocols and work within the nursing scope of practice and guidelines while assessing and documenting clinical data and intervention.
Be a coach to empower your patients to be at their best.
Focus on the overall well-being of your patients.
Work with the patient's treating physician to inform them of any new symptoms and health-related matters with an entire network of nurses that you can lean on.
At Accredo, you are a part of an eco-system that will support you and advocate for you.
Grow alongside your peers in a patient-centered environment.
Aid our clinical departments with new hire training and mentoring as well as conduct peer-to-peer quality documentation checks to provide feedback to management.
Full time work from home - you MUST reside in a compact state.
Start Date: Monday, January 26, 2026
Shift for this role: 10:30 am to 7:00 pm CST Monday - Friday
Please note, the first 6 weeks of training will be varied and may start between 8am-11:30am EST depending on the week.
The primary responsibility of this role is to provide telephonic education to patients and caregivers following Clinical Protocols and working within the nursing scope of practice and guidelines.
This opportunity allows you to improve the health and well-being of others, while giving them a sense of security
Minimum Qualifications:
Registered Nurse (RN) compact license required
MUST reside in a compact state
2 years or more of relevant experience with an RN License:
Requirements:
* The RN must have an active unencumbered license in the state that they reside and should have completed the NCLEX or a recognized state board exam.
* The RN will be required to apply for or have a compact license as well as the ability, with no restrictions, to apply for additional single state licenses
* Maintaining all nursing licenses required for this role is a condition of employment, and the failure or inability to do so will result in termination of employment.
* Must have taken Microbiology in order to obtain California licensure
* Knowledge and experience in the areas of Neurology / Multiple sclerosis, Rheumatology, Dermatology, Pulmonology, Gastroenterology, Infectious Disease, Asthma, Oncology, or Pediatrics.
* Proficient in using microsoft applications
* Minimum Internet speed: 5MBPS upload/2 MBPS download - Cable broadband or Fiber Optic.
* Excellent phone etiquette
Your Benefits as an Accredo Telephonic Registered Nurse (RN):
Internal Career Training Resources
Tuition Assistance
Medical, Prescription Drug, Dental, Vision and Life Insurance
401K with Company Match
Paid Time Off and Paid Holid...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-12-03 10:00:12
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Medical Principal Job Description
Position scope:
Primarily regional with national level case work for Cigna Healthcare (CHC) -- Cigna.
Summary description of position : A Medical Principal performs medical review and case management activities.
The physician provides clinical insight to the organization through peer review, benefit review, consultation, and service to internal and external customers.
He/she will serve as a clinical educator and consultant to utilization management, case management, network, contracting, pharmacy, and service operations (claims).
This is an entry to mid-level position for a physician interested in a career in health care administration.
Major responsibilities and required results:
* Performs benefit-driven medical necessity reviews for coverage, case management, and claims resolution, using benefit plan information, applicable federal and state regulations, clinical guidelines, and best practice principles.
* Works to achieve quality outcomes for customers/members with a focus on service and cost
* Improves clinical outcomes through daily interactions with health care professionals using active listening, education, and excellent communication and negotiation skills.
* Balances customer/member needs with business needs while serving as a customer/member advocate at all times.
* Participates in all levels of the Appeal process as appropriate and allowed by applicable regulatory agencies and accreditation organizations
* Participates in coverage guideline development, development and maintenance of medical management projects, initiatives and committees.
* Participates in quality processes such as audits, inter-rater reliability clinical reviews, and quality projects
* Serves as a mentor or coach to other Medical Directors and other colleagues in quality and performance improvement processes.
* Improves health care professional relations through direct communication, knowledge of appropriate evidence-based clinical information and the fostering of positive collegial relationships.
* Demonstrates knowledge as a peer reviewer by applying current evidence-based guidelines, including novel treatments, to support high-quality clinical decision-making across medical and behavioral health conditions, diseases, treatments, and procedures.
Medical directors are required to maintain and update their knowledge base through monthly focused updates of Cigna's comprehensive evidence-based coverage policies, as well as through mandatory inter-rater reliability testing, continuing medical education, and maintenance of board certification.
* Addresses customer service issues with mentoring and support from leadership staff.
* Investigates and responds to client and/or regulatory questions to assist in resolving issues or clarifying questions with mentoring and support from leadership staff.
* Achieves internal customer satisfaction and regulatory/accreditation ...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-12-03 10:00:10
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This is a full-time work from home position that must reside within the state of Arizona.
As a Pharmacy Technician with Freedom Fertility, you will be assisting patients in receiving needed medications to help achieve their dreams of building a family.
You'll be empowered to engage patients, insurance companies, and multiple departments to process orders and ensure timely shipment of medications.
This role is very detail oriented, and you'll spend your day working on our computer system, answering incoming calls and making outbound calls to patients to review benefit coverage.
Here's a little more on how you'll make a difference:
* Associate prescription images to patient profiles and create patient profiles in system if needed.
* Prepare prescriptions for processing, including assessing validity of prescription.
* Manually route orders to appropriate stage for processing, validation or clarity from Doctors' offices, insurances and/or patients.
* Accurately enter prescriptions into our system, run test claims, run test claims and support patients with their medication orders.
Use the knowledge you gain from training, your problem-solving skills and support from your team to accurately process prescription claims so they will be dispensed accurately.
* Associate and add insurance/discount program information to patients or specific medication, including setting up coordination of benefits.
* Resolve rejections and update patient on any and all delays in processing accordingly.
* Interact directly with healthcare providers and insurance companies.
Research issues with pharmacists and doctors' offices and provide guidance to our patients about medication coverage.
* Respond to incoming calls from patients with questions about their prescriptions, prescription coverage including copays, as well as setting up patient-driven medication refills.
* Complete multiple tasks without sacrificing attention to detail or customer service.
You will be busy handling multiple requests at any given time as well as documenting information in our system.
What you need to do the job:
* High School Diploma, or GED required.
* Relevant experience or a willingness to learn.
* Valid National Pharmacy Technician certification is required.
* Valid Arizona State pharmacy technician license is required.
* Microsoft Office proficiency and data entry skills
* Basic math skills (addition/subtraction/multiplication)
* Strong attention to detail, accuracy, and quality
* Excellent verbal and written communication skills
* Must reside within the state of AZ.
* Experience working prescriptions claims and knowledge of rejections helpful.
