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John Zink, a Koch Engineered Solutions company, is looking to add an Applications Engineer to our team.
This position is located in Tulsa, OK.
The Applications Engineer will be expected to have a strong technical ability connected to the selection and implementation of Thermal Oxidizers and adjacent solutions.
This role focuses on direct ownership of high value customer engagement, requiring strong economic thinking skills around marginal analysis and risk evaluation, to develop value proposition and influence key decision makers.
What You Will Do
• Lead formal and informal presentations to progress high level knowledge sharing around technologies and operating practices.
• Engage in discussions with a global customer base to better understand their equipment needs.
• Coordinate with multiple John Zink and Koch Engineered Solutions business offices to find creative solutions that best meet the customer's needs.
• Collaborate with a diverse team of engineers to develop the technical and commercial proposal that communicates the value of our proposed solution.
• Work with the equipment execution team to ensure the equipment is built in compliance with customer specifications and expectations.
• Develop commercial proposals based upon applications of our technical solutions.
The Experience You Will Bring
Requirements (Basic Qualifications):
• Experience with process design or technical sales
• Experience working cross functionally with sales and engineering teams
• Willing to travel up to 20%, both domestic and international
What Will Put You Ahead
• Five (5) years of applications engineering, technical sales, or business development experience
• Experience working in the Petrochemical or Refining industries
• Experience with pricing strategy, negotiating contracts, etc.
• Experience working with a global customer base
• Bachelor's degree in Mechanical, Electrical, Chemical, Technology Engineering, or other relevant technical degree or 5+ years of closely related experience in the combustion industry
At Koch companies, we are entrepreneurs.
This means we openly challenge the status quo, find new ways to create value and get rewarded for our individual contributions.
Any compensation range provided for a role is an estimate determined by available market data.
The actual amount may be higher or lower than the range provided considering each candidate's knowledge, skills, abilities, and geographic location.
If you have questions, please speak to your recruiter about the flexibility and detail of our compensation philosophy.
#LI-RP3
Hiring Philosophy
All Koch companies value diversity of thought, perspectives, aptitudes, experiences, and backgrounds.
We are Military Ready and Second Chance employers.
Learn more about our hiring philosophy here .
Who We Are
As a Koch Engineered Solutions company, John Zink Hamworthy Combustion (JZHC) is a global leader in emissions control and a pioneer in modern Sm...
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Type: Permanent Location: Tulsa, US-OK
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:45
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Molex possesses a rich heritage in the optical industry.
We provide the highest performing and field-proven wavelength management solutions from components, modules to integrated line-cards.
Continuous innovation in passive component function integration, miniaturization, and manufacturing automation, cutting edge WSS and amplification technology and comprehensive optical, mechanical, electrical and software design capabilities enable us to serve the needs of high-density, high-bandwidth, and flexible optical networks of telecom, datacom, hyperscale datacenter and supercomputing.
We serve global clients in telecom and datacom industries in providing innovative optical modules and subsystems to support our customer's next generation networks.
Molex is seeking a Technical Program Manager (TPM) to join our Optical Solutions Business Unit.
In this role the successful candidate will be part of a world-class engineering and operations team, contributing to the development of the next generation of optical transceivers.
This person will be leading critical projects that require interaction with senior executives in our major customers and Molex.
The ability to communicate and present at this level will be critical to our programs.
The Program Manager will have the responsibility of planning and executing global, complex development programs to achieve the desired performance objectives (e.g.
cost, schedule, performance, quality).
The TPM is a critical position in the product development team expected to ensure the co-ordination of the activities of a large, multi-functional and geographically dispersed team and be an interface to the customer.
Some travel may be required as needed for the success of the program(s).
What You Will Do
* Manage high growth hyperscale datacenter and AI/ML related programs
* Drive product development plan and the product qualification process (internal and customer-side) and all inherent dependencies
* Lead strategic plans for the product(s), operation, and the key electrical and optical BOM components such as ICs and Lasers
* Develop strong relationships with stakeholders in R&D, PLM, Sourcing and Manufacturing teams
* Communicate clearly while influencing your peers and managers and holding teams accountable
* Provide quality presentations and program updates to senior management and to the customer that are concise and engaging
* Drive a strict pace for complex projects by accurately identifying technical risks for appropriate and timely closures
* Perform constant risk analysis; then identify and execute on mitigation strategies while keeping the key internal and external stakeholders appropriately informed
* Organize and lead cross-functional team meetings to develop project schedules, resource planning, prioritize activities, review project/program process and resolve issues
Who You Are (Basic Qualifications)
* Bachelor's degree in engineering/science
* At l...
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Type: Permanent Location: Carlsbad, US-CA
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:44
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Tooling / Finishing Engineer
If you would love to be part of a company that is poised for substantial growth with opportunities for career advancement, then working for CPP may be the right fit for you! Join a results-oriented workplace that strives for success through innovation, collaboration, and teamwork.
Consolidated Precision Products (CPP) Euclid is an investment casting foundry that specializes in complex aerospace & gas turbine components.
With a stable business model and competitive compensation & benefits, CPP is a great option to consider as you look to make your next career move.
For more information, please visit https://www.cppcorp.com/
WHAT WE HAVE TO OFFER
* Weekly Pay for Hourly Employees
* Comprehensive Benefit Plans
* Quarterly Bonus Opportunity
* 401k with Company Match
* Emphasis on Employee Engagement
* Paid Holidays and Vacation Time
* Tuition Reimbursement
JOB SUMMARY
The Tooling / Finishing Engineer is responsible for collaboratively working with Engineering, Sales, Production Control, Operations and Outside Service Providers (OSPs) to effectively maintain tooling registrars / manifests / production usage rates / etc.
to track and convey proper tooling health and long-term viability.
Will work with Guaymas, Mexico Finishing department to develop and define procedures for Finishing best practices, this will include regular visits to that facility.
Will maintain and update part traceability items including Part Routers, Bill of Materials, Item Creation, Vendor Costs, etc.
and maintain the confidentiality of information.
PRIMARY RESPONSIBILITIES
* Manage the placement, execution, and delivery of all outsourced die mold, fixture, and/or gage builds.
* Assist in parallel with the Engineers to estimate costs and lead times, compile tooling guidelines (SOPs), and produce quotations to prime customers.
* Maintain a complex tooling library with input from Engineering, Sales, Customers, and Vendors.
* Maintain the integrity of customer/vendor models within tooling library and proper archiving.
