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Medical Director - Pediatric Cardiologist- Evicore- Remote
We have both full-time and part-time opportunities available.
Do you crave an intellectually stimulating job that allows you to leverage your clinical expertise while developing new skills and improving the lives of others? Then look no further! As a Pediatric Cardiologist Medical Director at Evicore part of Evernorth Health Services, a division of The Cigna Group, you'll use your clinical know-how to provide evidence-based medical reviews for patient care.
Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases.
This role offers you the opportunity to build new skills while enhancing the health and vitality of others.
We're seeking a detail-oriented individual with good communication, technology, and typing skills, as well as strong clinical judgment.
Drive growth in your career with our innovative team.
How you'll make a difference:
* You'll start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success.
* Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on eviCore's case management software.
* Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence-based medical necessity and appropriateness of the requested service or treatment.
* Leverage your clinical expertise to recommend alternative services or treatments as necessary.
* Work collaboratively with over 500 eviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making.
What you'll enjoy about working here:
* Benefits start on day one
* Predictable work schedules
* 100% work from home
* 8 Paid Holidays + 23 PTO Days
* 401(K) with company match
* Reimbursement for continuing medical education
* Career growth opportunities across the enterprise
* Networking with peers across multiple medical specialties
Requirements:
* M.D.
or D.O.
with a current, active, U.S.
state medical license and board certified inPediatric Cardiology recognized by the American Board of Medical Specialties, or American Osteopathic Association
* Eligible to acquire additional state licensureas required
* 5 years of relevant clinical experience post residency/fellowship
* Knowledge of applicable state federal laws
* Utilization Review Accreditation Commission and National Committee for Quality Assurance standards is a plus
* Ability to commit to a set, weekly work schedule (Monday through Friday)
* Strong computer skills: ability to work autonomouslywith automated processes, computer applications, and systems
* Meet physical demands of the role including, but not limited to, typing, speaking, and listening 100% of time
* In accordance with our HITECH Security Accredi...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-05-16 08:57:02
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As a Warehouse Lead Representative, you will be responsible for the distribution of workload and monitoring of workflow for members of their assigned area to ensure assigned work is completed timely and accurately.
Serves as a resource to supervisor and back up to cell owners and team members.
This role is Worksite dependent and can only be performed onsite.
3pm-11pm EST
What you'll do:
* Ensure appropriate distribution of workload and workflow for assigned area including scheduling, shifting resources and back filling as needed.
* Serve as the first line resource for questions/issues from team and cell owners, in coordination with supervisor; demonstrates leadership qualities consistent with the Cigna Group values.
* Effectively manages issues impacting productivity of team members; including offering solutions, collaborating with others, communicating status and escalating as needed.
* Assist 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, documentation and updating of policies and procedures for Coordinators , including specific training and validation material; Assist in training and validating Automation staff regarding procedures, including one on one training and/or to group sessions as needed, ensure that all team members are cross trained to cover production functions.
* Other duties as assigned.
What you need to do the job:
* High School diploma or equivalent is required
* 2-4 years relevant work experience
* Experience leading people or a team in warehouse setting is strongly preferred
* General PC knowledge: Microsoft Word, Excel, PowerPoint and email skills, preferred
* Knowledge of standard concepts, practices, and procedures within dispensing pharmacy
* Experience troubleshooting problems in a pharmacy dispensing environment is preferred
* Strong attention to detail with good organizational skills
* Good verbal and written communication skills
* Willingness to work a flexible schedule when needed and ability to stand for the full shift
* Ability to adapt in a dynamic work environment, learn quickly, troubleshoot problems and make decisions
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...
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Type: Permanent Location: New Castle, US-DE
Salary / Rate: Not Specified
Posted: 2025-05-16 08:57:01
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Role Overview:
The Enrollment/Billing Senior Representative works under the direction of the Manager of RCM to maintain the accuracy of Village Fertility Pharmacy's Accounts Receivable balances to ensure accuracy and timeliness of balances.
Essential Functions:
* Coordinates billing and collection across multiple payors.
* Utilizes knowledge of accounting and pharmacy systems to ensure proper posting and reconciliation of payments across multiple payors.
* Downloads reports from multiple portal locations daily/weekly as assigned.
* Downloads Leadernet reports daily and send to TPMS.
* Downloads credit card payments daily and assist with reconciliation of payments.
* Works directly with the shipping and scheduling teams to ensure front-end accuracy on completion of orders.
* Maintains multiple email boxes, instant messages, and communications with operations team on billing issues.
* Posts manual payments for patient accounts and handles patient account issues.
* Performs necessary investigation and collection procedures required to keep accounts receivable balances current & accurate.
* Communicates adjustments and reconciliations with finance department to enable accurate financial reporting.
* Works proactively with patients to educate them about their account balances, process payments and facilitate their questions.
* Creates invoices and history reports as needed and requested.
* Processes monthly patient account statements and invoices.
* Determines required adjustments to billed claims and adjusts claims as needed on a timely basis based on existing policy and procedures and reports them to Manager and Lead Analyst for processing.
* Reviews aging reports for clinic billing and patient accounts regularly.
* Reconciles credit card payments for multiple locations to pharmacy systems.
* Processes credit card payments as needed for office and patient payments due.
* Assists operations team with weekly claims reversals as needed.
* Assists accounting team with tasks as needed.
* Performs other duties and responsibilities as needed.
Requirements:
* Must be local to Scottsdale, AZ as training will be onsite followed by a hybrid schedule of 3 days onsite, 2 days remote
* Must be able to able to work an 8 hour shift Monday - Friday within this timeframe: 7:30am - 5pm MST
* HS diploma or GED required
* Experience in healthcare setting working in insurance and/or patient billing preferred
* 1+ year experience in specialty office, medical billing, or pharmacy preferred
* Proficient computer skills including all Microsoft programs
* Experience with accounts receivable & reconciliation functions preferred
* Basic knowledge of medical terminology, as well as a baseline understanding of specialty medications
* In-depth knowledge of insurance coverage, terminology, and benefit investigation
* Able to com...
