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Manager, Assistant Vice President jobs at AmTrust Financial - 26 jobs

  • AVP, Underwriting Program Manager

    Amtrust Financial Services, Inc. 4.9company rating

    Manager, assistant vice president job at AmTrust Financial

    AmTrust Specialty Programs, a division of AmTrust North America, is a market-leading insurance carrier with more than 20 years of experience developing and growing profitable delegated authority programs in partnership with select Managing General Agents. As a result of persistent, profitable growth within this division, AmTrust is looking to add an Assistant Vice President, Underwriting Specialty Programs to their team. Underwrite an assigned book of Program business across multiple insurance lines in accordance with corporate guidelines Assist in the production of new Program opportunities with a focus on business development. Demonstrate strong relationship management with Program Managers to ensure lasting, profitable books of business. Coordinate the product development for assigned programs Assist in the preparation of specific program filings, as needed. Provide coverage analysis of both competitor and AmTrust products, as needed. Perform audits to ensure compliance with underwriting guidelines Responsibilities Day-to-day underwriting of program business, to include new program opportunities, existing and renewal programs, as assigned. Demonstrate leadership by coordinating internal disciplines/resources to bind and manage the program. Handling of special acceptances, referrals, communication between AmTrust and Program Managers Monthly monitoring of Program performance Travel, as necessary to perform due diligence, underwriting audits, or other such travel as is necessary to properly service the Programs assigned. Attend industry conferences, as assigned. Qualifications A college degree required, in addition to property/casualty insurance experience, preferably 10+ years in an underwriting or product development role across various insurance lines at an insurance company. Ability to work independently and within a team. Self motivated with a high degree of initiative. Strong interpersonal skills, time management and organizational skills. Excellent written communication skills, including correct use of grammar, spelling and punctuation. The position requires strong PC skills, Microsoft Word and Microsoft Excel. The expected salary range for this role is $137K-$200K/year. Please note that the salary information shown above is a general guideline only. Salaries are based upon a wide range of factors considered in making the compensation decision, including, but not limited to, candidate skills, experience, education and training, the scope and responsibilities of the role, as well as market and business considerations. #LI-BL1 #AmTrust What We Offer AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off. AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities. AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a company, how we operate and how we see our future. Not ready to apply? Connect with us for general consideration.
    $137k-200k yearly Auto-Apply 12d ago
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  • AVP, Specialty Risk

    Amtrust Financial Services, Inc. 4.9company rating

    Manager, assistant vice president job at AmTrust Financial

    AmTrust Warranty & Specialty Risk is a recognized leader in specialty insurance solutions, committed to delivering innovative, customized products that address the unique needs of our clients. We focus on niche markets, combining deep risk management expertise with exceptional customer service to create value-driven partnerships. Job Summary We are seeking a strategic and results-oriented Assistant Vice President of Underwriting to lead our Warranty Lines underwriting team. This role is pivotal in driving profitable growth, shaping underwriting strategies, and fostering a culture of excellence across the organization. This senior leadership role is responsible for ensuring underwriting excellence, managing risk selection, and fostering strong Agent and Third-Party Administrator (TPA) relationships. The AVP will collaborate with actuarial, claims, sales, compliance, legal and reinsurance teams to deliver profitable and competitive warranty solutions while maintaining the highest standards of technical expertise and market responsiveness. Responsibilities Leadership & Strategy: - Develop and execute the underwriting strategy for Warranty Lines products in alignment with company goals for profitability, growth, and market leadership. - Lead, mentor, and manage a team of underwriters, fostering a culture of excellence, collaboration, and continuous improvement. Portfolio Management: - Oversee the underwriting process for complex and high-value risks, ensuring sound risk assessment and pricing decisions. - Monitor portfolio performance, identify trends, and implement corrective actions to maintain profitability and mitigate loss exposure. - Partner with actuarial teams to analyze loss ratios, pricing models, and emerging risks unique to Warranty Lines markets. Market & Relationship Management: - Build and maintain strong relationships with brokers, MGAs, TPAs, reinsurers, and key clients to enhance market presence and secure profitable business opportunities. - Represent the company in industry events, conferences, and negotiations to position AmTrust as a leader in Warranty Lines insurance. - Stay informed of market trends, competitor offerings, and regulatory changes impacting Warranty Lines products. Compliance & Risk Management: - Ensure all underwriting activities comply with company policies, state/federal regulations, and industry best practices. - Work closely with claims and legal teams to address complex claims and underwriting disputes effectively. Qualifications - Bachelor's degree in Business, Actuarial, Mathematics, Finance, Insurance, Risk Management, or a related field; advanced degree or professional designations (e.g., CPCU, ARM) preferred. - Minimum of 7 years of underwriting experience, with at least 2 years in a leadership role focused on Warranty Lines Insurance. - Proven expertise in one or more Warranty Lines areas, such as Automotive F&I, Consumer Goods (mobile phones, electronics, appliances) or Home Warranty. - Strong analytical skills with the ability to assess complex risks and make data-driven decisions. - Exceptional leadership and team management experience, with a track record of building high-performing teams. - Excellent communication and negotiation skills, with the ability to influence stakeholders at all levels. - Proficiency in data analytics tools, and industry-standard software. - Deep understanding of insurance market dynamics, reinsurance structures, and regulatory requirements. Key Competencies: - Strategic thinking and problem-solving. - Results-oriented with a focus on profitability and growth. - Ability to thrive in a fast-paced, dynamic environment. - Collaborative and customer-centric approach. The expected salary range for this role is $131,200-$175,000/year. Please note that the salary information shown above is a general guideline only. Salaries are based upon a wide range of factors considered in making the compensation decision, including, but not limited to, candidate skills, experience, education and training, the scope and responsibilities of the role, as well as market and business considerations. #LI-MM1 What We Offer AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off. AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities. AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a company, how we operate and how we see our future. Not ready to apply? Connect with us for general consideration.
    $131.2k-175k yearly Auto-Apply 17h ago
  • AVP, Provider Contracting- Cleveland and North Ohio Markets - Hybrid - Cigna Healthcare

    The Cigna Group 4.6company rating

    Independence, OH jobs

    **Hybrid position responsible for the Cleveland and Northern OH market. Will be needed to work 3 days per week in the office.** **Assistant Vice President, Provider Network Management, Cleveland and Northern OH (inclusive of Toledo, Akron, Canton, and Youngstown markets)** This position serves as an integral member of the Provider Contracting Team and reports to the Vice President, Network Management, Liberty Valley. This role is a member of the Liberty Valley Network Management leadership team and is accountable for contracting and network management activities for multiple local geographies. **DUTIES AND RESPONSIBILITIES** + Directly manages a contracting team and geography, providing leadership, mentoring, and development opportunities to their direct reports. + Accountability for managing contracting and network management activity supporting Commercial contracting and other products/initiatives as applicable to market. + Manages increasingly complex contracts and negotiations for fee for service and sophisticated value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups). + Leads cross market and cross functional initiatives as needed. + Proactively builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy. + Initiates, nurtures, 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. + Manages strategic positioning for provider contracting, develops networks and identifies and acts upon opportunities for greater value-orientation and risk arrangements. + Responsible for meeting unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position. + Identify and manages initiatives that improve total medical cost and quality. + Prepares, analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms. + Manages key provider relationships and is accountable for interface with providers and business staff. + Demonstrates comprehensive 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. **POSITION REQUIREMENTS** + **Bachelor's degree strongly preferred; preferably in the areas of Finance, Economics, Healthcare or Business related. Significant industry experience will be considered in lieu of a Bachelor degree. MBA or MHA preferred.** + **5+ years Provider Contracting and Negotiating experience involving complex delivery systems and organizations required.** + **Prior experience managing or mentoring direct reports, developing talent, and leading project teams in a non-centralized work environment required.** + Experience in developing and managing key provider relationships including senior executives. + Knowledge of complex reimbursement methodologies, including incentive models. + Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners. + Intimate understanding and experience with larger, more complex integrated delivery systems, managed care, and provider business models. + Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization. + The ability to influence both sales and provider audiences through strong written and verbal communication skills. + Demonstrates managerial courage and change leadership in a dynamic environment. + Superior problem solving, decision-making, negotiating skills, contract language and financial acumen. + Knowledge and use of Microsoft Office tools. + **Able to travel as required** If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 127,900 - 213,100 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. At The Cigna Group, 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), 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, click here (********************************************** . **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 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:_ _*********************_ _for support. Do not email_ _*********************_ _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._
    $100k-139k yearly est. 60d+ ago
  • AVP, Provider Contracting- Cleveland and North Ohio Markets - Hybrid - Cigna Healthcare