Schedule:
The ability to work a rotating schedule is essential for the position.
Schedule as follows:
* Monday-Friday
* 9:00am-5:30pm EST (2 days per week)
* 10:00am-6:30pm EST (2 days per week)
* 12:30pm-9:00pm EST (1 day per wee...
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Type: Permanent Location: Tempe, US-AZ
Salary / Rate: Not Specified
Posted: 2025-12-03 10:00:08
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Work Hours: Monday to Friday 6:00AM - 2:30PM.
As a Senior Pharmacy Production Clerk you will be responsible for owning the activities and needs within your cell or area of our production environment.
This is a great opportunity to take on new responsibilities and learn the first level of a management career path as well as helping your team be successful.
What you'll do:
* Ensure appropriate distribution of workload and workflow for clerks
* Oversee packing work and ensure it is completed timely and accurately
* Accurately and responsibly operate production equipment to include but not limited to changing labels, cleaning printers, loading bottles, monitoring production equipment, and restocking materials
* Escalate equipment malfunctions as needed
* Serve as the first line resource for questions/issues for clerks in coordination with supervisor
* Promote a positive work environment for team that supports high employee morale and job satisfaction
* Identify and document issues impacting performance and productivity of Clerks, escalate as needed, and provide input for improvement
* Assist lead and supervisor in ensuring that established policies and standard operating procedures are being followed and that individual and team goals for productivity and quality are met/exceeded
* Assist in the development and documentation of policies and procedures for Clerks, including specific training materials and ensuring these documents are current and accurate
* Assist in training new hires and up-training current team members including 1:1's and group sessions regarding procedures, efficiencies, and accuracy
What you'll need:
* High School diploma or GED
* 1+ years' experience in shipping and workflow distribution in a pharmacy related environment
* Leadership exposure preferred
* Ability to work independently, be self-directed
* Effective communication skills
* Basic computer skills required - Outlook, Word, Excel
* Detail and quality oriented
* Ability to lift, push, pull (up to apx.
20 lbs.)
* Willingness to work a flexible schedule/OT/and accommodate heavy work volumes
* Ability to stand for extended periods of time
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 inclu...
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Type: Permanent Location: Tempe, US-AZ
Salary / Rate: Not Specified
Posted: 2025-12-03 10:00:07
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At Integrity Rx Specialty Pharmacy, we ship time-sensitive fertility medications to patients nationwide.
In this role, you will make an impact while experiencing opportunities for cross training and career growth.
How our Shipping Clerks make an impact:
* Pack prescriptions and coordinate paperwork for shipment.
* Ensure medications are packed accurately according to order and other details.
* Charge orders and attach appropriate shipping label.
* Provide suggestions on how to continuously improve our process.
Why become a full-time employee with Cigna?
* Benefits & health coverage effective day 1.
* Holiday, PTO and OT pay.
* Annual bonus potential based on performance.
* Career growth opportunities into pharmacy, fulfillment, and other professional areas regularly available.
* Safety precautions in place (daily temperature checks, masks required for unvaccinated, distancing, hand sanitizer stations, regular deep clean of facility, etc.).
What you need to do the job:
* High School Diploma or GED is required.
* Warehouse/fulfillment or customer service experience preferred but not required.
* General computer skills.
* Strong work ethic with focus on the details, process efficiency and sense of urgency.
* Ability to walk around/be on your feet for duration of shift.
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.
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 ces...
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Type: Permanent Location: Scottsdale, US-AZ
Salary / Rate: Not Specified
Posted: 2025-12-03 10:00:06
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Job Description Summary
The oncology nurse coordinator is the primary point of contact for the Oncology Consult Service.
Delivers on delegated tasks assigned by manager or supervisor(s) of the Oncology Consult Service.
Completes day-to-day tasks with oversight by immediate supervisor and takes direction from manager and/or supervisor(s).
While working independently, the oncology nurse coordinator must track and manage all assigned customer cases through the process and outcomes of each case.
This encompasses:
* New Case consult eligibility evaluation involving coordination with manager, supervisor(s) and Oncology Consult Medical Director as appropriate
* Notifiying Cigna oncology case management of customer eligibility to participate in Oncology Consult Service
* Notifiying oncology provider office of customer benefit eligibility
* Notifying and educating customer of benefit eligibility and obtaining consent to participate
* Follow-up with oncology provider office and customer as needed
* Coordinate referrals to vendors and follow-up accordingly for customer throughout Oncology Consult process flow
* Collaboration with Oncology Consult Medical Director for Oncology Consult cases, as needed
* Track and document each Oncology Consult case through the entire process in OCS system
* Problem solving and escalation of issues as needed
* Report any provider and customer concerns
* Other tasks as assigned
* Hours: Monday-Friday; 8a-5p Eastern
Minimum Education, Licensure and Professional Certification requirement
* Current unrestricted Registered Nurse or Licensed Practical Nurse licensure.
Minimum Experience required
* Minimum 3 years clinical experience preferred; strong oncology experience preferred
* 2 - 4 years' experience in utilization management preferred
Required Skills
* High level of motivation and independence while maintaining accountability to immediate supervisor and manager
* Experience with Isaac and Image One preferred
* Exceptional time management skills required
* High level attention to detail in understanding and solving problems
* Computer skill proficient
* Microsoft Excel and Adobe experience preferred
* Excellent organizational, verbal communication, and written communication skills
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 56,600 - 94,400 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.
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.
Star...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-12-03 10:00:05
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Part time - Per Diem - Onsite Health Coach - Miami FL
Bilingual Spanish strongly preferred
Evernorth Workplace Care offers health care delivery services along with population health and health coaching solutions, conducted in person or virtually.
Our mission is to deliver proactive, personalized, and holistic patient care and coaching by acting on health data and insights to improve the overall health and wellness of our clients' employees, and those they care about most, by providing access to high quality, affordable services where they work and live.
Our Evernorth Workplace Care solution isn't a one-size-fits-all model.
Using data-driven insights, we'll customize a solution that addresses your organization's most pressing needs-creating a more affordable, predictable, and simple health care experience.
Evernorth Workplace Care - Personalized Care Where You Are
Our experienced Health Coach will:
• Provide onsite face-to-face customer coaching and support
• Identify customer health education needs through targeted health assessment activities.
• Collaborate with customers to establish health improvement plans, set personalized evidence-based goals, and support customers in achieving those goals.