* Meet development commitments with respect to established cost and time frames.
* Coordinate Engineering meetings with Guaymas, Mx facility.
* Work with Finishing department to establish and define best practices procedures.
* Enters, updates, and verifies data into various MRP systems for use by all personnel.
* Assist in the development of operations sequences and PEIs (engineering instructions) for Wax Processes, Cut/Clean/Grind, Machining, Gauging, and other dimensional related operations.
* Work on/participate in special projects as needed or assigned by Management.
* Work closely with other departments to ensure organization objectives are achieved.
* Maintain a positive work atmosphere by behaving and communicating in a professional manner.
QUALIFICATIONS
* Education: BS in Engineering or related technical field
* Exper...
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Type: Permanent Location: Euclid, US-OH
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:30
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The Warehouse Associate Representativeis responsible for performing tasks related to receiving product, stocking and replenishment, and inventory control.
This includes safely unloading trucks and unpacking received product, comparing the purchase order to the product received for accuracy, counting quantities of product received and ensuring the quality of the product is at an acceptable level, and removing damaged or non-conforming product using data entry and retrieval devices to record receipt transaction (using scanners and computer input).
In addition, this position safely transfers material from receiving area to warehouse or dispensing locations and ensures proper stock rotation-utilizing PDAs to update the inventory system.
The Warehouse Associate Representative also audits shelf counts for accuracy, reviews inventory for short-dated and expired product, and reports discrepancies to the supervisor.
Work Shifts Available:
Monday - Friday, 8 AM - 4:30 PM or Monday - Friday 12 PM - 8:30 PM
What you'll do:
* Safely unpack and evaluate incoming product for correct count and condition in comparison to purchase orders
* Safe operation of material handling equipment and hand tools such as forklifts, pallet jacks (manual and electric), carts, dollies, box cutters, wire cutters, etc.-to unload trucks and stock the warehouse/pharmacy
* Accurate data entry and retrieval using computers, and scanners (PDA)
* Bin and shelf inventory maintenance and stock rotation-including shelf counts, short shelf life and expired product audits
* Communicate discrepancies or issues as they are occur to the appropriate personnel
* Maintain organization and cleanliness of assigned work stations and areas
* Other duties as assigned
What you need to do the job:
* High School Diploma or GED required
* 0-1 years of relevant work experience
* Ability to accurately compare two sets of data
* Basic math, organization, computer, and communication skills
* Ability to do repetitive bending, squatting, standing, walking, pushing, pulling and hand motions
* Willingness to work a flexible schedule to accommodate heavy work volumes
* Ability to walk/stand for full shift
* Bend, stoop, and lift up to 50 lbs
* Ability to read and differentiate small print
* DSCSA working knowledge/experience preferred
Why Cigna:
* Day 1 medical insurance
* Paid Time Off
* Competitive Benefit package
* Growth and Advancement opportunities
* $1,600 Sign On Bonus paid in three installments:
+ $300 at 30 days post hire
+ $300 at 90 days post hire
+ $1,000 at 1 year post hire
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 div...
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Type: Permanent Location: New Castle, US-DE
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:29
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The Operations Manager will be a key member of the Operations team in Industry, CA.
We are looking for a motivated and driven individual that can drive execution in a diverse complex manufacturing environment that specializes in manufacturing aerospace castings or complex manufacturing.
Who are we?
This is a great opportunity to join a growth-oriented company within the aerospace industry that has been in business for over 100 years! We specialize in manufacturing aluminum and magnesium products for commercial, regional, corporate and military aircraft and engines.
What will you do?
* Design and implement plans for the effective use of material and labor resources to achieve manufacturing target
* Supervise the operations of manufacturing personnel to ensure a manufacturing process is within budget and time schedule
* Oversee the hiring, orienting, and training of technical production employees to ensure a competent workforce
* Conduct studies and research to identify and develop continuous improvement projects
* Oversee the regulation of work shift to ensure proper workload distribution
* Monitor a manufacturing team to ensure operations are in compliance with health and safety standards
* Schedule the maintenance of production equipment and machines to ensure efficient operations
* Analyze and provide solutions to manufacturing challenges or problems
* Liaise with the quality assurance department to ensure product quality and specification are consistent
* Conduct assessments to identify mechanical and procedural limitations that minimize work efficiency
* Monitor and control a production process to adjust operations in event of a problem
* Review personnel performance to determine individuals most suited for promotion.
What do we have to offer?
* $160K annually
* 10% annual bonus potential
* Positive and collaborative work environment
* Flexible schedule
* Paid training
* Educational Assistance
* 401K with match
* 3 weeks PTO
What will you need to be successful?
* High school diploma or BA
* 10+ years of manufacturing and management experience
* MS Office Suite, Statistical Process Control and organizational skills
* Bilingual in Spanish a plus
Consolidated Precision Products (CPP) is an industry-leading manufacturer of highly engineered components and sub-assemblies, supplying the commercial aerospace, military and industrial markets with small-to-large "function critical" products.
CPP provides its customers with a "total solution" source, taking them from concept to finished product with one of the broadest and most diverse product offerings in the industry.
More information about our company can be found at: http://www.cppcorp.com/.
Sponsorship is not available for this role.
Candidates must be legally authorized to work in the U.S.
on a permanent and consistent basis without company sponsorship now and in the f...
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Type: Permanent Location: City of Industry, US-CA
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:29
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The job profile for this position is Actuary- Hybrid which is a Band 4 Senior Contributor Career Track Role with Cigna Health and Life Insurance Company.
Responsibilities:
* Perform actuarial research and develop actuarial assumptions for global healthcare insurance company.
* Develop and maintain profit studies, pricing strategies and policies.
* Support preparation of financial forecasts to achieve profitability and growth goals.
Partial virtual/work from home benefit available.
Qualifications:
Position requires a Bachelor's degree in Actuarial Science, Mathematics, or a closely related field.
Must have passed at least 3 Society of Actuaries (SOA) exams towards ASA/FSA certification.
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.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible.
Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment.
These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:28
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If you're looking to add value, make an impact, and use your analytical skills in a fast-paced environment, starting your career within our Client Informatics team will allow you to do all this and more.
A key function of the Risk Management Underwriting organization is Client Informatics, which provides Cigna's clients with reporting, analytics, and consultation that is relevant, localized and actionable.
Informatics Consultants work together with Underwriters on our largest clients to demonstrate the financial value Cigna brings along with consultative recommendations to improve affordability, access and population health.