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Type: Permanent Location: Scottsdale, US-AZ
Salary / Rate: Not Specified
Posted: 2025-05-16 08:57:01
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Are you ready to step into a position that combines your attention to detail and communication skills with your unrelenting drive to help others? We're looking for Pick Packers to join our Operations team.
Your work will ensure orders are pulled, packed and shipped appropriately so our patients get the medication they need at the right time.
Want to know more about what you'll do? Great!
Schedule:
Monday - Friday, 11:30AM - 8PM
How you'll make an impact:
* Ensure process efficiency - Pull and verify orders, manifest cartons, verify accuracy of order, stack and shrink wrap orders for shipment.
* Pay attention to detail - Verify orders are accurate and packed according to specifications: extra dunnage, ice, and special instructions.
* Be a team player - Maintain general housekeeping of warehouse and pack stations, restock pack stations, return totes and carts to proper areas.
What you need:
* Ability to lift 50 lbs.
* Six months of work experience in a distribution center environment preferred.
* Basic computer skills and RF unit experience helpful.
* Ability to read, write and type in English.
* Ability to work Monday - Friday, 11:30AM - 8PM
* Ability to pass a drug screen, including nicotine screen
Why join Cigna?
* Health coverage effective day 1 (including medical, dental, vision)
* Holiday, PTO and OT pay
* Weekday shifts with rare weekend differential available
* Annual bonus potential based on performance
* Social distancing precautions in place (daily temperature checks, 6 ft.
distancing, hand sanitizer stations, regular deep clean of facility, staffing limitations in breakrooms, etc.)
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...
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Type: Permanent Location: Grove City, US-OH
Salary / Rate: Not Specified
Posted: 2025-05-16 08:57:00
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SOC 1 Compliance and Delivery Manager
*
*This is a senior, individual contributor role
*
*
Job Description:
This is a global role focused on leading SOC1 compliance and delivery of general computing control testing support for System and Organization Controls (SOC1) Reports.
The SOC1 Compliance and Delivery Manager will collaborate with organization-wide Technology teams to drive SOC control and risk mitigation practices for Evernorth, identify gaps in controls, and support audit activities.
The successful candidate will have the knowledge and skillset to understand audit best practices and serve as a subject matter expert over technology controls and SOC1 execution.
Responsibilities:
* Partner with internal and external auditors to coordinate SOC1 audit timelines, engagement planning, technology controls testing, fieldwork, process walkthroughs, and reporting across multiple Evernorth reports
* Prepare, review, and deliver documentation and reports for internal and external stakeholders
* Coordinate with external auditors to ensure timely completion of SOC audits and report issuance
* Execute key functions of Internal Audit's SOX/SOC oversight program for Evernorth
* Coordinate testing oversight, evidence gathering, deficiency analysis, and additional testing in support of external and internal audit teams
* Assist with reporting on and maintaining key measures of success for SOC Compliance efforts
* Collaborate with Financial Compliance team to assess scope and facilitate testing coverage
* Meet frequently with control owners to assess compliance with audit requests and stay appraised of changes in the environment
* Identify and communicate internal and external security/audit risks through analysis of control evidence
* Collaborate with technical teams to interpret control requirements and assess design and operating effectiveness of key controls
* Assess the effectiveness of IT general controls, including system development, security, change management, backup, batch/automated processing controls
* Review and provide feedback on scope changes to systems and infrastructure (including AWS, AI, and other technologies) and integrate them into SOX/SOC testing strategy
* Assist internal SOX testing team in execution of annual SOX/SOC test program
* Review and respond to internal and external data requests for regulatory audits
* Advise management on control implementation, remediation, and process changes, including follow-up on identified gaps
* Influence senior and line management on risks and control matters, and advise on remediation efforts
* Manage and review the work of staff performing control assessments, providing feedback and improvement opportunities
* Contribute to process improvements, including establishing continuous monitoring models and staying current on emerging technology trends
Qualifications:
* Bachelor's degree in a related fi...
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Type: Permanent Location: Philadelphia, US-PA
Salary / Rate: Not Specified
Posted: 2025-05-16 08:56:59
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LOCATION: Hybrid position aligned to the New England Market.
Will consider candidates that live in MA, RI and ME.
Preferred office location: Newton, MA
The Manager, Provider Contracting Network Management 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
* Should possess a bachelor's degree; preferably in the areas of Finance, Economics, Healthcare or Business related.
Significant industry experience will be considered in lieu of a bachelor's degree.
MBA or MHA preferred.
* 3+ years Managed Care c...
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Type: Permanent Location: Newton, US-MA
Salary / Rate: Not Specified
Posted: 2025-05-16 08:56:58
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POSITION SUMMARY
As the Operations Senior Analyst, you will collaborate among stakeholders in order to review, and analyze requirements, communicate our strategic vision against the request, and successfully implement requirements timely.You will need to understand business problems and opportunities in the context of the requirements and recommend solutions.
Candidates who reside within 50 miles of one of the following locations will be required to perform onsite 3 days per week: Bloomfield, CT; Chattanooga, TN; Denver, CO; St Louis, MO; and Scottsdale, AZ.
Primary Functions
* Responsible for the successful implementation and maintenance of requests within the department.
* Assist with requirement collection and analysis, identify problem areas and recommend revising requirements to ensure a successful implementation.
* Leverage technical skills to provide analysis, reporting, and assistance to management and stakeholders.
* Leverage communication and relationship skills, to manage the technical, client facing, product teams and update leadership.
* Responsibilities will include day-to-day operations, business analysis, project management, scheduling, and status reporting.
* Additional responsibilities may include interdepartmental process improvement and other internal initiatives.
Key Qualifications
* High school diploma or GED; Bachelor's degree preferred
* At least 2 years relevant experience in project management, campaign management, or print production preferred
* Knowledge of Express Scripts systems and platforms preferred
* Proficient using MS Office software
* Knowledge of SQL preferred
* Analytical and detail oriented with a strong customer service focus
* Ability to work cross-functionally
* Ability to manage timelines and meet tight deadlines
* Excellent oral and written communication skills
* Willingness to work a flexible schedule to accommodate project deadlines
* Able to work towards specific deliverables within tight deadlines amongst multiple projects.