• Empower customers to become an active participant in their own health outcomes.
• Assist Customer in overcoming barriers to better health
• Lead and support a variety of Health and wellness promotional activities, such as group coaching, wellness challenges and Health related seminars.
• May perform biometric screenings, including finger sticks, blood pressure, body composition, etc.
• Utilize biometric values and motivational interviewing techniques to collaborate with customer to drive to improve clinical outcomes.
• Provide support for health-related site events, which include open enrollment, wellness committee facilitation, flu shot events, health fairs, etc.
Qualifications :
• Strong Clinical skills with at least 3 or more years of experience health coaching, health education and health promotion
• Bachelor's degree in a health-related field.
Master's degree preferred.
• Registered Dietitian licensed in respective state is preferred
• CPR/BLS certification through the American Red Cross or American Heart Association is required.
• High energy level, with dynamic presentation skills is required.
• Positive role model in demonstrating healthy behaviors
• Passion for health improvement
• Ability to work independently
• Customer-centric focus
• Ability to proactively collaborate professionally with the client and other matrix partners.
• Understand and own a variety of clinical targets and outcome measurements.
Develop action plans that drive clinical value for the customers and clients.
• Proven administrative abilities, with strong computer and software application skills.
• Bilingual Spanish is preferred
Bonus points for :
• CHES (Certified Health Education Specialist)
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Type: Permanent Location: Miami, US-FL
Salary / Rate: Not Specified
Posted: 2025-12-03 10:00:04
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As a Compounding Pharmacy Technician, you will be part of a specialized team supporting high-touch programs designed to enhance patient care.
This detail-oriented role is primarily based in our compounding suite, where you will prepare sterile and non-sterile medications, maintain compliance with USP regulations, and ensure accurate documentation and formula entry.
Key Responsibilities
* Prepare sterile and non-sterile compounded medications according to established protocols.
* Maintain and clean compounding suite equipment and facilities to meet regulatory standards.
* Accurately label, package, and store chemicals and finished products.
* Enter and manage compounding formulas using specialized software.
* Complete daily documentation in accordance with USP guidelines.
Qualifications
* High School Diploma or GED required.
* Valid Massachusetts Pharmacy Technician License required; national certification preferred.
* Proficiency in Microsoft Office and strong data entry skills.
* Strong mathematical skills for prescription calculations.
* Exceptional attention to detail, accuracy, and quality assurance.
* Excellent verbal and written communication skills.
Work Schedule
Monday to Friday, 9:00 AM - 5:30 PM EST
Work Environment
This is a worksite-dependent position and must be performed onsite.
Why Join Cigna?
* Medical insurance coverage starting Day 1
* 401(k) plan with employer match
* Paid Time Off (PTO)
* Competitive benefits package
* Opportunities for professional growth and advancement
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 hourly rate of 17.88 - 26 USD / hourly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
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 Group .
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 improvin...
....Read more...
Type: Permanent Location: Newburyport, US-MA
Salary / Rate: Not Specified
Posted: 2025-12-03 10:00:02
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Accredo Specialty Pharmacy, part of Evernorth Health Services , is seeking a Staff Pharmacist to join their team in Warrendale, PA.
This role is onsite at our office in Warrendale, PA.
This role is worksite dependent and can only be performed onsite.
This position has a 7-week rotating schedule of (4) 10- hour shifts Monday through Friday 9:00 am -8:00 pm ET including a 1-week On Call rotation approximately 4 times per year.
For more than 30-years, Accredo has delivered dedicated, first-class care and services for patients.
We partner closely with prescribers, payers, and specialty manufacturers.
Bring your drive and passion for purpose.
You'll get the opportunity to make a lasting impact on the lives of others.
POSITION SUMMARY
As a Staff Pharmacist with Accredo, you will be responsible for monitoring and assuring compliance to State and Federal Rules and Regulations, FDA requirements, manufacturer contractual Adverse Event and Product Complaint clinical requirements and completing general Quality Assurance Checks.
ESSENTIAL FUNCTIONS
* Provide oversight and quality assurance to pharmacy technicians.
* Interpret physicians' or prescribers' prescriptions.
* Verify and confirm validity of controlled substances.
* Verify prescription information entered in the system by data entry or order entry.
* Back up other pharmacists as needed, perform additional duties as assigned by management, or train less experienced pharmacists.
QUALIFICATIONS
* Graduate of ACPE Accreditation School of Pharmacy with a B.S.
Pharmacy or Pharm.D, degree.
* 1+ years relevant experience.
* Current resident pharmacist license in good standing.
* Advanced problem solving skills and the ability to work collaboratively with other departments to resolve issues.
* Good oral and written communication skills.
* Ability to read and interpret prescriptions.
* Strong focus on customer service, quality and accuracy.
* Ability to manage timelines and meet tight client deadlines.
* Ability to adapt in a changing environment.
* Ability to work a flexible schedule for peak volume times.
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, vet...
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Type: Permanent Location: Warrendale, US-PA
Salary / Rate: Not Specified
Posted: 2025-12-03 10:00:00
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The shift is Monday through Friday 2:00 pm - 10:30 pm EST.
Portions of this shift are eligible for a shift differential.
Position Summary
Express Scripts Pharmacy by Evernorth, is looking for a Fulfillment Staff Pharmacist for our Whitestown, IN location.
In this position you will monitor and assure compliance to State and Federal Rules and Regulations, FDA requirements, manufacturer contractual Adverse Event and Product Complaint clinical requirements and complete general Product Verification Checks.
Essential Functions
* Provide oversight and quality assurance to pharmacy technicians.
* Replenish automated counting equipment
* Perform product verification of technician prepared items
* Address orders with patient specific special handling requests
* Direct supervision of technicians working in all areas of the pharmacy
* Opening, closing, and securing of pharmacy during production hours
* Fill liquid orders requiring pharmacist dispensing
* Maintain quality and efficiency expectations
* Adhere to all state and federal regulations surrounding pharmacy practice
* Training of other pharmacists and/or technicians in functions
* Back up other pharmacists as needed, perform additional duties as assigned by management, or train less experienced pharmacists.
Qualifications
* Graduate of ACPE Accreditation School of Pharmacy with a B.S.
Pharmacy or Pharm.D, degree.
* 1+ year relevant experience.
* Current resident pharmacist license in good standing.