    Cigna 4.6company rating

    Cleveland, OH jobs

    Hybrid position responsible for the Cleveland and Northern OH market. Will be needed to work 3 days per week in the office. Assistant Vice President, Provider Network Management, Cleveland and Northern OH (inclusive of Toledo, Akron, Canton, and Youngstown markets) This position serves as an integral member of the Provider Contracting Team and reports to the Vice President, Network Management, Liberty Valley. This role is a member of the Liberty Valley Network Management leadership team and is accountable for contracting and network management activities for multiple local geographies. DUTIES AND RESPONSIBILITIES * Directly manages a contracting team and geography, providing leadership, mentoring, and development opportunities to their direct reports. * Accountability for managing contracting and network management activity supporting Commercial contracting and other products/initiatives as applicable to market. * Manages increasingly complex contracts and negotiations for fee for service and sophisticated value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups). * Leads cross market and cross functional initiatives as needed. * Proactively builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy. * Initiates, nurtures, 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. * Manages strategic positioning for provider contracting, develops networks and identifies and acts upon opportunities for greater value-orientation and risk arrangements. * Responsible for meeting unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position. * Identify and manages initiatives that improve total medical cost and quality. * Prepares, analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms. * Manages key provider relationships and is accountable for interface with providers and business staff. * Demonstrates comprehensive 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. POSITION REQUIREMENTS * Bachelor's degree strongly preferred; preferably in the areas of Finance, Economics, Healthcare or Business related. Significant industry experience will be considered in lieu of a Bachelor degree. MBA or MHA preferred. * 5+ years Provider Contracting and Negotiating experience involving complex delivery systems and organizations required. * Prior experience managing or mentoring direct reports, developing talent, and leading project teams in a non-centralized work environment required. * Experience in developing and managing key provider relationships including senior executives. * Knowledge of complex reimbursement methodologies, including incentive models. * Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners. * Intimate understanding and experience with larger, more complex integrated delivery systems, managed care, and provider business models. * Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization. * The ability to influence both sales and provider audiences through strong written and verbal communication skills. * Demonstrates managerial courage and change leadership in a dynamic environment. * Superior problem solving, decision-making, negotiating skills, contract language and financial acumen. * Knowledge and use of Microsoft Office tools. * Able to travel as required If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 127,900 - 213,100 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. At The Cigna Group, 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), 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, click here. 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 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: ********************* for support. Do not email ********************* 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.
    $100k-139k yearly est. Auto-Apply 45d ago
  • AVP, Provider Contracting- Cleveland and North Ohio Markets - Hybrid - Cigna Healthcare

    The Cigna Group 4.6company rating

    Cleveland, OH jobs

    **Hybrid position responsible for the Cleveland and Northern OH market. Will be needed to work 3 days per week in the office.** **Assistant Vice President, Provider Network Management, Cleveland and Northern OH (inclusive of Toledo, Akron, Canton, and Youngstown markets)** This position serves as an integral member of the Provider Contracting Team and reports to the Vice President, Network Management, Liberty Valley. This role is a member of the Liberty Valley Network Management leadership team and is accountable for contracting and network management activities for multiple local geographies. **DUTIES AND RESPONSIBILITIES** + Directly manages a contracting team and geography, providing leadership, mentoring, and development opportunities to their direct reports. + Accountability for managing contracting and network management activity supporting Commercial contracting and other products/initiatives as applicable to market. + Manages increasingly complex contracts and negotiations for fee for service and sophisticated value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups). + Leads cross market and cross functional initiatives as needed. + Proactively builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy. + Initiates, nurtures, 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. + Manages strategic positioning for provider contracting, develops networks and identifies and acts upon opportunities for greater value-orientation and risk arrangements. + Responsible for meeting unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position. + Identify and manages initiatives that improve total medical cost and quality. + Prepares, analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms. + Manages key provider relationships and is accountable for interface with providers and business staff. + Demonstrates comprehensive 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. **POSITION REQUIREMENTS** + **Bachelor's degree strongly preferred; preferably in the areas of Finance, Economics, Healthcare or Business related. Significant industry experience will be considered in lieu of a Bachelor degree. MBA or MHA preferred.** + **5+ years Provider Contracting and Negotiating experience involving complex delivery systems and organizations required.** + **Prior experience managing or mentoring direct reports, developing talent, and leading project teams in a non-centralized work environment required.** + Experience in developing and managing key provider relationships including senior executives. + Knowledge of complex reimbursement methodologies, including incentive models. + Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners. + Intimate understanding and experience with larger, more complex integrated delivery systems, managed care, and provider business models. + Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization. + The ability to influence both sales and provider audiences through strong written and verbal communication skills. + Demonstrates managerial courage and change leadership in a dynamic environment. + Superior problem solving, decision-making, negotiating skills, contract language and financial acumen. + Knowledge and use of Microsoft Office tools. + **Able to travel as required** If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 127,900 - 213,100 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. At The Cigna Group, 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), 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, click here (********************************************** . **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 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:_ _*********************_ _for support. Do not email_ _*********************_ _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._
    $100k-139k yearly est. 60d+ ago
  • AVP, Provider Contracting- Cleveland and North Ohio Markets - Hybrid - Cigna Healthcare