* Ability to handle complex analysis from issue identification to proposal of potential solutions.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an annual salary of 52,900 - 88,100 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 hea...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-05-16 08:56:57
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Werde Postbote für Pakete und Briefe in der Region Lörrach (Rheinfelden, Grenzach, Schopfheim, Weil am Rhein, Efringen, Kandern)
Was wir bieten
* 18,47 € Tarif-Stundenlohn inkl.
50% Weihnachtsgeld und regionaler Arbeitsmarktzulage
* Weitere 50% Weihnachtsgeld im November
* Bis zu 332 € Urlaubsgeld
* Du kannst sofort unbefristet in Vollzeit starten, 38,5Stunden/Woche
* Möglichkeit der Auszahlung von Überstunden
* Ein krisensicherer Arbeitsplatz, garantierte Gehaltssteigerung gemäß Tarifvertrag und pünktliche Gehaltszahlungen
* Kostenlose Bereitstellung von hochwertiger Arbeitskleidung
* Ausführliche Einweisung (bezahlt) – wir machen dich fit für die Zustellung
* Unbefristete Übernahme und Entwicklungsmöglichkeiten (bspw.
Standortleiter) bei guten Leistungen und offenen Positionen möglich
* Attraktive Mitarbeiterangebote wie z.B.
arbeitgeberfinanzierte betriebliche Altersvorsorge, Fahrradleasing, Rabatte bei Mobilfunkanbietern, etc.
Deine Aufgaben als Postbote bei uns
* Zustellung von Brief- und Paketsendungen
* Auslieferung an 5 Werktagen (zwischen Montag und Samstag)
* Heben von Sendungen bis maximal 31,5 kg (Im Durchschnitt 10 kg)
* Transport mit einem unserer Geschäftsfahrzeuge
Was du als Zusteller bietest
* Du darfst einen Pkw fahren
* Du kannst dich auf Deutsch unterhalten
* Du bist wetterfest und kannst gut anpacken
* Du bist zuverlässig und hängst dich rein
Werde Postbote bei Deutsche Post DHL
Als Postbote bringst du den Menschen in deinem Bezirk Post- und Paketsendungen.
Dabei lässt du dir von keinem Wetter die Laune verderben und bist fünf Werktage pro Woche (zwischen Montag und Samstag) unterwegs.
Auch Quereinsteiger oder Studenten sind bei uns herzlich willkommen, denn du zählst, wie du bist!
Wir freuen uns auf deine Bewerbung als Fahrer, am besten online! Klicke dazu einfach auf den 'Bewerben' Button .
MENSCHEN VERBINDEN, LEBEN VERBESSERN
#werdeeinervonuns
#werdeeinervonunspostbote
#verbundfreiburgsocial
#jobsnlfreiburg
#zustellernlfreiburg
#jodelnlfreiburg
#F1Zusteller
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Type: Permanent Location: Lörrach, DE-BW
Salary / Rate: Not Specified
Posted: 2025-05-16 08:56:57
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The Cigna Group is hiring an Eligibility Senior Representative for Individual and Family plans (IFP) .
This role will be responsible for implementing, updating and maintaining electronic and manual eligibility data in the core systems.
You would also be accountable for identifying any file formatting or data integrity errors, identifying process improvement opportunities for eligibility, and partnering with internal and external partners and vendors to create a positive customer experience.
You may provide or facilitate limited technical support for electronic processing of eligibility and may work with internal partners to provide expertise and resolve file errors.
What you'll do:
* Reconciliation of eligibility between various eligibility source systems
* Interacts with internal and/or external partners on and offshore
* Takes individual ownership to identifier barriers and areas of opportunities
* May be assigned as a Subject Matter Expert (SME) for projects involving Eligibility and/or Electronic Enrollment
* Accountable for identifying file formatting or data integrity errors and working with the business leads for resolution
* Appropriately use DPL (Daily Production Log) as part of MOS (Management Operating System)
* Support cross functional activities to help with capacity shortages, this includes learning and adapting to the team's need and capacity availability
Requirements:
* High School Diploma or GED.
Bachelor's Degree preferred
* 2+ years of Individual Family Plan (IFP) or Group Plan Eligibility experience, highly preferred
* Centralized Eligibility Database, (CED) and/or Facets experience, preferred
* Technical ability with Microsoft Office products (i.e.
Outlook, Word, etc.), required
* Intermediate skills with Excel, including, V-lookups, pivot tables, etc.
and navigating multiple systems platforms, highly preferred
* High level of written and oral communication skills
* Demonstrated ability to learn and apply knowledge quickly while utilizing perseverance and customer-centric approaches in day-to-day work
* Ability to work independently with limited supervision and in a team environment
* Ability to manage multiple priorities simultaneously
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 19 - 28 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 ...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-05-16 08:56:56
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The Cigna Group is hiring an Eligibility Senior Representative for the error Resolution team.
As an Eligibility Senior Representative, you'll be responsible for implementing, updating and maintaining electronic and manual eligibility data in the core systems.
You'll also be accountable for identifying any file formatting or data integrity errors, identifying process improvement opportunities for eligibility, and partnering with internal and external partners and vendors to create a positive customer experience.
You may provide or facilitate limited technical support for electronic processing of eligibility and may work with internal partners to provide expertise and resolve file errors.
What you'll do:
* Reconciliation of eligibility between various eligibility source systems
* Interacts with internal and/or external partners on and offshore
* Takes individual ownership to identifier barriers and areas of opportunities
* May be assigned as a Subject Matter Expert (SME) for projects involving Eligibility and/or Electronic Enrollment
* Accountable for identifying file formatting or data integrity errors and working with the business leads for resolution
* Appropriately use DPL (Daily Production Log) as part of MOS (Management Operating System)
* Support cross functional activities to help with capacity shortages, this includes learning and adapting to the team's need and capacity availability
Requirements:
* High School Diploma or GED.