* Advanced problem solving skills and the ability to work collaboratively with other departments to resolve issues.
* Good oral and written communication skills.
* Ability to read and interpret prescriptions.
* Strong focus on customer service, quality and accuracy.
* Ability to manage timelines and meet tight client deadlines.
* Ability to adapt in a changing environment.
* Ability to work a flexible schedule for peak volume times.
This position is work site dependent and can only be performed onsite at our Whitestown, IN location.
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 ori...
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Type: Permanent Location: Whitestown, US-IN
Salary / Rate: Not Specified
Posted: 2025-12-03 09:59:58
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Job Description: Project & Product Manager - Business Enablement (Evernorth Workplace Care)
We are seeking a highly motivated and experienced Project & Product Manager to join our Business Enablement team within Evernorth Workplace Care.
This individual contributor role is pivotal in driving the successful execution of Epic upgrades, Epic Module implementations, product development initiatives, and cross-functional business projects for Health Centers, Custom Coaches, Occupational Health, and Behavioral Health services.
The ideal candidate will be a strategic thinker and proactive executor, capable of managing multiple concurrent projects and product initiatives independently.
This role does not include direct people management responsibilities but requires strong leadership, communication, and organizational skills to influence stakeholders and ensure success.
The successful candidate will bring Epic and/or healthcare experience, with Epic certification considered a strong plus.
This role will interface with Epic support teams operating in Agile; Agile experience is highly desirable.
Scrum certification or project management certification is required.
Familiarity with both Agile and Waterfall methodologies is essential to navigate the diverse project and product landscape.
________________________________________
Key Responsibilities
Project Management
• Lead and manage multiple concurrent Epic and business projects from initiation through completion, ensuring alignment with organizational goals and client commitments.
• Coordinate cross-functional teams including IT, clinical operations, training, and leadership to ensure seamless project execution.
• Develop and maintain detailed project plans, timelines, and documentation in alignment with PMO standards.
• Facilitate project meetings, track deliverables, and ensure timely communication of updates, risks, and mitigation strategies.
• Support Epic enhancements, upgrades, and new module implementations (e.g., Behavioral Health, Occupational Health).
• Drive operating effectiveness initiatives by streamlining workflows and improving change management processes.
• Serve as a liaison between technical and business teams, translating requirements and ensuring readiness for go-lives.
• Ensure compliance with governance standards, regulatory requirements, and workplace readiness protocols.
• Apply Agile and Waterfall methodologies appropriately across projects, ensuring flexibility and alignment with team practices.
Product Management & Development
• Gather and analyze market trends, customer feedback, and competitive insights to inform product decisions.
• Translate business requirements into product features and user stories.
• Partner with IT, Operations, and clinical teams to deliver high-quality product enhancements and new capabilities.
• Monitor product performance and adoption; identify opportunities for optimization and innovation.
• Develop business cases for n...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-12-03 09:59:57
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Sr.
Strategic Account Executive Job Description (O500 band 4)
As a Sr.
Strategic Account Executive, you are the face of Cigna to the client.
Your focus is on spending time with clients in person to cultivate the relationship, addressing client issues, selling annual renewal rate increases in addition to new products and services to expand the relationship.
You will be the trusted advisor and go-to partner for your clients, helping them navigate their business challenges and opportunities by offering strategic insights and ensuring an exceptional client and customer experience.
Key Responsibilities:
* Client Partnership: Act as a key influencer and trusted advisor, cultivating strong, personal relationships with decision-makers and other key stakeholders.
* Industry Expertise: Deeply understand your clients' businesses, their industries, and their unique challenges.
Continuously learn and adapt, offering tailored recommendations that address both their immediate needs and long-term goals.
* Relationship Building: Engage at all levels with both decision-makers and those who influence the decision-making process, ensuring Cigna's voice is heard and valued.
* Market Insights: Keep clients informed about the latest industry trends, helping them stay ahead of the curve and leveraging Cigna's solutions to meet their evolving needs.
* Financial & Underwriting Expertise: Strengthen your understanding of financials and underwriting to guide clients in managing their costs.
Demonstrate the value of Cigna's solutions, including specialty products, and offer creative, proactive solutions to meet their needs.
* Portfolio Management: Drive growth, earnings and retention across your client portfolio, meeting targets for both new business and renewals.
Work to expand Cigna's relationships through cross-selling additional products and services.
* Collaboration: Work closely with underwriting teams to ensure alignment, build trust, and ensure clients receive tailored, strategic solutions.
* Client Experience: Oversee client service requests, ensuring seamless execution and swift resolution by directing them to the right team for problem-solving.
* Channel Management: Manage key partner relationships to ensure client budgets align with reality, holding internal partners accountable and leveraging resources as needed to maintain success.
What You Bring:
* Strong relationship-building skills and a passion for developing deep client connections
* Expertise in financials, underwriting, and providing strategic solutions
* A collaborative mindset with the ability to work effectively across teams
* Proactive, creative thinking to develop tailored solutions for each client
* A desire to grow with a company that's committed to delivering innovative solutions in an ever-changing industry
At Cigna, we value people who bring both strategic insight and a hands-on approach to client management.
If you're...
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Type: Permanent Location: McLean, US-VA
Salary / Rate: Not Specified
Posted: 2025-12-03 09:59:56
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This position can be located anywhere in the USA
Summary
This role delivers professional activities in the Provider Contracting job family.
The position is responsible for dental provider recruitment and contracting as well as managing contracted provider relationships for a specified territory.
Conducts daily outreach to dental offices or providers to develop and maintain positive relationships with the purpose of negotiating a contract for participation in our dental networks.
Ability and willingness to travel frequently within the US including overnight stays.
Conduct quality reviews of Practitioner and/or Facility/Ancillary contracts.
Conducts comparison of contract data relative to provider data and/or demographic and reimbursement data submitted for processing.
Assesses the accuracy of provider data processed in accordance with documented and standard operating policies and procedures.
Applies standard techniques and procedures to routine instructions that require professional knowledge in specialist areas.
Provides standard professional advice and creates initial reports/analyses for review.
May provide guidance, coaching, and direction to more junior members of the team in the Network Management Organization.