    Cigna 4.6company rating

    Toledo, OH jobs

    Hybrid position responsible for the Cleveland and Northern OH market. Will be needed to work 3 days per week in the office. Assistant Vice President, Provider Network Management, Cleveland and Northern OH (inclusive of Toledo, Akron, Canton, and Youngstown markets) This position serves as an integral member of the Provider Contracting Team and reports to the Vice President, Network Management, Liberty Valley. This role is a member of the Liberty Valley Network Management leadership team and is accountable for contracting and network management activities for multiple local geographies. DUTIES AND RESPONSIBILITIES * Directly manages a contracting team and geography, providing leadership, mentoring, and development opportunities to their direct reports. * Accountability for managing contracting and network management activity supporting Commercial contracting and other products/initiatives as applicable to market. * Manages increasingly complex contracts and negotiations for fee for service and sophisticated value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups). * Leads cross market and cross functional initiatives as needed. * Proactively builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy. * Initiates, nurtures, 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. * Manages strategic positioning for provider contracting, develops networks and identifies and acts upon opportunities for greater value-orientation and risk arrangements. * Responsible for meeting unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position. * Identify and manages initiatives that improve total medical cost and quality. * Prepares, analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms. * Manages key provider relationships and is accountable for interface with providers and business staff. * Demonstrates comprehensive 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. POSITION REQUIREMENTS * Bachelor's degree strongly preferred; preferably in the areas of Finance, Economics, Healthcare or Business related. Significant industry experience will be considered in lieu of a Bachelor degree. MBA or MHA preferred. * 5+ years Provider Contracting and Negotiating experience involving complex delivery systems and organizations required. * Prior experience managing or mentoring direct reports, developing talent, and leading project teams in a non-centralized work environment required. * Experience in developing and managing key provider relationships including senior executives. * Knowledge of complex reimbursement methodologies, including incentive models. * Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners. * Intimate understanding and experience with larger, more complex integrated delivery systems, managed care, and provider business models. * Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization. * The ability to influence both sales and provider audiences through strong written and verbal communication skills. * Demonstrates managerial courage and change leadership in a dynamic environment. * Superior problem solving, decision-making, negotiating skills, contract language and financial acumen. * Knowledge and use of Microsoft Office tools. * Able to travel as required If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 127,900 - 213,100 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. At The Cigna Group, 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), 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, click here. 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 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: ********************* for support. Do not email ********************* 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.
    $101k-141k yearly est. Auto-Apply 45d ago
  • AVP, Provider Contracting- Cleveland and North Ohio Markets - Hybrid - Cigna Healthcare

    The Cigna Group 4.6company rating

    Toledo, OH jobs

    **Hybrid position responsible for the Cleveland and Northern OH market. Will be needed to work 3 days per week in the office.** **Assistant Vice President, Provider Network Management, Cleveland and Northern OH (inclusive of Toledo, Akron, Canton, and Youngstown markets)** This position serves as an integral member of the Provider Contracting Team and reports to the Vice President, Network Management, Liberty Valley. This role is a member of the Liberty Valley Network Management leadership team and is accountable for contracting and network management activities for multiple local geographies. **DUTIES AND RESPONSIBILITIES** + Directly manages a contracting team and geography, providing leadership, mentoring, and development opportunities to their direct reports. + Accountability for managing contracting and network management activity supporting Commercial contracting and other products/initiatives as applicable to market. + Manages increasingly complex contracts and negotiations for fee for service and sophisticated value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups). + Leads cross market and cross functional initiatives as needed. + Proactively builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy. + Initiates, nurtures, 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. + Manages strategic positioning for provider contracting, develops networks and identifies and acts upon opportunities for greater value-orientation and risk arrangements. + Responsible for meeting unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position. + Identify and manages initiatives that improve total medical cost and quality. + Prepares, analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms. + Manages key provider relationships and is accountable for interface with providers and business staff. + Demonstrates comprehensive 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. **POSITION REQUIREMENTS** + **Bachelor's degree strongly preferred; preferably in the areas of Finance, Economics, Healthcare or Business related. Significant industry experience will be considered in lieu of a Bachelor degree. MBA or MHA preferred.** + **5+ years Provider Contracting and Negotiating experience involving complex delivery systems and organizations required.** + **Prior experience managing or mentoring direct reports, developing talent, and leading project teams in a non-centralized work environment required.** + Experience in developing and managing key provider relationships including senior executives. + Knowledge of complex reimbursement methodologies, including incentive models. + Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners. + Intimate understanding and experience with larger, more complex integrated delivery systems, managed care, and provider business models. + Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization. + The ability to influence both sales and provider audiences through strong written and verbal communication skills. + Demonstrates managerial courage and change leadership in a dynamic environment. + Superior problem solving, decision-making, negotiating skills, contract language and financial acumen. + Knowledge and use of Microsoft Office tools. + **Able to travel as required** If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 127,900 - 213,100 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. At The Cigna Group, 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), 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, click here (********************************************** . **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 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:_ _*********************_ _for support. Do not email_ _*********************_ _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._
    $101k-141k yearly est. 60d+ ago
  • AVP, Provider Contracting- Cleveland and North Ohio Markets - Hybrid - Cigna Healthcare

    Cigna 4.6company rating

    Akron, OH jobs

    Hybrid position responsible for the Cleveland and Northern OH market. Will be needed to work 3 days per week in the office. Assistant Vice President, Provider Network Management, Cleveland and Northern OH (inclusive of Toledo, Akron, Canton, and Youngstown markets) This position serves as an integral member of the Provider Contracting Team and reports to the Vice President, Network Management, Liberty Valley. This role is a member of the Liberty Valley Network Management leadership team and is accountable for contracting and network management activities for multiple local geographies. DUTIES AND RESPONSIBILITIES * Directly manages a contracting team and geography, providing leadership, mentoring, and development opportunities to their direct reports. * Accountability for managing contracting and network management activity supporting Commercial contracting and other products/initiatives as applicable to market. * Manages increasingly complex contracts and negotiations for fee for service and sophisticated value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups). * Leads cross market and cross functional initiatives as needed. * Proactively builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy. * Initiates, nurtures, 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. * Manages strategic positioning for provider contracting, develops networks and identifies and acts upon opportunities for greater value-orientation and risk arrangements. * Responsible for meeting unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position. * Identify and manages initiatives that improve total medical cost and quality. * Prepares, analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms. * Manages key provider relationships and is accountable for interface with providers and business staff. * Demonstrates comprehensive 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. POSITION REQUIREMENTS * Bachelor's degree strongly preferred; preferably in the areas of Finance, Economics, Healthcare or Business related. Significant industry experience will be considered in lieu of a Bachelor degree. MBA or MHA preferred. * 5+ years Provider Contracting and Negotiating experience involving complex delivery systems and organizations required. * Prior experience managing or mentoring direct reports, developing talent, and leading project teams in a non-centralized work environment required. * Experience in developing and managing key provider relationships including senior executives. * Knowledge of complex reimbursement methodologies, including incentive models. * Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners. * Intimate understanding and experience with larger, more complex integrated delivery systems, managed care, and provider business models. * Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization. * The ability to influence both sales and provider audiences through strong written and verbal communication skills. * Demonstrates managerial courage and change leadership in a dynamic environment. * Superior problem solving, decision-making, negotiating skills, contract language and financial acumen. * Knowledge and use of Microsoft Office tools. * Able to travel as required If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 127,900 - 213,100 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. At The Cigna Group, 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), 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, click here. 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 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: ********************* for support. Do not email ********************* 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.
    $100k-139k yearly est. Auto-Apply 45d ago
  • AVP, Provider Contracting- Cleveland and North Ohio Markets - Hybrid - Cigna Healthcare