If you're looking to use you analytical and math skills in a competitive, fast-paced environment this could be the internship for you.
As part of our internship program, you will directly impact our business in assessing buyer group analytics that demonstrate Cigna's value proposition of managing total medical cost.
What you'll do:
The Cigna Group's 10 week summer internship program is designed to further develop your analytical skills and business acumen and give you experience working in a dynamic, flexible work environment.
The Client Informatics Internship offers:
* "Real work": you will be assigned a project that challenges your problem-solving, innovation, technical and leadership skills, while building industry knowledge.
Your work over the summer will allow you to make direct contributions to our mission and company goals.
* Community : you will have the opportunity for visibility with senior management as well as one-on-one learning with client informatics professionals, who will share their knowledge and experiences.
* Leader Speaker Series: You and your fellow interns will be exposed to a variety of sessions and presentations given by members of the Cigna community.
What you need to do the job:
* Ideal candidates will be progressing toward a bachelor's degree, and have completed at least 2 years in desired majors including; Finance, Business, Economics, Risk Management or related fields by start of internship program
* 3.0 or higher GPA is preferred
* C ustomer-centric mindset
* Excellent oral and written communication skills
* Strong analytical and strategic thinking skills
* Proficiency with Microsoft office software, especially Microsoft Power Point and Excel required
* An interest in pursuing a career in Underwriting & Analytics
Additional Information:
* Location: Hybrid in Bloomfield, CT; Philadelphia, PA; Chattanooga TN; Franklin, TN; Scottsdale, AZ or Denver, CO.
A hybrid position means that you will be expected to work in-person at your assigned office location 3 days a week with flexibility to work at home for balance of time.
* The internship is paid and housing assistance is not offered.
* Timeline: Our recruitment process consists of several rounds including a recruiter phone screen and 2 rounds of interviews.
Recruitment will con...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:27
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Home Infusion Registered Nurse - Accredo
Take your nursing skills to the next level by helping to improve lives with Accredo, the specialty pharmacy 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 by Evernorth® 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 within a designated area
* Ability to do patient visits 2-3 weekdays (day shift) per week, but may require some evening or weekend visits also
* Flexibility to work different shifts on short notice
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, ag...
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Type: Permanent Location: Claremont, US-NH
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:27
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Work Location - Remote, United States
Summary:
This position operates as an independent contributor focused on achieving departmental initiatives and goals, program development and valuation, project and process improvement, and team development.
This position functions within the PMO and collaborates with all Cigna Supplemental Benefits (CSB) departments, to include matrix organizations, as well as both internal and external partners to achieve successful program outcomes on behalf of CSB and its parent organization.
Responsibilities:
* Works in conjunction with leadership and the PMO to develop and support new programs/products, review and revise current programs/products, and perform other ancillary functions, as needed.
* Works with others to define and support business requirements for various initiatives that often require partnering with IT solution teams to support development and maintenance of CSB and Enterprise needs.
* Partners with leadership to develop and track relevant metrics and measures that highlight department program value and service delivery.
* Focuses on CSB product and project strategies and implementation as fundamental part of assigned role.
* Champions and maintains an agile methodology for business benefit valuation, tracking, and delivery.
* Develops relationships with matrix organizations and internal/external partners to refine requirements, support delivery processes, and influence schedules and roadmaps using the Agile Methodology.
* Applies project management skills in estimation, scheduling, tracking, and risk mitigation activities.
* Develops insights to key results and helps apply insights to prioritization of scope and activities.
Qualifications:
* Bachelor's degree or equivalent work experience.
High School diploma, required.
* Master's degree in a business, project management, or healthcare field, highly preferred
* Project management certification desired
* Experience in leading/managing business-oriented projects that may include IT requirements
* Agile experience preferred
* Experience in healthcare, including healthcare delivery knowledge
* Experience working with diverse teammates and business areas
* Experience working on process improvement initiatives
* Excellent leadership, consensus-building, and team building skills.
* Strong interpersonal skills
* Team, customer service, and collaboration oriented
* Strong oral, written and presentation communication
* Strong organizational, time management, and prioritization skills
* Ability to work independently
* Ability to work with highly confidential data
* Ability to learn and master subject matter content
* Ability to analyze, research, and problem-solve
* Proficiency in Health Management-related system applications, workflows, standard operating procedures, and resource tools
* Proficiency with Webex and other ...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:26
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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
Medical Assistant - Front Office - Evernorth - Fort Myers FL
* Greet and check in patients at the health care centers by verifying coverage and eligibility and completing appropriate paperwork.
* Obtains the patient history, takes vital signs, and assists with coordination of care.
* Administers medications
* Prepares examination room
* Cleans and sterilizes instrument per protocol
* Answer telephone in compliance with departmental procedures.
Ascertain nature of call and route appropriately.
If necessary, take accurate and legible messages.
* Schedule appointments and verify membership according to various benefit coverage
* Reviews preprinted instruction sheets with patients
* Attends department Staff Meetings and In-service programs
* Cross-trains to new procedures and departments.
What we expect from you :
* CMA, RMA, ABR-OE
* Current BCLS required
* At least 1 or more years of front and back office experience
* Experience answering phones and scheduling patients
* Phlebotomy skills
* Solid Computer skills including Electronic Health Records
* Excellent customer service skills required
* Team oriented
* Strong time management skills
* Responsible and reliable
* The clinic hours are listed below.
Must have flexibility to work when needed to cover vacations and staffing needs, within the hours listed:
Monday/Wednesday 7a - 5p, Tuesday/ Thursday/ Friday 7a - 3:30 p
The health center is based in Fort Myers FL.
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, dis...
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Type: Permanent Location: Fort Myers, US-FL
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:25
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Provides advanced professional input to complex Sales Operations assignments/projects.
Contributes to projects and processes that
improve the operational efficiency and effectiveness of the sales force.
Supports multi-functional sales operations often for a dedicated
geographic area or large business unit.
Resolves inquiries and conducts research to provide product and service information to sales
associates.
Fulfills requests for reports, diagrams, and sales materials.
May serve as a technical resource.
May lead projects or project steps
within a broader project or have accountability for ongoing activities or objectives.
Supports and provides direction to more junior
professionals.
Works autonomously, only requiring "expert" level technical support from others.
Exercises judgment in the evaluation,
selection, and adaptation of both standard and complex techniques and procedures.
Utilizes in-depth professional knowledge and acumen to
develop models and procedures, and monitor trends, within Sales Operations.