Responsibilities:
* Recruiting providers to join Cigna's dental networks (PPO & DHMO):
+ Field Recruitment: Candidates will visit offices in person(25-50% travel)
+ Outbound Calling: Candidates will follow up with visited offices via phone at home
* Identifying, recruiting, contracting, and retaining qualified health care professionals in geographic area within established guidelines to meet health plan needs
* Achieve competitive and cost-effective contracts in assigned areas or assigned client/customer needs
* Negotiate contracts and recruit dental providers to become a Cigna PPO and/or DHMO network provider.
* Explain plans, policies, and procedures to potential providers
* Maintain positive relationships with health care professionals and their office staff extending high quality service
* Conduct negotiations and ensure the smooth operation and administration of provider agreements
* Support and retention of offices in our dental networks
* Complete onsite quality assessments
* Respond to provider inquiries, concerns, complaints, appeals and grievances
* Provide ongoing product education to dentists and their staff
* Work to achieve contract discounts with new providers and current providers through thoughtful negotiation
* Use data and facts to identify and overcome objections
* Prioritize and organize own work to meet deadlines, and reach established personal and department goals
* Conduct ongoing support to contracted providers in our networks via telephone or by personal relationship visits.
Requirements:
* High School Diploma or equivalent required
* 1-3 year plus experience in healthcare administration or provide...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-12-03 09:59:55
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Our Evernorth Workplace Care solution isn't a one-size-fits-all model.
Using data-driven insights, we'll customize a solution that addresses your organization's most pressing needs-creating a more affordable, predictable, and simple health care experience.
Evernorth Workplace Care - Personalized Care Where You Are
This role is for a Family Practice / Internal Medicine Physician to act as a Collaborating Physician for the state of Georgia.
The physician will be required to review 10 charts per months completed by the clinician they are supervising using Epic Care Link.
The physician should be available in person, or by telephone for questions (We need to assign one on the agreement).
It is also important to alert our team if there are any quality concerns affecting patient care.
Duties & Responsibilities:
* Physician will not be required to prescribe medications nor order any lab or diagnostic testing.
The Nurse Practitioners and/or Physician Assistants that collaborate with this Physician will only be performing wellness exams.
They will be prescribing medications and ordering any diagnostic testing.
* Physician will not be responsible to see patients themselves.
* Physician will be responsible to review patient records for past and present health issues upon chart reviews.
* Physician must be able to interpret laboratory data and diagnostic testing when available to assist in diagnosis of medical conditions.
* Should be available by phone and/or email to answer clinical concerns of the in-field providers.
Assessments are typically only performed during normal work hours but should any of their providers work on weekends the physician would need to be available by phone.
* Improves clinical outcomes through interactions with providers primarily centered around chart review.
* The Collaborating Physician must review 10 charts/month and conducts quarterly meetings with the APP on 5 charts
* Participates in quality processes such as medical documentation audits, inter rater reliability actions and quality projects.
* Serves as a mentor or coach to mid-level providers in ongoing quality and performance improvement processes.
* Improves provider relations through direct communication, knowledge of appropriate.
evidence-based clinical information, and the fostering of positive collegial relationships.
* Physician will complete compliance trainings which are primarily web based.
* Physician will not be responsible to manage the providers' day to day work functions that are not clinically related.
* Demonstrated sensitivity to culturally diverse situations, participants and customers.
Knowledge, Skills & Abilities:
* MD/DO license in the state of SC (active and unrestricted)
* At least 5 or more years of clinical practice experience in a Family Medicine/Internal Medicine setting
* Experience with electronic medical records is required.
Also required is proficiency with...
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Type: Permanent Location: Seneca, US-SC
Salary / Rate: Not Specified
Posted: 2025-12-03 09:59:54
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Home Infusion Registered Nurse - Accredo Specialty Pharmacy
Take your nursing skills to the next level by helping to improve lives with Accredo Specialty Pharmacy, a division of Evernorth Health Services.
We are looking for dedicated registered nurses like you to administer intravenous medications to patients in their homes.
As a Home Infusion Registered Nurse at Accredo, you'll travel to patients' homes to provide critical infusion medications.
However, this job is about more than just administering meds; it's about building relationships with patients and seeing the positive impact of your care.
You'll work independently, making decisions that lead to the best outcomes for your patients.
You'll drive growth in your career by challenging yourself to use your nursing skills, confidence, and positive attitude to handle even the toughest situations, with the support from your team.
For more than 30 years, Accredo has delivered dedicated, first-class care and services for patients.
We partner closely with prescribers, payers, and specialty manufacturers.
Bring your drive and passion for purpose.
You'll get the opportunity to make a lasting impact on the lives of others.
How you'll make a difference and improve lives:
* Empower Patients:Focus on the overall well-being of your patients.
Work with pharmacists and therapeutic resource centers to ensure that patients' needs are met and to help them achieve their best health.
* Administer Medications:Take full responsibility for administering IV infusion medications in patients' homes.
* Provide follow-up care and manage responses to ensure their well-being.
* Stay Connected:Be the main point of contact for updates on patient status.
Document all interactions, including assessments, treatments, and progress, to keep track of their journey.
Requirements:
* Active RN license in the state where you'll be working and living
* 2+ years of RN experience
* 1+ year of experience in critical care, acute care, or home healthcare
* Strong skills in IV insertion
* Valid driver's license
* Willingness to travel to patients' homes within a large geographic region
* Ability to do multiple patient visits per week (can include days, evenings, and weekends, per business need)
* Flexibility to work different shifts on short notice and be available for on-call visits as needed
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.
Quali...
....Read more...
Type: Permanent Location: Savannah, US-GA
Salary / Rate: Not Specified
Posted: 2025-12-03 09:59:53
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Home Infusion Registered Nurse - Accredo Specialty Pharmacy
Take your nursing skills to the next level by helping to improve lives with Accredo Specialty Pharmacy, a division of Evernorth Health Services.
We are looking for dedicated registered nurses like you to administer intravenous medications to patients in their homes.
As a Home Infusion Registered Nurse at Accredo, you'll travel to patients' homes to provide critical infusion medications.
However, this job is about more than just administering meds; it's about building relationships with patients and seeing the positive impact of your care.
You'll work independently, making decisions that lead to the best outcomes for your patients.
You'll drive growth in your career by challenging yourself to use your nursing skills, confidence, and positive attitude to handle even the toughest situations, with the support from your team.
For more than 30 years, Accredo has delivered dedicated, first-class care and services for patients.