Bachelor's Degree preferred
* 2+ years of Individual Family Plan (IFP) or Group Plan Eligibility experience, highly preferred
* Centralized Eligibility Database, (CED) and/or Facets experience, preferred
* Technical ability with Microsoft Office products (i.e.
Outlook, Word, etc.), required
* Intermediate skills with Excel, including, V-lookups, pivot tables, etc.
and navigating multiple systems platforms, highly preferred
* High level of written and oral communication skills
* Demonstrated ability to learn and apply knowledge quickly while utilizing perseverance and customer-centric approaches in day-to-day work
* Ability to work independently with limited supervision and in a team environment
* Ability to manage multiple priorities simultaneously
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 19 - 28 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 hea...
....Read more...
Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-05-16 08:56:55
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SUMMARY:
As part of Cigna Pharmacy Management, the Pharmacy Account Management Advisor serves as the primary pharmacy benefits subject matter expert supporting Cigna Pharmacy clients in our under 500 employee market segment.
The Pharmacy Account Executive is responsible for developing and maintaining relationships with internal stakeholders, clients, brokers/consultants by supporting the medical sales teams with the Cigna Pharmacy Management client retention & growth strategies as well providing expertise with implementation, reporting, and day-to-day service functions.
PRIMARY RESPONSIBILITIES:
* Retain assigned book of business.
* Educate and consistently advance the knowledge of pharmacy with the Cigna medical sales organization.
* Participate in client meetings and presentations to review client performance and offer and successfully sell in a suite of pharmacy management programs and solutions.
* Uncover and promote opportunities to expand the pharmacy earnings contribution to the broader Cigna organization through individual client and medical sales organization initiatives and efforts.
* Partner with medical sales, underwriting, and others as the pharmacy subject matter expert for pricing, competitive intelligence, and pharmacy renewal strategies to retain and grow assigned book of business.
ADDITIONAL RESPONSIBILITIES:
* Coordinate core service delivery external messaging, working cross-functionally with all operational support areas.
* Facilitate service concern resolution meetings with clients and brokers; act as escalated issue contact for pharmacy issues when contacted by the medical sales teams.
* Actively participate in finalist meetings for new and existing business.
* Analyze pharmacy utilization in order to provide clients with consultative solutions and manage follow-up questions.
* Develop a clear understanding of clients' needs, goals and objectives.
* Provide pricing, audit, and contract support to clients and internal medical partners.
* Explain pharmacy coverage rules based on Cigna policies or with support of a Clinical partner.
IDEAL CANDIDATES WILL HAVE A COMBINATION OF THE FOLLOWING:
* Bachelor's degree preferred
* 5+ years of Pharmacy Benefit Management (PBM) experience supporting client expectations
* Experience with consultative client management methodologies
* Proven ability to manage a renewal independently with minimal supervision
* Ability to navigate and leverage the broader organization to better support clients
* Self-motivation, displaying ownership, flexibility, accountability and responsibility
* Operational understanding and competence with the PBM business model
* Understanding of financial and pricing strategies of PBM
* Excellent verbal and written communication skills
* Excellent presentation skills in group settings
* Technical skills using all Microsoft programs
* Ability t...
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Type: Permanent Location: Tampa, US-FL
Salary / Rate: Not Specified
Posted: 2025-05-16 08:56:54
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Evernorth Care Group, the group practice division of CIGNA HealthCare of Arizona, is one of the Valley's largest primary care group practices with 18 offices located throughout metropolitan Phoenix.
The Nurse Practitioner will provide advanced nursing care across the continuum of health care services to meet the specialized physiologic and psychological needs of patients with acute, critical, and/or complex chronic health conditions.
The Nurse Practitioner will provide these services at multiple Evernorth clinics within Central Phoenix and West Valley to support extended clinician PTO, leaves of absence and vacancies.
The NP will typically cover at least 1 week at a time per clinic.
Clinical Responsibilities and Essential Functions
* Performs initial patient screenings, patient history, and physical examinations in order to determine care plan and/or treat health conditions.
* Updates patient health records and ensures records are accurate at each patient appointment, ensuring continuity of care and ability to collaborate with other health care professionals in the overall health care of each patient.
* Analyze test results and imaging reports to determine the need for follow-up appointments and/or further treatment options.
* Serves as the resource patients need for ongoing care information, counseling, and provide guidance for any patients with critical conditions.
* Performs chronic health assessments to determine health conditions and develop a treatment plan that includes ordering labs, imaging, referrals to specialty, and/or prescribe medication.
* Performs differential medical diagnosis which includes ordering, conducting and interpreting diagnostic laboratory tests, including radiology studies and EKGs.
* Orders pharmacologic and non-pharmacologic treatments in the direct management of acute and chronic illness.
* Responds to onsite emergencies until EMS can arrive.
* Uses medical training and expertise to responds to the rapidly changing physiologic status of patients.
* Assesses response to therapeutic interventions and recommends continued/change in treatment plan.
* Directs and clinically supervises the work of nurses and other members of the care team.
* Acts in accordance with legal and ethical professional responsibilities (e.g., patient management, documentation, advance directives).
* Accountable to follow all state laws and report as required.
* Follows roles and functions as outlined by the State Board of Nursing
Qualifications:
* Minimum 3 years of experience working as an NP in a primary care setting
* Board Certified Family Nurse Practitioner required AANP, AANC
* Graduate of Certified Nurse Practitioner Program (Master's, post masters or doctoral preparation.)
* Active and unrestricted AZ license required (needed to obtain certification and APN number).
* Pharmacy and DEA prescription privileges required
* BLS certific...
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Type: Permanent Location: Phoenix, US-AZ
Salary / Rate: Not Specified
Posted: 2025-05-16 08:56:54
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Claims Representative - Remote
SUMMARY
The claims representative is responsible for manually reviewing and processing medical, supplemental, or dental claims.
Claims are processed according to benefits, eligibility, and internal processes, policies, and procedures and may be completed, held for additional information/review, or denied.
New claim representatives will be provided with a robust training program, which includes virtual classroom training, on-the-job learning/feedback, and gradually increasing claims per hour/quality requirements over several months.