• Support output of a key discipline within U3000 Health Engagement Organization
• Focus on achievement of assigned goals and support in achieving functional goals
• Inform direct managers and teams to address resource and operational needs
• Focus on short-term outputs and other work areas as assigned
• Main contributor to business strategy by understanding market benefit offerings to ensure benefit education success to clients
and customers in group setting
• Able to self-manage assignments and schedule event times
• Demonstrate in-depth understanding of key Cigna plan benefits, ancillary programs, and initiatives
• Work with assigned Cigna clients during pre-effective timeline to coordinate tailored education events with available modality
options (on-site, telephonic, and self-service engagement options)
• Identify customer education opportunities to drive maximum utilization of available resources (all lines of benefit plans and
programs)
• Lead and deliver virtual and/or onsite awareness and education presentations, engagement offerings, and activation duties in group setting as assigned to existing and prospective customers in Select & Middle Market Segment (U3000)
• Coordinate with local Health Engagement team to ensure needs are met and potential problems are averted
• Provide information to Cigna client(s) on the use of available steerage resources throughout the plan year as assigned
• Keeps account partners informed about account status and opportunities for expanded business
• Follows established guidelines and procedures of benefit education events and other events as assigned
• Maintains current knowledge in all Cigna products, programs, and tactics
• Refers customer service inquiries, administrative functions, implementation, billing questions, and other production matters
to appropriate service organization partners
• Coordinate, track, and update event meetings, including attendance, an...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:24
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JOB DESCRIPTION
The Clinical Account Executive (CAE) position is an exciting opportunity for a pharmacist who is looking to leverage their pharmacy and healthcare expertise to meet the Health Plan client's strategic goals and drive improved clinical and financial outcomes for their membership.
In this role the CAE will use their deep understanding of the pharmacy/healthcare landscape and pipeline, as well as strong clinical, analytical, financial, and business skills to develop and present a comprehensive strategy aligning and supporting to the client's strategic goals.
The strategic plan should address critical business metrics such as member and client satisfaction, clinical support and clinical solution program adoption - with a goal to deliver lower healthcare costs and optimal clinical outcomes.
The CAE independently manages a book of moderately complex clients requiring this role to think forward into the future as the healthcare landscape continues to evolve, be comfortable with a wide variety of data elements, have an ability to draw insights from that data while being member-centric and promoting an optimal patient experience.
They must serve as the client's gold-standard clinical resource and be knowledgeable of new clinical innovations that are occurring beyond medications, including digital health innovations and new healthcare delivery models.
They will partner with the Health Plan's Pharmacy Director, Medical Director and clinical staff to provide a comprehensive management plan.
They are the client's healthcare consultant and expert and are responsible for providing comprehensive management of clinical strategies, initiatives, and new clinical solution adoption in order to meet the client's and ESI's common goals.
ESSENTIAL FUNCTIONS:
* Leads (and partners with Account Executive) the adoption of clinical solutions to clients through consultative sales methods (e.g.
client P&T presentations, quarterly/annual business reviews, presentation of modeling/reporting,etc.) in accordance with client business goals and upon collaboration and coordination with account management & internal team members.
* Leads custom formulary management recommendation discussions with client aligning internally with enterprise formulary operational best practices and goals.
Partners with Account Executive, and internal Finance & Formulary Teams to manage rebate performance to meet client contractual rebate guarantees, when applicable.
* Leads the development, preparation, and presentation of healthcare strategy for each client assigned.
Acts in concert with assigned Account Executive and Account Manager to service the health management consultative needs of the client.
* Leads clinical client Strategic Planning and Review Consultation (SPARC) meetings.
Responsible for retention, client loyalty and maximizing solution sales opportunities within assigned portfolio.
Maintains strong client relationships with clients to ensure retention...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:24
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Home Infusion Nurse (RN):
Empower your patients.
Pursue your passion.
Be the RN you dreamed of.
Because it all matters.
Get ready for a nursing career experience unlike any other.
Accredo Infusion Nurses travel to patient homes and deliver critical infusion drugs, but that's only half of our story.
The other half? It's being able to develop meaningful relationships with patients - without feeling rushed or pressure to move on to the next.
In this role, you'll work independently to make decisions and execute them for the best possible outcome for your patients, while feeling the impact you're making every single day.
How you'll make a difference:
* Be a coach to empower your patients to be at their best.
Focus on the overall well-being of your patients and work with Pharmacists and Therapeutic Resource Center (TRC) to ensure your patients' needs are met.
* Take full ownership of the patient experience.
Travel to patient homes and administer IV infusion medications autonomously, providing response management and follow-up care.
* Be the single point of contact for regular updates on patient status.
Armed with a tablet, you are the single point of contact to ensure all clinicians are in the know about your patient.
You'll be expected to document all interactions and communication with patients including assessments, treatments, responses, disease progression, etc.
* Challenge yourself to be a better nurse every day.
Use your commitment to your craft, confidence in your abilities, positive attitude, and adaptability to handle even the most difficult situations with the support of your leader and team.
What you must have :
* Registered Nurse (RN) license in good standing in the state of residence
* BSN degree, plus 2+ years of relevant RN experience; or
* ASN degree, plus 5+ years of relevant RN experience; or
* Nursing Diploma, plus 8+ years of relevant RN experience
* 1+ years as a specialty RN in a critical care, acute, or home healthcare environment
* Strong IV insertion skills
* Valid driver's license
* Willingness to travel within an assigned geographic area
* Ability to work Monday-Friday, day shift, as well as the ability to do occasional evening or weekend patient visits as needed.
* Flexibility to work alternate shifts on short notice and be on call for field visits as determined by business need
Your Benefits as an Accredo Home Infusion Nurse (RN) :
* Medical, Prescription Drug, Dental, Vision, and Life Insurance
* 401K with Company Match
* Paid Time Off and Paid Holidays
* Bonus Eligibility
* Mileage reimbursement
* Internal Career Training Resources
* Tuition Assistance
Accredo, Evernorth Health Services' specialty pharmacy, serves patients with complex and chronic health conditions, including cancer, hepatitis C, HIV, bleeding disorders, and multiple sclerosis.
If you will be working at home occasionally or permanently, t...
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Type: Permanent Location: New Hyde Park, US-NY
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:23
-
The Advocate role is a non-clinical customer service position within an inbound call center that supports Evernorth Behavioral Health.
Advocates are responsible for handling inbound calls from both members and providers or their office support staff regarding mental health or substance use disorder services.