We partner closely with prescribers, payers, and specialty manufacturers.
Bring your drive and passion for purpose.
You'll get the opportunity to make a lasting impact on the lives of others.
How you'll make a difference and improve lives:
* Empower Patients:Focus on the overall well-being of your patients.
Work with pharmacists and therapeutic resource centers to ensure that patients' needs are met and to help them achieve their best health.
* Administer Medications:Take full responsibility for administering IV infusion medications in patients' homes.
* Provide follow-up care and manage responses to ensure their well-being.
* Stay Connected:Be the main point of contact for updates on patient status.
Document all interactions, including assessments, treatments, and progress, to keep track of their journey.
Requirements:
* Active RN license in the state where you'll be working and living
* 2+ years of RN experience
* 1+ year of experience in critical care, acute care, or home healthcare
* Strong skills in IV insertion
* Valid driver's license
* Willingness to travel to patients' homes within a large geographic region
* Ability to work 40 hours a week (can include days, evenings, and weekends, per business need)
* Flexibility to work different shifts on short notice and be available for on-call visits as needed
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 hourly rate of 40 - 67 USD / hourly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
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 suppor...
....Read more...
Type: Permanent Location: Oxnard, US-CA
Salary / Rate: Not Specified
Posted: 2025-12-03 09:59:52
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Home Infusion Registered Nurse - Accredo Specialty Pharmacy
Take your nursing skills to the next level by helping to improve lives with Accredo Specialty Pharmacy, a division of Evernorth Health Services.
We are looking for dedicated registered nurses like you to administer intravenous medications to patients in their homes.
As a Home Infusion Registered Nurse at Accredo, you'll travel to patients' homes to provide critical infusion medications.
However, this job is about more than just administering meds; it's about building relationships with patients and seeing the positive impact of your care.
You'll work independently, making decisions that lead to the best outcomes for your patients.
You'll drive growth in your career by challenging yourself to use your nursing skills, confidence, and positive attitude to handle even the toughest situations, with the support from your team.
For more than 30 years, Accredo has delivered dedicated, first-class care and services for patients.
We partner closely with prescribers, payers, and specialty manufacturers.
Bring your drive and passion for purpose.
You'll get the opportunity to make a lasting impact on the lives of others.
How you'll make a difference and improve lives:
* Empower Patients:Focus on the overall well-being of your patients.
Work with pharmacists and therapeutic resource centers to ensure that patients' needs are met and to help them achieve their best health.
* Administer Medications:Take full responsibility for administering IV infusion medications in patients' homes.
* Provide follow-up care and manage responses to ensure their well-being.
* Stay Connected:Be the main point of contact for updates on patient status.
Document all interactions, including assessments, treatments, and progress, to keep track of their journey.
Requirements:
* Active RN license in the state where you'll be working and living
* 2+ years of RN experience
* 1+ year of experience in critical care, acute care, or home healthcare
* Strong skills in IV insertion
* Valid driver's license
* Willingness to travel to patients' homes within a large geographic region
* Ability to work 40 hours a week (can include days, evenings, and weekends, per business need)
* Flexibility to work different shifts on short notice and be available for on-call visits as needed
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...
....Read more...
Type: Permanent Location: Des Moines, US-IA
Salary / Rate: Not Specified
Posted: 2025-12-03 09:59:50
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LOCATION: must live in the Charlotte, North Carolina area
The Senior Contract Negotiator for Physician/Ancillary/Hospital groups serves as an integral member of the Provider Contracting Team and reports to the AVP, Provider Contracting.
This role assists in developing the strategic direction and management of the day to day contracting and network management activities for a local given territory.
DUTIES AND RESPONSIBILITIES
* Manages complex contracting and negotiations for fee for service and value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups).
* Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
* Initiates and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management.
Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service.
* Contributes to the development of alternative network initiatives.
Supports and provides direction to develop network analytics required for the network solution.
* Works to meet unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position.
* Creates and manages initiatives that improve total medical cost and quality.
* Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist with total medical cost initiatives.
* Prepares, analyzes, reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms.
* Creates healthcare provider agreements that meet internal operational standards and external provider expectations.
Ensures the accurate implementation, and administration through matrix partners.
* Assists in resolving elevated and complex provider service complaints.
Researches problems and negotiates with internal/external partners/customers to resolve highly complex and/or escalated issues.
* Manages key provider relationships and is accountable for critical interface with providers and business staff.
* Demonstrates knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape.
* Responsible for accurate and timely contract loading and submissions and interface with matrix partners for network implementation and maintenance.
* May provide guidance or expertise to less experienced specialists.
POSITION REQUIREMENTS
* 3+ years Physician/Ancillary/Hospital contracting and negotiating experience involving complex delivery systems and organizations required.
* Experience in a Managed Care, Healthcare or Health Insurance environment.
* Experience with Commercial Healthcare contracting, preferred.
* Experience in developing and m...
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Type: Permanent Location: Charlotte, US-NC
Salary / Rate: Not Specified
Posted: 2025-12-03 09:59:49
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The Senior Software Development Engineer in Testing (SDET) is responsible for designing and implementing automated tests, tools, and test environments for the Verity 340B platform.
This role ensures the reliability and quality of our software through robust testing practices and collaboration with development teams.
Responsibilities:
* Implement and maintain automated testing environments and tools.
* Maintain documentation for test systems and environments.
* Maximize test coverage for critical system features.
* Develop, maintain, and expand automated regression tests for RESTful web services and browser-based client functionality.
* Generate large, complex data sets for testing purposes.
* Validate transactional data against documented business rules.
* Collaborate with developers to define hooks in core code to facilitate automated testing.
* Actively participate in the Scrum development process.
* Document bugs in the tracking system.
* Participate in defining and clarifying business and product requirements.
* Communicate progress, issues, and risks promptly.
* Share responsibility for project success.
* Contribute to improving software development processes (version control, code reviews, unit testing, build/release, automation, etc.).
* Promote software QA best practices.
* Protect confidentiality of sensitive company and customer information, including HIPAA data.
* Support and promote Verity Solutions values through positive interactions with stakeholders.
Qualifications:
* Bachelor's degree in a related field or equivalent experience.
* 10+ years developing automated test software.
* Proficient in developing automated test systems for transactional web applications, including RESTful web services and client-side functionality.
* Programming proficiency in a high-level language, with the ability to quickly learn new languages.