    The Cigna Group 4.6company rating

    Akron, OH jobs

    **Hybrid position responsible for the Cleveland and Northern OH market. Will be needed to work 3 days per week in the office.** **Assistant Vice President, Provider Network Management, Cleveland and Northern OH (inclusive of Toledo, Akron, Canton, and Youngstown markets)** This position serves as an integral member of the Provider Contracting Team and reports to the Vice President, Network Management, Liberty Valley. This role is a member of the Liberty Valley Network Management leadership team and is accountable for contracting and network management activities for multiple local geographies. **DUTIES AND RESPONSIBILITIES** + Directly manages a contracting team and geography, providing leadership, mentoring, and development opportunities to their direct reports. + Accountability for managing contracting and network management activity supporting Commercial contracting and other products/initiatives as applicable to market. + Manages increasingly complex contracts and negotiations for fee for service and sophisticated value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups). + Leads cross market and cross functional initiatives as needed. + Proactively builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy. + Initiates, nurtures, 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. + Manages strategic positioning for provider contracting, develops networks and identifies and acts upon opportunities for greater value-orientation and risk arrangements. + Responsible for meeting unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position. + Identify and manages initiatives that improve total medical cost and quality. + Prepares, analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms. + Manages key provider relationships and is accountable for interface with providers and business staff. + Demonstrates comprehensive 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. **POSITION REQUIREMENTS** + **Bachelor's degree strongly preferred; preferably in the areas of Finance, Economics, Healthcare or Business related. Significant industry experience will be considered in lieu of a Bachelor degree. MBA or MHA preferred.** + **5+ years Provider Contracting and Negotiating experience involving complex delivery systems and organizations required.** + **Prior experience managing or mentoring direct reports, developing talent, and leading project teams in a non-centralized work environment required.** + Experience in developing and managing key provider relationships including senior executives. + Knowledge of complex reimbursement methodologies, including incentive models. + Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners. + Intimate understanding and experience with larger, more complex integrated delivery systems, managed care, and provider business models. + Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization. + The ability to influence both sales and provider audiences through strong written and verbal communication skills. + Demonstrates managerial courage and change leadership in a dynamic environment. + Superior problem solving, decision-making, negotiating skills, contract language and financial acumen. + Knowledge and use of Microsoft Office tools. + **Able to travel as required** If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 127,900 - 213,100 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. At The Cigna Group, 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), 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, click here (********************************************** . **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 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:_ _*********************_ _for support. Do not email_ _*********************_ _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._
    $100k-139k yearly est. 60d+ ago
  • AVP, S&S Small Business Team

    Crum & Forster Holdings Corp 4.5company rating

    Richardson, TX jobs

    Crum & Forster (C&F), with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+"(Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry. Our most valuable asset is our people: more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2024 Great Place to Work Award for our employee-first focus and our steadfast commitment to diversity, equity and inclusion. C&F is part of Fairfax Financial Holdings, a global, billion dollar organization. For more information about Crum & Forster, please visit our website: ************** Job Description AVP - Small Business Underwriting Team - remote position. Summary: As an experienced Excess underwriter, you will be responsible for leading a dedicated team of Excess underwriters along with the review and analysis of underwriting data to build and maintain a profitable book of construction business. You will manage wholesale broker relationships through continued customer service and marketing activities, working independently under limited supervision, and will actively contribute to the development and execution of functional strategy and the operational direction of the Excess team. Minimum Duties and Responsibilities * Provide input into the development of strategic annual department planning activities. * Implements strategy to drive profitability, retention, and written premium goals of the department in conjunction with the Vice President and/or Senior Vice President. * Maintains awareness of market trends and identifies emerging threats to the department. * Meet profitability, retention, and written premium goals determined by the department. * Makes independent decisions within underwriting letter of authority and maintains proper file documentation. * Assist in developing annual business goals for assigned wholesale brokers. * Responsible for analyzing results and maintaining accountability of wholesale broker partners within the department. * Has an in-depth knowledge of department products and services * Drives training, initiatives and projects. * Can clearly articulate the department's value proposition * Participates in training and initiatives to develop knowledge base. * Will be a team lead of a small group of UW's. * May participate in projects. * Travel required. * Other duties as assigned. Education and Skills * Bachelor's degree (or equivalent) and 10+ years of underwriting experience, small business through various classes preferred. * Possesses strong communication and analytical skills to pursue new business and manage a renewal book. * Proficient in software needed to succeed in department. * Excellent organizational and time management skills. * Possesses or is pursuing underwriting and industry designations applicable to area of specialization. * Ability to lead and direct a small to medium sized team of underwriters. What C&F will bring to you At C&F you will BELONG We value inclusivity and diversity. We are committed to equal employment opportunity and welcome everyone regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you require special accommodation, please let us know. For California Residents Only: Information collected and processed as part of your career profile and any job applications you choose to submit are subject to our privacy notices and policies, visit **************************************************************** for more information. Crum & Forster is committed to ensuring a workplace free from discriminatory pay disparities and complying with applicable pay equity laws. Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions. The annualized base pay for the advertised position, located in the specified area, ranges from a minimum of $110,600 to a maximum of $208,000. The actual compensation is determined by various factors, including but not limited to the market pay for the jobs at each level, the responsibilities and skills required for each job, and the employee's contribution (performance) in that role. To be considered within market range, a salary is at or above the minimum of the range. You may also have the opportunity to participate in discretionary equity (stock) based compensation and/or performance-based variable pay programs. * Flexible work arrangements. * Competitive compensation package. * Generous 401K employer match. * Employee Stock Purchase plan with employer matching. * Generous Paid Time Off. * Excellent benefits that go beyond health, dental & vision. Our Wellness programs focus on your family's complete wellness, including your physical and mental wellbeing * A core C&F principle is that you manage your career. To support your development, we have a wealth of ways for you to keep learning, including tuition reimbursement, industry related certifications and professional training available to you. * A dynamic, ambitious, fun and exciting work environment. * A spirit of social responsibility, matching donation program, volunteer opportunities, and an employee driven corporate giving. #LI-JA1 #LI-Remote Responsibilities AVP - Small Business Underwriting Team - remote position. Summary: As an experienced Excess underwriter, you will be responsible for leading a dedicated team of Excess underwriters along with the review and analysis of underwriting data to build and maintain a profitable book of construction business. You will manage wholesale broker relationships through continued customer service and marketing activities, working independently under limited supervision, and will actively contribute to the development and execution of functional strategy and the operational direction of the Excess team. Minimum Duties and Responsibilities - Provide input into the development of strategic annual department planning activities. - Implements strategy to drive profitability, retention, and written premium goals of the department in conjunction with the Vice President and/or Senior Vice President. - Maintains awareness of market trends and identifies emerging threats to the department. - Meet profitability, retention, and written premium goals determined by the department. - Makes independent decisions within underwriting letter of authority and maintains proper file documentation. - Assist in developing annual business goals for assigned wholesale brokers. - Responsible for analyzing results and maintaining accountability of wholesale broker partners within the department. - Has an in-depth knowledge of department products and services - Drives training, initiatives and projects. - Can clearly articulate the department's value proposition - Participates in training and initiatives to develop knowledge base. - Will be a team lead of a small group of UW's. - May participate in projects. - Travel required. - Other duties as assigned. Education and Skills - Bachelor's degree (or equivalent) and 10+ years of underwriting experience, small business through various classes preferred. - Possesses strong communication and analytical skills to pursue new business and manage a renewal book. - Proficient in software needed to succeed in department. - Excellent organizational and time management skills. - Possesses or is pursuing underwriting and industry designations applicable to area of specialization. - Ability to lead and direct a small to medium sized team of underwriters.
    $110.6k-208k yearly Auto-Apply 9d ago
  • VP, Operations (Remote)