Advocates guide and assist the members and providers to help them work with Cigna/Evernorth more effectively and ensure first-call resolution.
The types of calls an Advocate service may include but are not limited to: triaging and assessing the need for clinical intervention, inquiries about provider referrals and access to care, eligibility, and benefits.
Due to the wide variety of call types, several applications are required to service these inquiries, and multiple applications are often needed within the same call.
Independent problem-solving, multitasking, and technical savvy are essential in order to be able to carry out the responsibilities of this role.
Calls must be serviced helpfully and professionally.
The nature of discussions within the Behavioral Advocate role often delves into personal and sensitive topics with members.
It demands a nuanced understanding of mental health and substance use issues.
This role differs from its medical counterpart in that mental health is a sensitive subject and staff are helping members navigate complex and emotional mental health challenges.
Responsibilities:
The primary responsibility of this role is to answer inbound calls from members and providers.
The work environment is structured, and the majority of the day will be spent answering these calls from a queue.
Occasional outbound calls may be necessary for issues requiring follow-up.
Within a call, an Advocate may:
* Use active listening and empathy skills to triage and assess for risk of harm and substance use concerns
* Coordinate with multiple matrix partners, and facilitate seamless handoffs to clinical partners for timely support
* Communicate eligibility, generate a list of provider referrals, quote benefits, or advise of authorization requirements for services
* Write authorizations to ensure claims are paid correctly
* Provide follow-up on issues by making outbound calls when necessary
* Send resources to members and providers via email
* Submit a complaint on the member's or provider's behalf
* Independently problem-solve to ensure accurate information is given, and exceptional customer service and first-call resolution is achieved
Qualifications
* Bachelor's degree in the mental health field or psychology/social work-related field (family communications, health coaching, community/public health or other related major), is strongly preferred .
Alternatively, a bachelor's degree in another field or equivalent work experience, combined with 2+ years of experience in the behavioral health field will be considered
* Customer Service experience
* Prior experience working in a ...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:22
-
Provides advanced professional input to complex Sales Operations assignments/projects.
Contributes to projects and processes that
improve the operational efficiency and effectiveness of the sales force.
Supports multi-functional sales operations often for a dedicated
geographic area or large business unit.
Resolves inquiries and conducts research to provide product and service information to sales
associates.
Fulfills requests for reports, diagrams, and sales materials.
May serve as a technical resource.
May lead projects or project steps
within a broader project or have accountability for ongoing activities or objectives.
Supports and provides direction to more junior
professionals.
Works autonomously, only requiring "expert" level technical support from others.
Exercises judgment in the evaluation,
selection, and adaptation of both standard and complex techniques and procedures.
Utilizes in-depth professional knowledge and acumen to
develop models and procedures, and monitor trends, within Sales Operations.
• Support output of a key discipline within U3000 Health Engagement Organization
• Focus on achievement of assigned goals and support in achieving functional goals
• Inform direct managers and teams to address resource and operational needs
• Focus on short-term outputs and other work areas as assigned
• Main contributor to business strategy by understanding market benefit offerings to ensure benefit education success to clients
and customers in group setting
• Able to self-manage assignments and schedule event times
• Demonstrate in-depth understanding of key Cigna plan benefits, ancillary programs, and initiatives
• Work with assigned Cigna clients during pre-effective timeline to coordinate tailored education events with available modality
options (on-site, telephonic, and self-service engagement options)
• Identify customer education opportunities to drive maximum utilization of available resources (all lines of benefit plans and
programs)
• Lead and deliver virtual and/or onsite awareness and education presentations, engagement offerings, and activation duties in group setting as assigned to existing and prospective customers in Select & Middle Market Segment (U3000)
• Coordinate with local Health Engagement team to ensure needs are met and potential problems are averted
• Provide information to Cigna client(s) on the use of available steerage resources throughout the plan year as assigned
• Keeps account partners informed about account status and opportunities for expanded business
• Follows established guidelines and procedures of benefit education events and other events as assigned
• Maintains current knowledge in all Cigna products, programs, and tactics
• Refers customer service inquiries, administrative functions, implementation, billing questions, and other production matters
to appropriate service organization partners
• Coordinate, track, and update event meetings, including attendance, an...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:21
-
Position Scope:
* Manages/coordinates an active caseload of case management cases for Cigna Medicare.
Uses clinical knowledge to assess the treatment plan and goals, and identifies gaps in care or risks for readmission or complications.
* Establishes patient centric goals and interventions to meet the member's needs
* Interfaces with the member, family members/caregivers, and the healthcare team, and embedded care coordinator as well as internal matrix partners.
* Build solid working relationships with internal staff, matrix partners, key functional areas, customers, and providers
Summary description of position:
This position, the Nurse Case Manager Senior Analyst, through the case management process, will promote the improvement of health outcomes to members and assist those members experiencing the burdens of illness and injury.
The Case Manager will assess, plan, implement, coordinate, monitor and evaluate options and services to meet an individual's health needs within case load assignments of a defined population based on business perspectives.
The Case Manager will promote quality cost-effective outcomes managing care needs through the continuum of care utilizing effective verbal and written communication skills and a consumerism approach through education and health advocacy to members serviced.
Ability to work independently and effectively communicate to internal and external customers in a telephonic environment.
Major responsibilities and desired results:
Obtains informed verbal consent and takes all steps to obtain written consent as appropriate.
* Establishes a collaborative relationship with client (plan participant/member), family, physician(s), and other providers to determine medical history and current status and to assess the options for optimal outcomes.
* Promote consumerism through education and health advocacy.
* Assesses member's health status and treatment plan and identifies any gaps or barriers to healthcare.
Establishes a documented patient centric case management plan involving all appropriate parties (client, physician, providers, employers, etc), identifies anticipated case results/outcomes, criteria for case closure, and promotes communication within all parties involved.
* Implements, coordinates, monitor and evaluate the case management plan on an ongoing, appropriate basis.
* Adheres to professional practice within scope of licensure and certification quality assurance standards and all case management policy and procedures
* Participates in unit and corporate training initiatives and demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate.
* Demonstrates sensitivity to culturally diverse situations, clients, and customers.
Work schedule:
Monday to Friday 8:00 AM-5:00 PM AZ time
Minimum requirements:
Active, unrestricted Registered Nurse (RN) Multi-State License.