After completion of training, claim representatives must meet specific accuracy/quality, volume/claims per hour, and on production performance metrics.
$19/Hour Pay Rate
RESPONSIBILITIES
• Independently research and navigate various documents and databases to accurately process claims, ensuring compliance and adherence to established guidelines.
• Confirm the presence of necessary documents within submitted claims.
• Validate the accuracy of medical codes provided in claim submissions.
• Assess the eligibility status of claims based on established criteria.
• Review and verify other insurance coverage information in submitted claim.
• Evaluate authorizations provided in claim submissions for accuracy.
• Analyze account benefit plans to ensure claims align with coverage and policies.
• Identify discrepancies, errors, or missing information.
• Utilize multiple computer applications simultaneously.
• Maintain self-discipline, consistently uphold a strong work ethic, and complete work tasks/responsibilities while working without close supervision.
• Meet or exceed quality and productivity goals.
• Identify claim processing learning opportunities by working directly with supervisors, coaches, and trainers to learn efficient and effective processing techniques and workflows.
• Utilize a variety of virtual tools, including Outlook email, Cisco Webex, and similar applications, to effectively collaborate, communicate, and stay connected with colleagues and supervisors.
QUALIFICATIONS
• High school diploma or equivalent
• Ability to quickly learn a variety of computer applications to complete job functions ,
• Experience sending/receiving emails, scheduling calendar appointments/sending invitations, attaching files in Microsoft Outlook .
• Knowledge of basic Microsoft Excel functions, such as filtering/sorting.
• Experience in navigating multiple computer applications through the use of shortcut keys and other techniques.
• Detail-oriented with experience in applying complex policy/procedure documents.
• Strong organizational skills to maximize available work time.
Ability to prioritize tasks to ensure job tasks are completed before deadlines.
• Proven experience completing work with quality and productivity performance standards.
• Experience working independently in a virtual environment preferred.
• Experience with medi...
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Type: Permanent Location: Philadelphia, US-PA
Salary / Rate: Not Specified
Posted: 2025-05-16 08:56:53
-
POSITION SUMMARY
The Enterprise Print & Distribution (EPD) Quality Review and Audit Senior Analyst of Communications Fulfillment/Inspection leads projects or project steps with a broader perspective/wider business acumen.
This role takes accountability for ongoing activities or objectives that impact the entire facility.
This role requires autonomy but also much collaboration with peer groups/business partners.
This person exercises judgment in the evaluation, selection, and adaptation of both standard and complex techniques and procedures.
We are looking for exceptionally ambitious and communicative individuals.
We are always looking at ways to improve the team and looking for individuals who will be proactive in that process.
EP&D strives to maintain a collaborative community that promotes continued growth and learning.
Additionally, the Senior Analyst will perform data analysis & tracking related to errors, trends and potential risks.
Candidates who reside within 50 miles of the following locations will be required to work in person 3 days per week: Bloomfield, CT, Chattanooga, TN, Denver, CO, St Louis, MO, and Scottsdale, AZ.
Primary Responsibilities
* Inspect/Review program, compliance, and/or campaign communications; comparing input and output to ensure all requirement per client/customer have been satisfied and free from error.
* Create /refine policies and procedures for quality assurance.
* Continually adhering to quality and industry regulatory requirements; communicating industry changes or updates
* Recognize flaws in the production process and fix them; End to End Management of EP&D Issues/Defects, from root cause to preventative measures.
* Provide recommendations for process improvement based on analysis and observation.
* Resolves non-routine issues and completes tasks involving forward thinking & experience.
Key Qualifications
* High school diploma or GED; Bachelor's degree preferred.
* 2+ years of relevant experience, i.e., data analysis, quality assurance, or related
* Experience with testing, auditing, and quality inspection
* Experience within Enterprise Print & Distribution required
* Meticulousness in the details
* Skilled in Excel and data analytics reporting
* Excellent approach to problem solving.
* Excellent written, verbal communication skills.
* Ability to plan for and integrate multiple tasks concurrently.
* Strategic thinker, with excellent prioritization skills.
* Ability to effectively navigate a highly matrixed organization.
* Sound business and technical acumen.
* Demonstrate maturity and flexibility required to interact independently & with diverse and growing internal and external partner bases.
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 up...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-05-16 08:56:52
-
The Pharmacy Production Clerk Associate is responsible for ensuring that all medication meets quality control standards; medications are properly labeled, stored, and stocked; visually inspect patient-bound medications for any defects, spills or quality concerns and report any concerns or issues promptly.
Areas they can be assigned to include, but are not limited to, Bulk and Prep, Packing, Mail Manifest, or any other Pharmacy Support function.
This role is Worksite dependent and can only be performed onsite.
Shifts: Monday - Friday 12:00pm-8:30pm OR Monday - Friday 3:00pm-11:30pm
ESSENTIAL FUNCTIONS
* Ensure each package receives the correct paperwork, envelopes, medications, packing and / or shipping labels before sealing and sending packages to patients.
* Consistently work on only one order at a time at their workstation at all times.
* Ensure that the address prints correctly on each package.
* All bags are correctly sealed; Printers are accurately loaded with the correct paper.
* Accurately package prescriptions requiring special handling according to specific process and policy requirements.
* Work collaboratively with all coworkers to ensure that best practices are shared while maintaining productivity and quality standards.
* Capability to accurately escalate issues to leadership for action; provide input regarding solutions.
* Bulk up medications from manufacturer bottles, including visual inspection and labeling of large containers.
* Visual inspection of patient bound medications.
* Orientation of packages for sortation system.
* Preparation of mail sacks or bulk containers for shipment.
* Manual material handling, storage, and stocking of shelves, workstations, and/or channels.
* Sorting and distribution of literature packs to CADS / Averts stations.
* Keep workstation clean at all times.
* Other duties assigned as needed.
QUALIFICATIONS
* 0-1 years of relevant experience.
* General PC knowledge is required.
* Excellent verbal and written communication skills.
* Good visual acuity.
* Ability to read and compare and differentiate data.