    Crum & Forster 4.5company rating

    Glastonbury, CT jobs

    Travel Insured International (TII), a Crum & Forster company, is hiring for a VP, Operations, TII. Travel Insured International is a leading travel insurance provider with more than 30 years in business. As a key component of our Specialty Business Unit, within the Accident & Health division, TII provides travel protection plans to help each individual travel confidently. Travel Insured International is proud to offer products to consumers and to agency partners of all sizes. We're committed to providing dependable coverage, great value, and customer satisfaction. Job Description TII is dramatically transforming its customer and partner support services to simplify a customer's journey through their travel insurance plan experience. Our goal is to personalize each interaction through a set of omni-channel capabilities where customer questions are answered the first time, and their experience is backed up by a best-in-class experience rating. As the Vice President, Operations, TII, you will play a pivotal role in shaping and executing TII's operational strategy to achieve key performance and scalability goals. You will have the opportunity to lead by example, foster a culture of empathy and support, and drive operational excellence across our contact center, claims administration and quality assurance departments. This is an exciting opportunity for an accomplished operations leader to make a significant impact in transforming travel insurance experiences. Reporting to the President, TII, this is a crucial role in our organization for both day-to-day operational success as well as long-term operational strategy, planning, and optimization. This leader will be responsible not only for the performance of more than a hundred individuals on the team but also for the cross-functional partnership between operations and other departments at the company, including Sales, Account Management, Marketing, Product Management, Underwriting, Strategy, PMO, Continuous Improvement, IT, Compliance and HR/Training. The VP, Operations, will also build and leverage relationships with clients to achieve the goals of the company. The work will be fast paced with evolving needs, requiring flexibility, emotional intelligence, curiosity, and grace under pressure. As you onboard and assimilate to the role, TII, A&H and C&F, you can expect to roll up your sleeves to immerse yourself in the day-to-day work of the team to understand and impact continual improvement efforts. This role sits on our Senior Executive Leadership team and is a Leader of Leaders, with 4 direct reports. What you will do: Oversee and lead Call Center, Claims, Quality Assurance and 3rd Party Vendor operational departments and functions which includes: omni-channel inbound customer service and sales, claims intake and customer service, claims adjudication, quality assurance programs for customer service and claims activities, appeal and complaint resolution, subrogation recovery activities, and third-party vendor management oversight. Direct and lead an engaged workforce including customer experience, workforce planning, training and performance management. Provide coaching and mentorship to staff to foster talent and grow the organization. Develop and oversee staffing plans to organizational budget for all functions and departments. Collaborate cross functionally with Sales, Account Management, Marketing, Product Management, Underwriting, Strategy, PMO, Continuous Improvement, IT, Compliance, HR/Training, and other teams to achieve goals and partner on their planned initiatives. Maintain operational excellence by implementing efficient processes, optimizing workflows, and leveraging technology to drive productivity and cost-effectiveness. Skillfully develop and manage relationships with external clients and partners, in collaboration with Business Development and Account Management teams. Carefully manage operational expense with an eye towards financial responsibility and company growth trajectory. Provide management and oversight of third-party vendor relationships and services, including ongoing performance management, audits, contract renewals, RFPs and business reviews. Call Center: Customer Service, Inbound Sales, Partner Support Service, Claims Customer Service Leads the development and execution of the service model including strategy, performance and employee engagement. Develop and then execute a robust 3-5-year strategic roadmap to deliver market required capabilities, emerging contact center technologies, industry best practices and innovation to support customer growth and retention outcomes. Execute roadmap to deliver enhanced self-service capabilities, increased revenue generating capacity (inbound service to sales optimization), and third-party augmentation. Develop and implement new processes to incorporate digitally enabled services that encompass consumer value chain, from plan purchase to plan engagement to claims transactions. Drive excellence in key service performance metrics, including ASA, abandonment rates, quality service scores, first call resolution, sales conversion and call center satisfaction. Collaborate and coordinate efforts with IT to continuously assess and optimize the contact center infrastructure, including maintaining direct production support and configuration responsibilities for the IVR and ancillary enterprise telephony environment. Oversee business readiness of new programs and technology in partnership with IT, Sales & Account Management, Marketing, Product and Operations. Claims Administration: First Notice of Loss (FNOL), Claims Intake Support, Adjudication Create, communicate, and drive an aligned Claims strategy with emphasis on quality adjusting practices, process automation, and customer experience delivery. Ensure effective management of all claims, processing service levels, and claims issues, provide quality management and technical oversight to ensure execution of the company's claims policies and philosophies. Drive and facilitate planning and evaluation activities including budgets, forecasts, loss costs calculations, data analytics, setting and adjusting reserves, and effective risk transfer, as applicable Exhibit keen understanding of travel insurance industry practices and trends, and of the competitive landscape. Quality Assurance: Auditing, Resolutions, Subrogation Lead a team of Quality Assurance, Appeal and Complaint Resolution, and Subrogation professionals who manage and implement effective Quality Assurance programs for TII's customer service and claims operations. Develop and execute the TII Quality Assurance strategy aimed at driving continuous process and talent improvement while delivering a return on QA resource investment. Provide guidance to audit quality control framework and maintain compliance with audit methodology, while also operating within industry best practices, applicable regulations, and internal and external professional practice expectations. Support strategic initiatives of the business as well as the larger corporate quality assurance, internal and external audit and compliance obligations. Support the preparation of responses to regulatory and compliance inquiries, complaints, and examinations. Other duties as required. What YOU will bring to C&F: Transformational Experience: Extensive experience in leading and executing transformational initiatives, driving change, and implementing innovative solutions to enhance organizational effectiveness and competitiveness. Proven Leadership Success: Demonstrated success in guiding and developing experienced leaders and their teams to maintain high levels of employee engagement. Large Team Management: Proven ability to successfully manage and lead large teams, ensuring alignment with organizational goals and fostering a high-performance culture. Outstanding Communicator: Highly effective written and verbal communication skills, including proficiency in developing and delivering presentations. Ability to tailor communication styles to different audiences, including internal cross-functional teams and external customers and partners. Strategic mindset: Proven abilities to develop and execute operational strategies aligned with the organization's goals and objectives. Aptitude for identifying trends, patterns, and operational bottlenecks to proactively address challenges and optimize processes. Analytical mindset: Thinks analytically with the ability to articulate complex ideas into clear frameworks; uses data to conduct root cause analysis and develops high quality, consumable, and consistent metrics that drive strategic objectives and priorities. Customer Centric: skilled at prioritizing the customers' needs and experiences, understanding what they want and delivering exceptional service. Has a thorough understanding of our industry, the relevant business landscape, and trends in growth and insurance environments; can spot early indicators of change and apply strategies to adapt quickly is required. Flexible and agile, comfortable with the ambiguity of a growing and transforming organization, skilled at working and building culture in remote environments. Requirements: A bachelor's degree is required 15+ years of progressive experience in Operations Management roles including the areas of: Contact Center; Claims; Quality Assurance and Vendor Management are required. 10+ years of experience in people management, which includes leadership of leaders. Experience with financial management principles, including budgeting, cost control, and revenue generation. Experience in managing operational expenses while ensuring financial responsibility and achieving profitability targets is required. In-depth knowledge and experience in call center operations, including call management, queue management, and call routing strategies is required. Understanding of contact center metrics, such as Average Handle Time (AHT), First Call Resolution (FCR), Service Level Agreement (SLA), and Customer Satisfaction (CSAT) is required. Familiarity with call center technologies, including Automatic Call Distribution (ACD) systems, Interactive Voice Response (IVR) systems, and Computer Telephony Integration (CTI) is required. Proficiency in workforce management principles and tools to optimize staffing levels, scheduling, and forecasting is required. Proficiency in data analysis and interpretation to drive data-driven decision-making and operational improvements is required. #LI-MS #LI-REMOTE What C&F will bring to you Competitive compensation package Generous 401K employer match Employee Stock Purchase plan with employer matching Generous Paid Time Off Excellent benefits that go beyond health, dental & vision. Our programs are focused on your whole family's wellness, including your physical, mental and financial wellbeing A core C&F tenet is owning your career development, so we provide a wealth of ways for you to keep learning, including tuition reimbursement, industry-related certifications and professional training to keep you progressing on your chosen path A dynamic, ambitious, fun and exciting work environment We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community At C&F you will BELONG If you require special accommodations, please let us know. We value inclusivity and diversity. We are committed to equal employment opportunity and welcome everyone regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you require special accommodations, please let us know. Belonging at C&F, is a mindset. It's about fostering a culture of inclusion and connection, where everyone feels valued, heard, and empowered to thrive and where our social impact efforts help strengthen the communities where we live and work. For California Residents Only: Information collected and processed as part of your career profile and any job applications you choose to submit are subject to our privacy notices and policies, visit **************************************************************** for more information. Crum & Forster is committed to ensuring a workplace free from discriminatory pay disparities and complying with applicable pay equity laws. Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions. The annualized base pay for the advertised position, located in the specified area, ranges from a minimum of $200,000 to a maximum of $250,000. The actual compensation is determined by various factors, including but not limited to the market pay for the jobs at each level, the responsibilities and skills required for each job, and the employee's contribution (performance) in that role. To be considered within market range, a salary is at or above the minimum of the range. You may also have the opportunity to participate in discretionary equity (stock) based compensation and/or performance-based variable pay programs.
    $200k-250k yearly Auto-Apply 60d+ ago
  • Vice President, Specialty Pharmacy Services- Evernorth