Must be willing to get licensed ...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:20
-
This Financial Analysis Lead Analyst role will be responsible for supporting the financial analysis through data analytics for the Tennessee and Carolinas Medicare market within the Finance.
The analyst will focus on the analysis of medical claims, revenue and related financial information to make recommendations based on relevant findings.
We seek an analyst that will provide operational and analytical support to assist in affordability and improving financial results.
This role will work with various team, including but on limited to, Finance, Medical Economics, Network Operations, and Actuary through data-driven reporting.
Essential Responsibilities:
• Enhance, improve and develop analytical reporting to assist to support market strategy and operations
• Enhance and develop reporting to track key financial performance indicators to identify areas of risk, trends and options for improvements through the use of data analytics.
• Develop methods for improving internal processes in order to create efficiencies.
• Manipulate and combine a variety of data sources to create analytical solutions to business problems.
• Create highly effective, visual graphics that tell complex stories in formats that can be easily conveyed to leadership and executive clients.
• Work collaboratively and partner with departments across the organization to ensure deliverables are accomplished
• Supports team with ad-hoc requests.
Qualifications:
• Bachelor's degree in Finance, Analytics, Health Information Management, Management Information Systems, Economics or related field strongly preferred
• 2+ years increasingly complex database and data management with SQL and/or Teradata is needed.
• Microsoft Excel experience
• Experience with claims analytics, clinical data, and/or financial data preferred
• Proven ability to work collaboratively in complex matrix organizations, driving outstanding results
• Strong verbal/written communication skills to work with various matrix partners
• Willingness to learn and apply new skills to improve processes
Preferred Competencies:
• Strong analytical and problem solving skills
• Team player that is able to work in a matrix environment with tight deadlines
• Innovative and deal with ambiguity
• Ability to communicate results of analytics to various individuals/group
*This is a Hybrid role and you must be near one of the office locations to be considered.
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 Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life.
We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality.
Join us in...
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Type: Permanent Location: Birmingham, US-AL
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:20
-
The job profile for this position is Database Administration Senior Advisor which is a Band 4 Senior Contributor Career Track Role with Cigna-Evernorth Services, Inc.
Responsibilities:
* Review SQL and PL/SQL code to identify performance issues.
* Provide consultation to Application Development teams on SQL and PL/SQL best practices.
* Lead troubleshooting calls with various infrastructure and application teams.
* Work with Oracle vendor to find root cause for complex database issues.
Troubleshoot complex performance issues of Oracle wait events.
* Review Linux and storage internals that influence database activity.
I
* nstall and manage Oracle Database Software, building databases per requirements and standards, and setting up database backups.
* Install and manage Oracle ClusterWare and troubleshooting issues with ClusterWare processes.
* Review database migrations, export/import, and transportable tablespaces.
Restore and recover Oracle databases using RMAN.
* Restore databases from block corruptions and logical corruptions and recover the database to Point-In-Time.
* Apply Quarterly Patches to Database, Standalone Grid Infrastructure, and ClusterWare, and troubleshoot any issues with patching by utilizing a good understanding of Oracle internal processes.
* Set up and manage Oracle Enterprise Manager (OEM) infrastructure and set up monitoring using OEM for database environment.
* Automate routine database operations using Ansible.
Participate in 24
*7 on-call support to resolve Incident tickets and be responsible for database availability.
Virtual/work from home benefit available.
Qualifications:
Requires a Master's degree in Computer Science or a closely related field and 3 years of Oracle database administration experience (or a Bachelor's degree in Computer Science or a closely related field and 5 years of Oracle database administration experience).
Must have experience with: implementing backup and recovery strategies and procedures; RMAN; SQL
*Loader; EXP; IMP; Expdp; Impdp; TOAD; TKPROF; Explain Plan; STATSPACK; SQL Developer; Exadata; GoldenGate; Linux Shell Scripting; Ansible; Python; Microsoft Azure; Oracle Enterprise Manager ("OEM"); SQL; PL/SQL; and performance tuning reports generated by SQL Trace, TKPROF, AWR, ADDM, ASH, and SQL-T.
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 applicant...
....Read more...
Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:19
-
(RN) Non-Premium Oncology Nurse Case Manager
Case managers are healthcare professionals, who serve as customer advocates to coordinate, support, and guide care for our customers, families, and caregivers to assist with navigating through the healthcare journey.
Additionally, the candidate will be responsible for the adoption and demonstration of the Care Solutions cultural beliefs.
They will be responsible for role modeling the six cultural beliefs to drive personal accountability and organizational results.
* Customer Strong: I deliver world-class experiences for all my customers.
* Me to We: I take accountability to trust, partner, and deliver.
* Own It: I see a need and deliver value because I care.
* Evolve and Adapt: I learn and adapt to meet evolving business needs.
* Be Bold: I pioneer and think broadly to solve challenges.
* Take Care: I prioritize self-care and act with compassion toward colleague.
Day in the Life Responsibilities
* Collaborates with customer in creation of care plan and documents plan in medical management system.
* Partners with each customer to establish goals and interventions to meet the customer's needs.
* Establishes plan of care in conjunction with the customer and provider then document into a medical management system.
* Utilizes motivational interviewing, behavior change, and shared decision making to help customers achieve optimal health and well-being.
* Empowers customers with skills to enhance interaction with their providers.
* Interfaces with the customer, family members/caregivers, providers, and internal partners to coordinate the needs of the customer through telephonic, email, text, and chat interactions.
* Collaborates with nutritionist, pharmacist, behavioral clinician, Medical Director and customer's provider and other Cigna Medical Management programs to provide whole-person health support.
* Tracks daily activities to trend volume and outcomes.
* Follows standard operating procedures.
* Toggles between multiple systems and applications.
* Research relevant topics in health promotion and disease prevention, as required for specific customers.
* Prioritizes work to meet commitments aligned with organizational goals.
* Understands and adheres to Case Management performance measures to deliver on key results.
* Completes training within the communicated time limit as required per role.
* Demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate.
Minimum requirements:
Active unrestricted Registered Nurse (RN) license in state or territory of the United States.
Minimum of two years full-time direct patient care as an RN required.
Preferred requirements:
* For Specialty Case management positions, experience in the specialty Oncology preferred.
* Must have an active and unencumbered RN License.
* Within four (4) years of hire...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:18
-
SUMMARY
Customer Service Representative - Remote
PROCLAIM- FACETS
Are you a caring, curious, dedicated, and compassionate person that wants to make an impact on the lives of others? If so, Cigna Healthcare, a division of The Cigna Group, is hiring customer service representatives like you to join our US Medical team.