* Ability to stare/review small medications or bottles for extended periods of time.
* Ability to be on feet walking and standing for extended periods of time.
* Demonstrate flexibility and adaptability to perform different roles during a shift.
* Ability to lift up to 40 pounds
Why Choose Us?
* Comprehensive Health Coverage from Day One (including medical, dental, vision).
* Competitive Holiday, Paid Time Off (PTO), and Overtime Compensation.
* Robust 401K Plan with Company Match.
* Vibrant and Inclusive Culture: Embrace our engaging and welcoming workplace environment, where authenticity is celebrated.
Join us in shaping the future of pharmacy operations while enjoying a supportive and enriching work environment that fosters professional growth and fulfi...
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Type: Permanent Location: New Castle, US-DE
Salary / Rate: Not Specified
Posted: 2025-05-16 08:56:51
-
Are you ready to step into a position that combines your communication skills, attention to detail and unrelenting drive to help others? We're looking for a experience pharmacy technician to join our pharmacy team.
As a Pharmacy Technician Sr.
Representative you will be responsible for using advanced knowledge of the job under limited supervision to advise pharmacy techs on order fulfillment and related activities.
Work Schedule: Rotating shifts M-F of 9am-6pm (2 weeks), 11am-8pm (1 week)
ROLES & RESPONSIBILITIES:
* Coordinates and monitors daily workflow in the pharmacy.
* Excellent communication skills
* Ability to multi-task
* Leads team huddles and provides initial coaching and direction to pharmacy techs.
* Participate in Lean and Continuous Improvement efforts internal and external to the department.
Supports staffing of pharmacy tech functions as described in the Pharmacy Technician/Sr - Fulfillment job description.
* Supports and trains new employees, and identifies ongoing training needs of tenured employees that require retraining.
* Conducts quality and productivity audits as assigned by the supervisor.
* Create and modify SOPs.
REQUIREMENTS:
* High School diploma or equivalent; Post-secondary education preferred.
* 3 - 5 years relevant experience; experience in a Specialty pharmacy setting preferred.
* Strong attendance record
* Computer savvy ability in MS Office with strong Excel skill.
* Sit and/or stand for lengthy periods.
* Lift up to 50 lbs.
occasionally and 20 lbs.
frequently
* Perform repetitive motion with fingers, hands, and arms.
* Ability to adapt in a changing environment
Why join Accredo by Evernorth?
• Health coverage effective day 1 (including medical, dental, vision)
• Holiday, PTO and OT pay
• Work/life balance
• Tuition Reimbursement Program
• Opportunities for career growth and advancement
•ABOUT ACCREDO
Through our range of health care products and services offered, Accredo team members provide in-depth care for patients with chronic health conditions like hemophilia, oncology, rheumatoid arthritis and growth hormone deficiency.
In addition to health care products, we provide comprehensive management services - including outcomes measurement, counseling, clinical care management programs, social services and reimbursement services.
By performing in these very high-touch roles, employees have a daily opportunity to make a positive impact on their patients' lives.
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, prev...
....Read more...
Type: Permanent Location: Warrendale, US-PA
Salary / Rate: Not Specified
Posted: 2025-05-16 08:56:51
-
The Pharmacy Production Clerk is responsible for ensuring that all medication meets quality control standards; medications are properly labeled, stored, and stocked; visually inspect patient-bound medications for any defects, spills or quality concerns and report any concerns or issues promptly.
Areas they can be assigned to include, but are not limited to, Bulk and Prep, Packing, Mail Manifest, or any other Pharmacy Support function.
SHIFTS: Saturday-Tuesday 5:00 AM - 3:30 PM OR Monday-Thursday 3:30 PM - 2:00 AM.
This role is Worksite dependent and can only be performed onsite.
How you'll make a difference:
* Juggle multiple tasks without sacrificing deadlines or attention to detail.
Sort, package, seal, and inspect packages.
* Use your expert problem solving skills to help our patients receive their product on time .
Package and label for safe delivery, then work with technology to efficiently get it out the door.
* Create new knowledge with our systems and new relationships with your peers.
You'll start with training and you're not doing it alone.
You'll have the opportunity to cross-train and support overall pharmacy health in other areas like technicians, bulk & prep, and the packing manifest area.
You'll enjoy a supportive environment with your peers and other teams who want you to succeed.
ESSENTIAL FUNCTIONS
* Ensure each package receives the correct paperwork, envelopes, medications, packing and / or shipping labels before sealing and sending packages to patients.
* Consistently work on only one order at a time at their workstation at all times.
* Ensure that the address prints correctly on each package.
* All bags are correctly sealed; Printers are accurately loaded with the correct paper.
* Accurately package prescriptions requiring special handling according to specific process and policy requirements.
* Work collaboratively with all coworkers to ensure that best-practices are shared while maintaining productivity and quality standards.
* Capability to accurately escalate issues to leadership for action; provide input regarding solutions.
* Bulk up of medications from manufacturer bottles, including visual inspection and labeling of large containers.
* Visual inspection of patient bound medications.
* Orientation of packages for sortation system.
* Preparation of mail sacks or bulk containers for shipment.
* Manual material handling, storage, and stocking of shelves, workstations, and/or channels.
* Sorting and distribution of literature packs to CADS / Averts stations.
* Keep workstation clean at all times.
* Other duties assigned as needed.
QUALIFICATIONS
* 0-1 years of relevant experience.
* General PC knowledge is required.
* Excellent verbal and written communication skills.
* Good visual acuity.
* Ability to read and compare and differentiate data.
* Ability to stand/walk for extended periods of time.
...
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Type: Permanent Location: St. Louis, US-MO
Salary / Rate: Not Specified
Posted: 2025-05-16 08:56:50
-
Werde Postbote für Pakete und Briefe in Müllheim
Was wir bieten
* 18,47 € Tarif-Stundenlohn inkl.