    Cigna 4.6company rating

    Remote

    As a strategic leader in Specialty Pharmacy, you will shape high-performing Specialty Pharmacy Management Services programs by driving operational excellence, strengthening financial outcomes, and elevating clinical quality for partners nationwide. This role blends deep specialty pharmacy expertise, collaborative leadership, and a passion for transforming patient access and experience in a rapidly evolving healthcare environment. Responsibilities Serve as the organization's expert on specialty pharmacy, accreditation standards, and compliance best practices. Strengthen internal and client-facing teams through education on workflows including benefits verification, prior authorization, patient counseling, and clinical support. Drive financial performance by optimizing revenue cycle processes, reducing leakage, and improving reimbursement outcomes. Provide strategic guidance on 340B capture models, payer engagement, and manufacturer collaboration. Support development of innovative service offerings and go-to-market strategies in partnership with product and commercial teams. Participate in client presentations and solution design efforts, ensuring offerings align with clinical, operational, and financial goals. Required Qualifications Minimum 8+ years of progressive leadership experience in infusion operations. Expertise in accreditation standards, patient access workflows, and revenue cycle management. Strong understanding of 340B program requirements and optimization strategies. Exceptional communication skills with proven ability to influence leaders and clients. Preferred Qualifications Bachelor's degree. Advanced degree (MBA, MHA, PharmD) preferred. Experience supporting payer or provider-based specialty pharmacy programs and scaling operational models. 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 117,800 - 196,300 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 and long term incentive plan. At The Cigna Group, 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), 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, click here. 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: ********************* for support. Do not email ********************* 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.
    $138k-200k yearly est. Auto-Apply 26d ago
  • Vice President, Specialty Pharmacy Services- Evernorth

    Cigna Group 4.6company rating

    Remote

    As a strategic leader in Specialty Pharmacy, you will shape high-performing Specialty Pharmacy Management Services programs by driving operational excellence, strengthening financial outcomes, and elevating clinical quality for partners nationwide. This role blends deep specialty pharmacy expertise, collaborative leadership, and a passion for transforming patient access and experience in a rapidly evolving healthcare environment. Responsibilities Serve as the organization's expert on specialty pharmacy, accreditation standards, and compliance best practices. Strengthen internal and client-facing teams through education on workflows including benefits verification, prior authorization, patient counseling, and clinical support. Drive financial performance by optimizing revenue cycle processes, reducing leakage, and improving reimbursement outcomes. Provide strategic guidance on 340B capture models, payer engagement, and manufacturer collaboration. Support development of innovative service offerings and go-to-market strategies in partnership with product and commercial teams. Participate in client presentations and solution design efforts, ensuring offerings align with clinical, operational, and financial goals. Required Qualifications Minimum 8+ years of progressive leadership experience in infusion operations. Expertise in accreditation standards, patient access workflows, and revenue cycle management. Strong understanding of 340B program requirements and optimization strategies. Exceptional communication skills with proven ability to influence leaders and clients. Preferred Qualifications Bachelor's degree. Advanced degree (MBA, MHA, PharmD) preferred. Experience supporting payer or provider-based specialty pharmacy programs and scaling operational models. 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 117,800 - 196,300 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 and long term incentive plan. At The Cigna Group, 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), 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, click here. 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: ********************* for support. Do not email ********************* 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.
    $138k-200k yearly est. Auto-Apply 26d ago
  • Vice President, Population Health & Clinical Operations

    Centene 4.5company rating

    Remote

    Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members. In partnership with the CMO, serve as a key stakeholder, decision maker, and catalyst, for all market level population health identification, strategy, evaluation, and monitoring to achieve the Quadruple Aim and drive Centene's Population Health mission at the market level. Provide strategic leadership for population health internally, as well as with providers, community organizations, advocacy groups, and applicable legislature. Understand the local healthcare landscape to look for key drivers & opportunities for innovative models targeting the Quadruple Aim. Understand the unique community health needs and the attributes of the populations served to drive development of programs and service. Uses analytics to identify key insights about the populations served and drive the development of the interventions to target unique populations. Oversees performance of all UM functions (prior authorization, concurrent review) for the market per the defined partnership agreement; co-leads agenda planning and annual performance goal setting, unique to market needs Orchestrates all elements of the population health strategy for the business Drives MLR initiatives locally through strong partnership and routine with Finance Partner with the Special Investigations Unit (SIU) to proactively identify patterns of potential fraud, waste, and abuse (FWA) through clinical, claims, and utilization data insights, ensuring timely escalation and coordinated mitigation strategies. Additionally, NHHF will integrate SIU‑driven findings into Population Health & UM operational workflows, informing policy updates, provider education, and process improvements to prevent recurrence of FWA and enhance overall compliance and accountability. Partners with MDs to translate the needs of the members into intentional clinical program design that delivers successful health outcomes Liaises with state regulators for clinical programs; proactively reviews and evaluates the utility, performance and ROI of clinical programs and acts as lead/champion to drive awareness and advocacy where needed Develops comprehensive position papers-supported by clear rationale, data analysis, and documented recommendations-to advocate for program enhancements and strategic changes with internal and external stakeholders. Coordinates quality initiatives (audits, star ratings, contract reviews, etc.) and activate enterprise and local policies Informs and executes against contracts (including provider contracts) - driving outcomes captured in contract and operationalizing locally Contributing member of enterprise and local committees Serves as an integral member of the executive leadership team, charged with delivering clinical solutions to evolving business needs Executes on standards and customizing per local requirements while partnering with the COEs to drive continuous improvement through governance and performance monitoring. Education/Experience: Bachelor's Degree with 5+ years of relevant experience required. Master's Degree preferred. Current state RN license preferred. research, health policy, information technology or other relevant field. Must have at least five years of progressively responsible professional experience in population health, service coordination, ambulatory care, community health, case or care management, or coordinating care across multiple settings and with multiple providers. Proven leadership in a large, matrixed organization with 3-5 years of experience working with state or federal regulators Pay Range: $171,900.00 - $326,900.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
    $171.9k-326.9k yearly Auto-Apply 4d ago
  • Vice President, Operations, IHPA