* Familiarity with cloud environments.
* Ability to analyze and programmatically generate complex test data sets.
* Experience with MongoDB and Golang is highly desirable.
* Familiarity with web application security best practices and security testing.
* Strong problem-solving, written, and verbal communication skills.
* Self-motivated and effective with minimal direction.
* Collaborative team player in a Scrum-based environment.
* Adaptable to changing requirements and business processes.
* High level of curiosity, critical thinking, and desire to learn new concepts.
* Healthcare industry experience is a major plus.
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 127,400 - 212,300 USD / yearly, depending on relevant factors, in...
....Read more...
Type: Permanent Location: Kirkland, US-WA
Salary / Rate: Not Specified
Posted: 2025-12-03 09:59:48
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The Agile Product Owner 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.
They must have strong business skills and experience, with either some past experience working with technology teams, or the ability and interest to learn how to work with technology teams.
The Agile Product Owner will be 100% allocated to this role.
The incumbent provides 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.
POSITION SUMMARY
The Pharmacy Benefit Services (PBS), Operations Business Product Owner (BPO) serves as the key interface and liaison between the business sponsor, or client and technology counterparts to advance high ROI/efficiency, division-wide and enterprise-wide initiatives.
This individual would have responsibility for the accuracy and comprehensiveness of business requirements of new and modified business applications and/or products.
The Business Product Owner serves as the interface to the Technical Product Owners (TPO) for business applications, product or client requests to contribute to business requirements for new and existing systems from ideation through production and project oversight.
They will participate heavily in:
o the extraction of requirements from business sources
o discussions with technical resources on business intent and requirements
o skills to discuss, if not influence, technical design of associated applications
o the ability to guide technical support
PRIMARY FUNCTION
• Participate in defining business requirements with business sponsors, TPO and System Engineering teams for new and modified business applications, product, or client requests
• Apply new technical tools and techniques to support business within the digital and communication BPO space.
• Apply Express Scripts project tools and methodologies to advance business applications, products, or client requests.
• Provide input and insight into technical design of new and existing business applications.
• Owns the creation of epics to support analytic needs
• Participates in essential meetings, ceremonies, and release planning conversations to ensure training or documentation resources support a successful adoption
• Communicate and report on progress regularly with stakeholders
• Prioritize and manage workload and meet project deadlines.
• Business, technical and financial acumen applied to projects and portfolio
KEY QUALIFICATIONS
• High school diploma or GED ...
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Type: Permanent Location: Bloomington, US-MN
Salary / Rate: Not Specified
Posted: 2025-12-03 09:59:47
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This is a HYBRID position that requires on-site presence in St.
Louis, MO
POSITION SUMMARY
This position will be responsible for interpreting client contracts to identify and set up Financial, Rebate, and Pricing Discount Guarantees.In addition, this position will assist in reconciliation reporting.
This includes gathering results and preparing reporting to present to Account Management for distribution to clients.The position requires regular communication with cross functional areas in order to meet deadlines, including Client Pricing, Account Teams, IT, Audit, etc.The ability to communicate requests, results, and issues effectively with team members, management, and cross functional areas is essential.The successful candidate will also be expected to proactively contribute to driving and developing best practices across the Financial Client Operations team.
ESSENTIAL FUNCTIONS
* Review of client contracts and setting up of Financial, Rebate, and Pricing Discount Guarantees in respective systems.
* Development, analysis, validation and communication of reporting provided to Account Management.
* Communicate cross functionally with various departments via set up conference calls.
* Conduct special projects as assigned.
* Assist Account Management with issue resolution by providing data analysis and special reporting requests.
* Provide data and answer questions to assist withInternal and External Audits.
QUALIFICATIONS
* Bachelors degree in Business, Finance, Economics, Accounting.
* 1+ years of experience with degree.
* Excellent customer service and communication skills.
* Strong Analytical Skills.
* Detail oriented.
* Excellent PC skills with ability to utilize MS Excel and Access.
* Knowledge of PBM and healthcare industry preferred.
* Ability to organize and plan multiple projects.
* Ability to demonstrate self-initiative, work cross functionally to resolve issues as they occur.
* Proven ability to work under tight deadlines.
ABOUT THE DEPARTMENT
If your niche is in financial reporting and analysis, underwriting, cash management, audit or investor relations, our Finance department may be a perfect fit for you.
Our teams within Finance work together to ensure that spending stays on track and that we remain a profitable industry leader.
We're always on the lookout for innovative people who will bring outside-the-box thinking to our team.
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 enhancin...
....Read more...
Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2025-12-03 09:59:45
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This is a HYBRID role which requires on-site presence in St.
Louis, MO
POSITION SUMMARY
This position is responsible for interpreting client contracts to identify and record Pharmacy Management Fund and Other Funds and Credits and process/record reimbursements against those allowances.
This position maintains overall responsibility for monthly, quarterly, and annual reporting and reconciliation of allowances and related activity, including gathering proper data and documentation.
This position requires regular communication and partnering with cross functional areas including Client Pricing, Account Teams, Accounting, Accounts Payable and Billing, among others.
The ability to communicate requests, results and issues effectively with team members, management and cross functional areas while meeting deadlines is essential.
The successful candidate will also proactively contribute to driving and developing best practices across the Financial Client Operations team.
This position supports over 3,000 active clients in the establishment of, and reimbursement against, Pharmacy Management Funds and Other Funds and Credits by ensuring client balances are correctly calculated and recorded, policy requirements for reimbursement are met, and payments are properly processed and recorded.
ESSENTIAL FUNCTIONS
* Works independently or under minimal supervision, through established procedures, to ensure appropriate processing, recording and analysis of the Pharmacy Management Fund.
* Identifies issues during the reconciliation and analysis process and recommends solutions and on-going process improvements.
* Possesses excellent communication skills and ability to work cross-functionally with business partners at all levels.
QUALIFICATIONS
* Bachelor's Degree in Accounting/Business/Finance or related field preferred.
* 1+ years relevant experience.
* Related work experience in PBM, Pharmaceutical, or Healthcare industry preferred.
* Excellent PC skills including Microsoft Office (Excel and Access).
* Experience with PostgreSQL, SQL Servers, Excel VBA and accounting systems helpful.
* Strong analytical, planning and problem solving skills.
* Demonstrated personal initiative and commitment to quality.