50% Weihnachtsgeld und regionaler Arbeitsmarktzulage
* Weitere 50% Weihnachtsgeld im November
* Bis zu 332 € Urlaubsgeld
* Du kannst sofort unbefristet in Vollzeit starten, 38,5 Stunden/Woche
* Möglichkeit der Auszahlung von Überstunden
* Ein krisensicherer Arbeitsplatz, garantierte Gehaltssteigerung gemäß Tarifvertrag und pünktliche Gehaltszahlungen
* Kostenlose Bereitstellung von hochwertiger Arbeitskleidung
* Ausführliche Einweisung (bezahlt) – wir machen dich fit für die Zustellung
* Unbefristete Übernahme und Entwicklungsmöglichkeiten (bspw.
Standortleiter) bei guten Leistungen und offenen Positionen möglich
* Attraktive Mitarbeiterangebote wie z.B.
arbeitgeberfinanzierte betriebliche Altersvorsorge, Fahrradleasing, Rabatte bei Mobilfunkanbietern, etc.
Deine Aufgaben als Postbote bei uns
* Zustellung von Brief- und Paketsendungen mit zur Verfügung gestellten Hilfsmitteln
* Auslieferung an 5 Werktagen (zwischen Montag und Samstag)
* Sendungen bis 31,5 kg (im Durchschnitt unter 10 kg)
* Zustellung mit unseren Geschäftsfahrzeugen, bspw.
vollelektrische Fahrzeuge
Was du als Zusteller bietest
* Du darfst einen Pkw fahren
* Du kannst dich auf Deutsch unterhalten
* Du bist wetterfest und kannst gut anpacken
* Du bist zuverlässig und hängst dich rein
Werde Postbote bei Deutsche Post DHL
Als Postbote bringst du den Menschen in deinem Bezirk Post- und Paketsendungen.
Dabei lässt du dir von keinem Wetter die Laune verderben und bist fünf Werktage pro Woche (zwischen Montag und Samstag) unterwegs.
Auch Quereinsteiger oder Studenten sind bei uns herzlich willkommen, denn du zählst, wie du bist!
Wir freuen uns auf deine Bewerbung als Fahrer, am besten online! Klicke dazu einfach auf den 'Bewerben'-Button – auch ganz ohne Lebenslauf.
MENSCHEN VERBINDEN, LEBEN VERBESSERN
#werdeeinervonuns
#werdeeinervonunspostbote
#jobsfreiburg
#postbotenjobsfreiburg
#jobsnlfreiburg
#jobsfreiburgsea
#zustellernlfreiburg
#F1Zusteller
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Type: Permanent Location: Müllheim, DE-BW
Salary / Rate: Not Specified
Posted: 2025-05-16 08:56:49
-
The job profile for this position is Software Engineering Advisor which is a Band 4 Career Track Role with eviCore healthcare MSI, Inc.
Responsibilities:
BI Data Engineer building ETL processes to allow data to flow seamlessly from source to target.
Load and enhance dimensional data models and leverage code to apply business rules to ensure data is clean and is interpreted correctly by all business stakeholders.
Perform code reviews and quality assurance and participate in sprint ceremonies.
Provide on-call support to offshore operations teams and train operations teams on ETL processes being developed.
Troubleshoot and address issues with data or ETL process and fine-tune existing code to make processes more efficient.
Maintain and create documentation to describe data management processes.
Analyze reports with various tools including Micro Strategy, Tableau, and SSRS.
Support user questions on data management processes and results.
Hybrid work schedule.
Requirements:
Bachelor's or foreign equivalent degree in computers or engineering plus three years of experience in data warehouse integration and development or closely related position.
Must have experience with: Microsoft Azure; SQL, Python, Scala, PowerShell, and Unix; Teradata, Oracle, and SQL Server; Azure Data Factory, Databricks, SSIS, Informatica, IICS, and Teradata utilities; SSRS; Git Lab, TFS, and VSS.
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 unle...
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Type: Permanent Location: Plano, US-TX
Salary / Rate: Not Specified
Posted: 2025-05-16 08:56:48
-
Job Objective:
The Product Manager or Senior Product Manager will play a crucial role in defining the product vision , strategy , roadmap and backlog for one or more products .
An ideal candidate would have successfully led a product from concept to launch and managed the product for continued success.
Wo rk ing closely with cross-functional teams to grow existing products and bring new innovative products to market is an important part of this role .
The ideal candidate will have a strong passion for technology, an exceptional ability to understand and articulate the problem space , conceptualize f rameworks and develop strategies .
Duties and Responsibilities:
*
+ Define and communicate a vision, strategy , r oadmap and backlog for new and existing products .
+ Deliver detailed product documentation with prioritized features and justification based upon business value, product strategy and roadmap.
+ Communicate with customers (internal & external) to gain feedback on user product experiences and opportunities.
Ensure correct features are identified , considering customers, operations, sales, finance, related lines of business and others.
Prioritize and negotiate to build the best possible set of features to be included and developed in the new products.
+ Assist/develop/coordinate new idea reviews and recommendations, concept and design development, project management, and market introduction.
+ Develop wireframes and UI/UX artifacts that can help with communicating a vis ion for the product and enable the engineering teams to move faster.
+ Assist/develop product profiles, competitive analysis, presentations, demos, white papers, and product updates for organizational marketing materials.
+ Able to synthesize relevant data to generate insights that inform understanding of problems, product performance, strateg y and KPI s .
+ Partner with Marketing to coordinate external messaging and expression of product/feature value propositions.
+ Partner with Finance on estimating product demand, profitability and establishing pricing.
+ Present to the Senior Leadership team as necessary .
+ Represent Verity Solutions at industry trade group meetings and presentations as requested .
+ Support and promote Verity Solutions values through positive interactions with both internal and external customers on a regular basis .
Experience, Skills and Qualifications:
*
+ B achelor's d egree in business, engineering, computer science, technology , design or equivalent experience.
+ 7 + years in software product management experience.
+ Deep e xperience in all phases of product management , from concept to launch and on going iterations.
+ Solid understanding of product management best practices and methodologies .
+ Familiarity with Agile development processes and to...
....Read more...