    Centene 4.5company rating

    Remote

    Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members. This is a unique executive leadership opportunity for a hands-on operator with enterprise vision. This role serves as the Chief Executive Officer of the Illinois Health Practice Alliance (IHPA) - a Behavioral Health Independent Practice Association and joint venture between Centene Corporation and Provider Co, and is responsible for day-to-day and long-term strategic leadership related to the performance of IHPA's statewide clinically integrated network. While titled at the VP level, this role carries full CEO accountability for a focused, high-impact organization.The role provides strategic, operational, and financial leadership to ensure IHPA's objectives align with broader business priorities while advancing value-based care, provider performance, and improved health outcomes for a diverse member population.Position Purpose: Plan and direct all aspects of the company's operational policies, objectives, and initiatives. Oversee the development of policies and procedures for operational processes to ensure optimization and compliance with established standards and regulations. Oversee the negotiation and administration of value based contracts to ensure a strong provider network. Influence and drive network provider performance. Ensure IHPA clients access to quality of care and adherence to regulatory requirements. Represent the organization in its relationships with all stakeholders, including health care providers, government agencies, trade associations, health plans, and similar groups. Deliver leadership and oversight to IHPA staff and contracted vendors. Develop a sound short-and long-range plan for the organization. Ensure the adequacy and soundness of the organization's financial structure and review projections of working capital requirements. Promote enrollment growth by supporting marketing event planning and execution. Develop and manage network provider relationships. Education/Experience: Bachelor's Degree in Business Administration, Finance, Accountancy or a related field required. Master's Degree preferred. 9+ years of operations, management, or administration in the healthcare or insurance industry required. Extensive experience in contracting, contract acquisition, operations management, and strategic planning and development. IPA experience preferred. Experience in an integrated delivery system and value-based contracting preferred. Understands the healthcare field from the provider and health plan perspectives, preferably in multiple states and knowledge of the Illinois market. Pay Range: $168,500.00 - $320,500.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
    $168.5k-320.5k yearly Auto-Apply 28d ago
  • Vice President, Clinical Operations & System Integration

    Centene 4.5company rating

    Remote

    Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members. Leads the strategy and execution of technology solutions to support clinical operations, including but not limited to systems requirement gathering, monitoring and improvements. Oversees the implementation, integration, and ongoing support of clinical systems, as well as ensuring that technology effectively enables clinical staff to deliver high-quality care. Oversees and executes vision and roadmap in collaboration with clinical and technology leaders to drive enterprise-wide clinical technology initiatives and improvements. Partners with senior leaders to ensure successful product launch, execution, and support for technology solutions. Leads complex projects and technical innovation activities in collaboration with cross functional leaders in a matrixed environment. Leads the SME team who provides consultation and direct testing services for all technology initiatives and implementations. Partners with stakeholders to analyze system needs for all business operations functions, assist with system requirements, influences the design of integrated solutions, and develops integration strategies. Implements integration solutions within the operations space, ensure thorough testing to guarantee functionality and performance, and oversees deployment. Identifies and resolves issues related to system integration and provide technical support to end-users. Documents integration processes, workflows, and system configurations, and provides training to relevant personnel. Continuously monitors the performance of integrated systems, identifies areas for improvement, and optimizes system performance and reliability. In essence, the Operations and Systems Integration role is crucial for ensuring that different systems within an organization work together efficiently and effectively, supporting overall business objectives. Performs other duties as assigned. Complies with all policies and standards. Education/Experience: Bachelor's Degree required or equivalent experience required 7+ years Strong understanding of system architecture, integration technologies, and relevant programming languages required 6+ years Ability to analyze complex technical issues, troubleshoot problems, and develop effective solutions required. Excellent verbal and written communication skills to effectively collaborate with teams, stakeholders, and end-users required. Ability to manage integration projects, prioritize tasks, and meet deadlines required Adaptability to changing technologies and business needs required or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. Pay Range: $223,200.00 - $422,900.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
    $127k-164k yearly est. Auto-Apply 13d ago
  • Vice President Underwriting - Eden Prairie, MN, Irvine, CA or Remote

    Unitedhealth Group 4.6company rating

    Irvine, CA jobs

    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Optimize financial performance through enhancements that balance pricing discipline and sales success with specific responsibility for OptumRx's Underwriting team leading external Health Plan pricing + Evolve segment-specific bid strategy and decision making in lockstep with transformation initiatives and external positioning through an in-depth understanding of OptumRx and health plan competitors, industry trends, market dynamics and internal key performance indicators + Interact with all levels of the organization; routinely with OptumRx Market Presidents to influence go to market strategies and goal setting. Regularly meet with OptumRx ELT leaders to drive goals, strategy, and build solid relationships + Delivering all pricing strategies and objectives within established deadlines through active collaboration and engagement with the Sales and Account Management leadership team; identify and prioritize key areas of focus + Drive strategic decision making that ultimately delivers on OptumRx revenue, margin, and retention targets established in Annual Business Plan; directly impact PBM, Specialty, and Home Delivery business segments + Provide exceptional team leadership with a focus on employee engagement, development, retention, and attracting top talent into the organization + Function as AI champion driving integration into tools and processes + Lead and manage a team to achieve high quality outcomes and improve process targets driven by KPIs + Develop capabilities to leverage market-driven insights that systematically turn intelligence into actionable recommendations and competitive practices + Empower colleagues and key partners with targeted support that delivers strategic viewpoints and advisement driven by insights from key stakeholders + Execute with agility by driving enterprise-wide "closed loop" collaboration that efficiently addresses market shifts You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + 8+ years of experience in financial pharmacy benefit management, working with the PBM pricing, underwriting or actuary + 5+ years of experience in a direct management role, leading and inspiring people at various levels within the organization + Client-facing experience, including negotiating and consulting with clients + Experience collaborating cross-functionally and communicating effectively and efficiently at multiple levels of large, complex organizations + Advanced skills in MS Excel, MS Office product suite + Demonstrated solid business and financial acumen, including solid financial analysis experience + Proven eagerness to drive AI integration + Ability to travel up to 25% **Preferred Qualifications:** + Experience working with Health Plan clients + Experience managing a P&L *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $156,400 to $268,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
    $156.4k-268k yearly 60d+ ago
  • Vice President, Population Health & Clinical Operations