* Ability to work under pressure while meeting performance goals under tight deadlines.
* Ability to work independently as well as plan for and integrate multiple tasks concurrently.
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 enhanci...
....Read more...
Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2025-12-03 09:59:44
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Job Description Summary
eviCore is seeking a highly skilledBusiness Analytics Senior Analystto support complex analytics initiatives within Operations.
This role requires strong technical expertise, independent problem-solving, and the ability to translate business needs into actionable insights.
The ideal candidate will develop and maintain reporting solutions and dashboards, ensuring data accuracy and driving operational efficiency.
Key Responsibilities
* Design, develop, and maintain operational reports and dashboards using Tableau and Power BI.
* Write and optimize SQL queries to extract, transform, and analyze data from various sources.
* Ensure data integrity through validation, cleansing, and documentation.
* Collaborate with stakeholders to gather requirements and deliver insights aligned with business goals.
* Lead analytics projects or components of larger initiatives, ensuring timely delivery and quality outcomes.
* Mentor junior analysts, providing technical guidance and professional development support.
* Continuously improve reporting processes and identify opportunities for automation and efficiency.
Technology Stack
The Business Analytics team utilizes the following technologies to develop reports and deliver insightful analysis to leadership:
* SQL (including SSMS and Oracle)
* Databricks
* Tableau
* Power BI
Required Qualifications:
* US Citizenship
* 2 - 3 years of experience in data analysis or business intelligence
* Proficiency in SQL and dashboard development
* Strong commitment to thorough documentation practices
* Ability to work independently and manage multiple priorities
Preferred Qualifications:
* Bachelor's Degree in Business Analytics, Data Science, Computer Science, or related field
* Experience with Databricks Notebooks
* 1+ years of experience in data engineering or ETL development
* Experience with project management methodology and tools
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 66,500 - 110,900 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.
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 detai...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-12-03 09:59:43
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SUMMARY
This external, provider-facing role manages a medium- to low-complexity book of business and is accountable for the overall provider experience.
The position collaborates with matrix partners to drive service improvements, resolve impacts, and implement strategic planning solutions.
Empowered to make decisions within scope, the role requires local market knowledge and visibility, fosters strong provider relationships, and continuously enhances engagement between Cigna and its providers.
DUTIES AND RESPONSIBILITIES
* Accountable for the end-to-end provider experience and overall service delivery for assigned book of business
* Supports a medium to low complex providers to include all medical lines of business
* Lead and collaborate on local market strategies to enhance provider experience
* Creates and maintains individual provider strategic action plans
* Identify provider opportunities and risks at market or national level and drive resolution
* Exercises good judgment and discretion to support the provider experience
* Capturing and sharing market intelligence to inform strategies and drive improvements
* External facing with providers in assigned BOB
* Capture and share market intelligence to drive strategy.
* Drive Provider Index score improvement through proactive network support
* Review provider reports/dashboard with individual providers
* Educate providers on Cigna's objectives, policies, and processes to influence collaboration
* Serve as a provider advocate both internally and externally
* Apply service culture principles and methodology to enhance provider interactions
* Serves as a provider advocate both internally and externally
* Serves in a consultative role or subject matter expert to key matrix partners
* Develops and participates in presentations to existing and prospective providers
* Represent Cigna as an advocate to medical societies and provider associations
* Manage joint operating committees, including agendas, participation, and follow-up
QUALIFICATIONS
* Bachelor's degree or higher strongly preferred or equivalent work experience required
* 3+ years in provider relations required
* 2+ years of face-to-face provider experience required
* 1+ year analyzing and interpreting provider data required
* Knowledge of medical insurance products required
* Strong negotiation and interpersonal skills
* Exceptional oral, written, communication skills
* Ability to understand and interpret provider perspectives
* Proficient in Microsoft Office and other systems
* Ability to work effectively in a matrix environment
* Willingness to travel >40%
CORE COMPETENCIES
* Decision Quality
* Resilience
* Organizational Savvy
* Instills Trust
* Planning and Alignment
* Customer Focus
* Collaboration
* Effective Communication
* Interpersonal...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-12-03 09:59:42
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The Third-Party Management (TPM) Advisor is responsible for conducting activities associated with governance, vendor and risk management, portfolio administration, and relationship management processes that support The Cigna Group Technology & Operations organization.
This position includes oversight of Enterprise Operations suppliers (Print & Distribution) as well as Artificial Intelligence (AI) initiatives.
The TPM Advisor is required to coordinate across these domains to ensure consistency with The Cigna Group strategic objectives and operational standards.
Responsibilities involve communication with senior leadership to develop portfolio and vendor management strategies that reflect The Cigna Group global Technology initiatives, projects, and programs.
The role also aids Procurement / Sourcing teams during negotiations, RFPs, and proposal analysis.
Familiarity with legal contracts, strong analytical abilities, and financial expertise are preferred.
KEY RESPONSIBILITIES:
Vendor Management
* Responsible for delivering strategic guidance and governance for assigned supplier relationships, including the following:
* Tracking and reporting supplier performance against established criteria on a regular basis.
* Managing governance actions and resolving issues throughout the assigned portfolio.
* Conducting scheduled Enterprise Business Review sessions with internal business partners, matrix partners and suppliers.
* Applying analytical skills to assess and improve processes, focusing on ongoing enhancement of supplier management and operational workflows.
Portfolio Management
* Accountable for developing effective relationships with Technology & Operations business stakeholders to understand their business portfolio and implement supplier-based solutions for their needs, which includes:
+ Navigating complex environments with evolving strategies and priorities.
+ Facilitating discussions between Cigna senior leaders and supplier counterparts.
* Supporting overall business requirements, enterprise agreements, service level agreements, and statements of work through strategic planning.
Program Support
* Besides vendor and portfolio management duties, the TPM Advisor supports cross-functional initiatives, coordinating and executing projects in areas such as technology, print & distribution, and AI applications.
* The TPM Advisor is expected to identify opportunities for process improvement and efficiency, analyze existing workflows, suggest enhancements, and oversee implementation of best practices for third-party engagements.
Qualifications/Requirements:
* At least 4 years' experience in third party management, procurement, or operations and management is strongly preferred.
* Experience building and maintaining relationships with Senior and Executive levels inside and outside the organization to accomplish results through contracted engagements.
* Experience pr...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-12-03 09:59:41