Use your problem-solving and listening skills to answer questions from Cigna Healthcare customers.
As a trusted customer service representative, you'll help answer questions about benefits, eligibility, prior authorizations, and claims.
You'll also suggest other programs that could help the customers overall wellbeing.
We'll prepare you for success with 11-12 weeks of required training during your first 90 days.
This training will give you everything you need to provide excellent service to our customers.
An added benefit is that this position is work at home.
So, you get to enjoy helping people from the comfort of your own home.
How you'll make a difference:
* Answer 40+ calls per day on average from customers and help with their questions.
* Use several computer programs at the same time for each call.
* Solve problems on your own and try to fix issues in one call.
* Meet call center goals and provide accurate information politely and professionally.
* Listen carefully to understand what customers need and use your knowledge to respond effectively and guide them on what to do next.
* Adapt to changes in procedures or guidelines and stay professional and focused while working from home.
* Work with other teams to resolve issues and improve service.
Requirements:
* High School diploma or equivalent
* 2+ years of customer service experience
* A quiet, distraction-free workspace at home
* Clear and effective communication skills
* Comfortable using a computer
* Good organizational skills
* Strong written and verbal communication
* Ability to stay calm and helpful, even in tough situations
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 - 23 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 ou...
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Type: Permanent Location: Plano, US-TX
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:17
-
Cigna Supplemental Benefits (CSB) provides peace-of-mind and financial security for more than 800,000 policyholders of all ages through Medicare Supplement and Supplemental Health and Life (SHL) products.
Our environment is fast paced, the work is meaningful and intense, and our performance expectations are high.
The ideal candidate will leverage their creative data insights and advanced analytics skills to shape the strategy of Cigna Supplemental Benefits, making recommendations across both the finance and operational lines of business.
The Business Analytics Advisor will be responsible for leading critical analytical work that supports CSB (Cigna Supplemental Benefits).
They will work closely with CSB leadership and their teams to deeply understand the business problems at hand, develop analytical models/insights and build compelling business cases presentations that positively influence go forward strategy.
This role will be highly visible, and the individual will be a critical thought partner to the organizations that they directly support.
Key Job Functions
* Extract knowledge/insights from disparate data sources to create insights and trends
* Leverage a data first approach to identify critical business trends and insights to make specific actionable recommendations.
* Combine data and business acumen to make strategic recommendations to leadership
* Make recommendations for process changes based on identified gaps that could lead to exposure for CSB
* Build machine learning models from design through training, evaluation and implementation
* Manage large projects or processes with limited oversight from manager.
* Interpret internal or external issues and recommend solutions/best practices.
* Solve complex problems; take a broad perspective to identify solutions.
* Identify and develop relationships with internal and external stakeholders to achieve program objectives.
* Communicate regularly with senior leadership team on emerging trends
Qualifications
* Bachelor's Degree in statistics, mathematics, physics, economics, or other analytical or quantitative discipline.
Master's Degree or PhD preferred.
* 5+ years of experience in data analytics and/or data modeling
* Extract and manipulate large healthcare data using data analytics tools such as Databricks, SAS, SQL, R, Python, Teradata, etc- must have experience in one of these.
* Hands on experience with both traditional and open source tools:
+ SAS
+ Databricks
+ SQL
+ Python/R
+ Pytorch/Tensorflow
* Develop actionable insights and present results to non-technical business partners and stakeholders to drive the decision-making process
* Demonstrated analytic strength related to healthcare data analytics
* Handle personal and confidential information with high degree of integrity.
* Highly organized and detail oriented.
* Solid research and ...
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Type: Permanent Location: Philadelphia, US-PA
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:17
-
Position Summary:
Responsible for collaborating with healthcare providers, members, and business partners, to optimize member benefits, evaluate medical necessity and promote effective use of resources.
Medical necessity reviews may include: planned elective services, surgical and diagnostic procedures, durable medical equipment and out of network services.
Conduct reviews in compliance with medical policy, member eligibility, benefits, and contracts.
Essential Duties and Responsibilities:
* Responsible for the effective and sufficient support of all Utilization Management activities to include review of inpatient and outpatient medical services for medical necessity and appropriateness of setting according to established policies and compliance guidelines.
* Uses an established set of criteria to evaluates and authorize the medical necessity of services.
* Provide notification of decisions in accordance with compliance guidelines.
* Coordinate with Medical Directors when services do not meet criteria or require additional review.
* Participation in staff meetings, regular trainings and other collaborative meetings as appropriate.
* Works with management team to achieve operational objectives and financial goals.
* Supports teams across UM Department as needed.
* Active participation and completion of all required trainings.
* Maintain Required Licensures.
* Adherence to regulatory and departmental timeframes for review of requests
* Meet/exceed department Turn Around time, daily established productivity goals, and service levels
* Proficient knowledge of policies and procedures, Medicare, HIPPA and NCQA standards;
* Professional demeanor and the ability to work effectively within a team or independently;
* Flexible with the ability to shift priorities when required
* Other duties as required
Qualifications:
* Current Licensed Practical Nurse LPN or Licensed Vocational Nurse LVN or RN License
* Minimum 2-3 years clinical experience.
* Experience in regulated managed care setting preferred
* Strong Customer orientation
* Strong organizational, planning, and communication skills
* Working knowledge of insurance industry, medical coding (CPT/HCPCS/ICD-10), and overall claims process a plus
* Knowledge of National Coverage Determinations, Local Coverage Determinations and MCG criteria are a plus.
* Excellent time management skills
Knowledge, Skills, Abilities Required:
* Excellent interpersonal and communications skills with nursing staff, physicians, nurse practitioners and other health workers involved in the care of a member
* Ability to meet deadlines and manage multiple priorities, and effectively adapt and respond to complex, fast-paced, rapidly growing, and results-oriented environments
* Able to work in a dynamic, fast-paced team environment and to promote team concepts
* Excellent typing skills.
...
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Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:16
-
Case managers are healthcare professionals, who serve as customer advocates to coordinate, support, and guide care for our customers, families, and caregivers to assist with navigating through the healthcare journey.
Additionally, the candidate will be responsible for the adoption and demonstration of the Care Solutions cultural beliefs.
They will be responsible for role modeling the six cultural beliefs to drive personal accountability and organizational results.
* Customer Strong: I deliver world-class experiences for all my customers.
* Me to We: I take accountability to trust, partner, and deliver.