Type: Permanent Location: Kirkland, US-WA
Salary / Rate: Not Specified
Posted: 2025-05-16 08:56:47
-
*
* Any Work at Home Location is Acceptable for This Position
*
*
Responsibilities:
* Researches, analyzes and calculates claims in accordance with provider contracts
* Works with internal matrix partners to resolve pended claims/tickets issues
* Utilizes our SRS system to route work items to matrix partners and external retailer claim administration staff
* Follow audit protocols and workflows to ensure quality goals.
* Special pricing projects as requested by retailers
* Partners with matrix organizations to ensure that appropriate action is taken to identify and implement high potential process improvements
* Supports and drives process improvement to further enhance claim accuracy outcomes
* Engagement, partnership with supervisor, claim processing team, and other internal and external partners
* Position requires excellent interpersonal skills; ability to understand and interpret policy provisions, and to present report analysis and meaningful findings in a clear, concise way.
* Pricing identification of errors and management of resolution with provider contracting/maintenance internal teams.
* Identifies steps necessary to process a varying complexity of contracts for pricing accuracy
Qualifications:
* 1 year of Payer Solutions claim processing technical knowledge and application
* Customer Service Driven; ability to meet and exceed the internal partner and external customer expectations
* Take accountability in critical thinking and decision-making outcomes
* Problem solving skills; utilization of technical skills and resources to ensure accuracy of final claim resolution
* Strong communication skills, both verbal and written
* Ability to teach, educate, coach others through a variety of claim complexities
* Process improvement skills; ability to assess trends, processes, and barriers to drive positive outcomes for claim resolutions
* Fluent understanding and application of key tools and resources for claim processing; C-Kit 2.0, Calculators, CPF/PWB, SANP, Facets, etc.
* Comfortable working with others in multiple locations; office and work at home
* Basic knowledge with Word, Excel, PowerPoint, WebEx and Outlook preferred
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 22 - 33 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 incl...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-05-16 08:56:45
-
Pharmacy Production Clerk
Location: Work on site
Hours: Mon-Fri 12-8:30 pm est
The Pharmacy Production Clerk is responsible for ensuring that all medication meets quality control standards; medications are properly labeled, stored, and stocked; visually inspect patient-bound medications for any defects, spills or quality concerns and report any concerns or issues promptly.
Areas they can be assigned to include, but are not limited to, Bulk and Prep, Packing, Mail Manifest, or any other Pharmacy Support function.
This role is Worksite dependent and can only be performed onsite.
ESSENTIAL FUNCTIONS
* Ensure each package receives the correct paperwork, envelopes, medications, packing and / or shipping labels before sealing and sending packages to patients.
* Consistently work on only one order at a time at their workstation at all times.
* Ensure that the address prints correctly on each package.
* All bags are correctly sealed; Printers are accurately loaded with the correct paper.
* Accurately package prescriptions requiring special handling according to specific process and policy requirements.
* Work collaboratively with all coworkers to ensure that best-practices are shared while maintaining productivity and quality standards.
* Capability to accurately escalate issues to leadership for action; provide input regarding solutions.
* Bulk up of medications from manufacturer bottles, including visual inspection and labeling of large containers.
* Visual inspection of patient bound medications.
* Orientation of packages for sortation system.
* Preparation of mail sacks or bulk containers for shipment.
* Manual material handling, storage, and stocking of shelves, workstations, and/or channels.
* Sorting and distribution of literature packs to CADS / Averts stations.
* Keep workstation clean at all times.
* Other duties assigned as needed.
QUALIFICATIONS
* 0-1 years of relevant experience.
* General PC knowledge is required.
* Excellent verbal and written communication skills.
* Good visual acuity.
* Ability to read and compare and differentiate data.
* Ability to stare/review small medications or bottles for extended periods of time.
* Demonstrate flexibility and adaptability to perform different roles during a shift.
* Flexibility to adapt to a dynamic work environment; willingness to work a flexible schedule when needed.
* Ability to speak English is required for this position due to the need to communicate safety rules on the shop floor.
* Must be able to lift 40 lbs.
* Able to be on your feet for your entire 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...
....Read more...
Type: Permanent Location: New Castle, US-DE
Salary / Rate: Not Specified
Posted: 2025-05-16 08:56:45
-
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 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 w...
....Read more...
Type: Permanent Location: Sugar Land, US-TX
Salary / Rate: Not Specified
Posted: 2025-05-16 08:56:44
-
As a S trategic 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 clien t issues, selling annual renewal rate increase s in addition to new products and services to expand the relationship .
Y ou 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 driven by client success and want to work for...
....Read more...
Type: Permanent Location: San Diego, US-CA
Salary / Rate: Not Specified
Posted: 2025-05-16 08:56:42
-
The U.S.
Employer Consultant Relations team drives relationship growth and development with key firms at both a national and local level.
The team leads the development of consultant strategies, analyzes data to identify opportunities and risks and establishes touchpoints with key consultant partners.
The Consultant Relations Coordinator will work with the team to provide these partners with the information, tools and resources to efficiently and effectively sell, and best articulate Cigna's value proposition in the market.
DUTIES AND RESPONSIBILITIES
* Work with Consultant Relations Directors to develop and execute strategies for key consultant partners and select markets.
* Assist in the strategy, planning and implementation of events and leadership meetings, including on-site participation where appropriate.
* Provide first point of contact operational support for firms that are directly managed.
* Prepare reporting packages with consultant data for distribution internally and externally.
Analyze the data to identify opportunities and risks.
* Work collaboratively with the entire Consultant Relations team to track, organize and distribute operational information.
QUALIFICATIONS
* Bachelor's Degree
* Minimum 3 years insurance industry experience preferred
* Strong project and process management skills, with high attention to detail
* Experience in analyzing data to identify trends and summarize insights
* Strong Word, Excel, PowerPoint, SharePoint, Outlook skills
* Proficient in webinar & conference call management
* Strong interpersonal skills
* Willingness to travel
* Team player with proven ability to manage strong working relationships within a matrix organization
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 75,300 - 125,500 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
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 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 heal...
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Type: Permanent Location: Bloomfield, US-CT
Salary / Rate: Not Specified
Posted: 2025-05-16 08:56:41