* Own It: I see a need and deliver value because I care.
* Evolve and Adapt: I learn and adapt to meet evolving business needs.
* Be Bold: I pioneer and think broadly to solve challenges.
* Take Care: I prioritize self-care and act with compassion toward colleague.
Day in the Life Responsibilities
* Collaborates with customer in creation of care plan and documents plan in medical management system.
* Partners with each customer to establish goals and interventions to meet the customer's needs.
* Establishes plan of care in conjunction with the customer and provider then document into a medical management system.
* Utilizes motivational interviewing, behavior change, and shared decision making to help customers achieve optimal health and well-being.
* Empowers customers with skills to enhance interaction with their providers.
* Interfaces with the customer, family members/caregivers, providers, and internal partners to coordinate the needs of the customer through telephonic, email, text, and chat interactions.
* Collaborates with nutritionist, pharmacist, behavioral clinician, Medical Director and customer's provider and other Cigna Medical Management programs to provide whole-person health support.
* Tracks daily activities to trend volume and outcomes.
* Follows standard operating procedures.
* Toggles between multiple systems and applications.
* Research relevant topics in health promotion and disease prevention, as required for specific customers.
* Prioritizes work to meet commitments aligned with organizational goals.
* Understands and adheres to Case Management performance measures to deliver on key results.
* Completes training within the communicated time limit as required per role.
* Demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate.
Minimum requirements:
Active unrestricted Registered Nurse (RN) license in state or territory of the United States.
Minimum of two years full-time direct patient care as an RN required.
Preferred requirements:
* Nursing experience in Transplant strongly preferred
* Must have an active and unencumbered RN License
* Within four (4) years of hire as a case manager will possess a URAC-recognized certification in case management.
...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:15
-
Flexible Onsite Location: Bloomfield, CT, Chattanooga, TN, St.
Louis, MO, Scottsdale, AZ, Denver, CO.
* Willing to consider other onsite locations.
OVERVIEW :
The Vice President Provider Data Operations will serve as an essential part of the Provider Solutions & Operations (PS&O) leadership team, developing a provider data strategy to unlock Cigna's strategic plans leveraging networks and provider data capabilities for growth and monetization.
Reporting to the Senior Vice President of PS&O, the Vice President will be primarily responsible for overseeing the end-to-end process of provider data ingestion and maintenance.
Additionally, will partner with other leaders across Technology and Operations to ensure that Cigna's capabilities and strategic partnerships are resulting in industry leading provider data capabilities and experience for all critical stakeholders.
Their expertise will guide the organization's evolution to dramatically improved accuracy and compliance through enhanced data collection methodologies, and technologies.
The long-term goal will be to simplify, accelerate and improve all facets of provider data across the organization.
Successful candidates will be able to articulate the differentiating value they will bring to the organization and how their experience can activate the overall vision of our provider data strategy.
Candidates must be adept at change management, have a strong understanding of transformative technologies, and the ability to build strong teams and influence results in a highly matrixed environment.
They must consciously and strategically balance possibilities with reality, which may involve a phased implementation of ideas and initiatives.
The successful candidate will have a track record of building a network of champions for effective execution, both in and outside the organization.
RESPONSIBILITIES:
* Lead the Operations Teams responsible for provider data, inclusive of (but not limited to) credentialing, onboarding, loading, maintenance, network build and new solution delivery.
* Develop and execute on a provider data strategy that will result in industry-leading accuracy, experience and compliance for all stakeholders.
* Establish a Provider Data Governance process, which will create and implement enterprise-wide guidelines, controls and decision-making processes regarding the ingestion and maintenance of Provider Data.
* Develop and execute the provider data strategy, focusing on data needs specific to organizational priorities and business units (i.e.
Operations, Growth Segments, Regulatory/Compliance, etc.).
* Oversee the collection, integration, and quality assurance of diverse provider data sources, including proprietary data sets, third party data, research data, and alternative data.
* Collaborate with Operations and Technology leads to identify opportunities (through artificial intelligence and other technology-enabled platforms) and drive innovation in prov...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:13
-
Software Engineering Senior Advisor - Mobile Developer (Band 4 High)
Cigna, a leading Health Services company, is looking for exceptional Full Stack Engineers (FSE) in our Data & Analytics organization.
A senior mobile advisor is a person that has a breadth of knowledge in computer science, a problem solving mentality and a desire to learn.
The candidate will play a technical leadership role within the Evernorth Consumer group and is responsible for driving the adoption of software engineering best practices and innovative product introduction.
The individual must have superb analytical and technical skills coupled with the ability to mentor effectively.
The applicant will be working in a team that demands technical excellence and whose members are expected to hold each other accountable in the overall success of the output.
The applicant will be working with internal and external stakeholders and customers for building solutions as part of Evernorth Consumer mobile space and will need to demonstrate technical acumen and communication skills.
Job Responsibilities:
•The Sr.
Mobile Advisor will be responsible for delivering business needs end-to-end from requirements to development into production.
•Through a hands-on engineering approach, this individual will code for backend, middleware and front-end applications.
•The SMA will map user stories to detailed technical specifications, automate test cases, triage bugs, and optimize infrastructure.
•The applicant will be responsible for following mobile software engineering best practices with an automation first approach and continuous improvement mindset.
•The applicant will also drive reuse, engage in peer code reviews and foster innovation.
•The applicant will ensure adherence to enterprise architecture direction and architectural standards.
•The applicant should be able to collaborate in a high-performing team environment, with an ability to influence and be influenced by others.
Skills/qualifications:
• At least 5 years of experience in mobile software engineering.
• Strong experience with React, React Native, and JavaScript.
• Experience with development in at least one modern native mobile OS language including Swift and Kotlin.
• Experience with legacy native mobile OS languages including Objective-C and Java is a plus.
• Experience building and using pipelines with mobile CI/CD tools such as Bitrise or Microsoft AppCenter is a huge plus.
• Experience with migrations from native mobile to React Native mobile platforms is preferred.
• Strong expertise with Git.
• Experience with microservices and cloud native frameworks.
• Experience creating and consuming REST APIs.
• Proficient in self-testing of applications, unit testing, and use of mock frameworks, test-driven development (TDD)
.
• Experience in building a software 'product' which will be transitioned to others for support and further evolution (including documentation, complete to...
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Type: Permanent Location: Charlotte, US-NC
Salary / Rate: Not Specified
Posted: 2024-10-31 07:41:12