    Centene 4.5company rating

    Columbus, OH jobs

    Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members. The Vice President of Population Health & Health Outcomes is a senior leadership role responsible for developing and executing strategies that drive measurable improvements in member health. Reporting directly to the Chief Medical Officer, this leader will oversee a team of Directors and large cross-functional teams to ensure initiatives are strategically aligned, operationally executed, and continuously improved. This role is charged with assuring that the organization has a robust population health strategy that supports achievement of business goals, improves the current and future health of members, and aligns with the direction of Centene and the Ohio Department of Medicaid. While the primary focus is on Medicaid, the VP will also collaborate with organizational partners who lead Medicare and Marketplace initiatives to ensure alignment and shared best practices. Key Responsibilities Strategic Leadership Develop, implement, and maintain a comprehensive population health strategy that advances business objectives, improves member health outcomes, and aligns with Centene and the Ohio Department of Medicaid. Lead population health initiatives with a strong focus on Medicaid while collaborating with partners on Medicare and Marketplace programs. Translate organizational vision into actionable initiatives with clear metrics and accountability. Serve as a trusted advisor on population health strategy as part of the senior leadership team. Operational Execution Ensure the successful implementation of population health initiatives by driving accountability for results, measuring impact, and aligning resources with strategic priorities. Translate strategy into operational reality by building systems, processes, and performance standards that deliver sustained improvements in quality, outcomes, and efficiency. Integrate population health initiatives across clinical, operational, and financial functions to ensure consistency, compliance, and alignment with organizational goals. Continuously monitor program performance, identifying opportunities for innovation and course correction to achieve optimal results for members and the organization. Regulatory & Corporate Collaboration Build and maintain strong partnerships with the state Medicaid regulator to ensure compliance and program success. Collaborate with Centene corporate teams to align local initiatives with enterprise-wide strategies. Partner with leaders responsible for Medicare and Marketplace to ensure consistency, integration, and shared learning. Work closely with operations, finance, and other internal teams to achieve organizational objectives. Communication & Stakeholder Engagement Build trusted relationships with state regulators, providers, community partners, and internal executives to advance shared goals and improve member outcomes. Serve as a visible ambassador for population health initiatives, clearly articulating strategy, progress, and outcomes to diverse audiences, including the Board, senior leadership, regulators, and community stakeholders. Anticipate stakeholder needs and concerns, proactively engaging in dialogue that fosters collaboration, transparency, and alignment across all levels of the organization. Vendor & Partner Management Oversee relationships with key vendors to ensure programmatic success, accountability, and value. Negotiate and manage vendor contracts to align deliverables with organizational priorities. Team Leadership & Development Mentor, coach, and develop a high-performing team of Directors and staff. Delegate effectively while ensuring accountability and ownership across teams. Foster a culture of innovation, collaboration, and continuous improvement. Education/Experience: Current state RN license preferred. Previous experience in a managed care organization strongly preferred. 3+ years of leadership experience required. Master's degree or other advanced degree in nursing, social work, health services research, health policy, information technology or other relevant field. Must have at least five years of progressively responsible professional experience in population health, service coordination, ambulatory care, community health, case or care management, or coordinating care across multiple settings and with multiple providers. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. Candidate must reside or relocate to Ohio Pay Range: $180,400.00 - $343,300.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
    $109k-137k yearly est. Auto-Apply 6d ago
  • Vice President of AI Growth & Customer Engagement

    Unitedhealth Group Inc. 4.6company rating

    Eden Prairie, MN jobs

    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Vice President of AI Growth & Customer Engagement will lead the transformation for the AI team's operating model and engagement approach to accelerate adoption and empower business units to identify and realize AI-driven growth opportunities for internal and external teams. You will drive initiatives that ensure AI services deliver measurable customer value, foster lasting relationships, and enhance collaboration between AI teams and business units. This role will lead a focused transformation of the function over an initial 12-18 month period, then transition to drive sustained adoption and innovation within a specific business segment as an AI Engagement Lead. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires within 30 minutes of an office in Minnesota or Washington, D.C., you'll be required to work a minimum of four days per week in-office. Primary Responsibilities: Strategic Growth & Customer Engagement * Develop a deep understanding of internal business units and external client needs to identify and support AI-driven growth opportunities ensuring accountability for outcomes * Develop frameworks and playbooks that help business leaders recognize and evaluate AI opportunities aligned to strategic priorities * Educate and engage teams on integrating AI into workflows for measurable impact * Innovation & Value Realization: Identify and advance high-impact AI opportunities, from proof of concept through scaled deployment * Collaborate closely with Optum AI leaders to shape and lead growth initiatives Customer Engagement * Enhance team engagement strategies to position Optum AI as a trusted partner with deep collaboration and understanding * Ensure AI services anticipate customer needs and deliver measurable value * Establish executive-level relationships to foster trust and long-term engagement Operating Model & Governance * Influence adoption models and workflows within designated business units * Partner with technical leads and business leaders to ensure alignment between AI strategy, execution, and corporate objectives * Create mechanisms for continuous learning and co-innovation so teams can confidently adopt AI Team Collaboration & Capability Building * Enhance engagement strategies between AI teams and business units * Create mechanisms for continuous learning and co-innovation so teams can confidently adopt AI Enterprise AI Integration & Innovation * Collaborate with CIO's, AI Center of Excellence, and business leaders to embed AI into core organizational processes and platforms * Drive initiatives such as Clinical Health Data Platform development, AI call center modernization, and digital acceleration aligned with corporate strategy * Advise commercial teams to inform readiness and positioning for AI-driven products and services, leveraging partnerships and market insights Transformation Leadership * Redesign team structures and engagement models to shift from technical delivery to strategic adaption and growth enablement * Lead a team of Technical Product Managers with a focus on redefining their function to serve as customer engagement leaders and drivers of business value realization You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Proven leadership in AI strategy, digital transformation, and customer engagement at an enterprise scale * Demonstrated ability to influence executive stakeholders and align AI initiatives with business objectives * Ability to bridge technical and business domains, influencing senior stakeholders and driving cross-functional collaboration * Solid understanding of AI/ML trends, applications, and governance best practices * Experience in complex environments (regulated preferred) * Exceptional communication skills, with the ability to simplify complex concepts for diverse audiences * Track record of leading cross-functional teams and driving organizational change * Expertise in operating model design, governance, and portfolio management Preferred Qualifications: * 15+ years in technology leadership roles, with significant experience in AI/ML strategy and implementation * Track record of delivering growth through AI initiatives in healthcare or similar regulated industries * Experience managing large, distributed teams and complex stakeholder environments * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $196,600 to $337,100 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $196.6k-337.1k yearly 11d ago
  • Vice President of AI Growth & Customer Engagement

    Unitedhealth Group 4.6company rating

    Eden Prairie, MN jobs

    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** The Vice President of AI Growth & Customer Engagement will lead the transformation for the AI team's operating model and engagement approach to accelerate adoption and empower business units to identify and realize AI-driven growth opportunities for internal and external teams. You will drive initiatives that ensure AI services deliver measurable customer value, foster lasting relationships, and enhance collaboration between AI teams and business units. This role will lead a focused transformation of the function over an initial 12-18 month period, then transition to drive sustained adoption and innovation within a specific business segment as an AI Engagement Lead. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires within 30 minutes of an office in Minnesota or Washington, D.C., you'll be required to work a minimum of four days per week in-office. **Primary Responsibilities:** **Strategic Growth & Customer Engagement** + Develop a deep understanding of internal business units and external client needs to identify and support AI-driven growth opportunities ensuring accountability for outcomes + Develop frameworks and playbooks that help business leaders recognize and evaluate AI opportunities aligned to strategic priorities + Educate and engage teams on integrating AI into workflows for measurable impact + Innovation & Value Realization: Identify and advance high-impact AI opportunities, from proof of concept through scaled deployment + Collaborate closely with Optum AI leaders to shape and lead growth initiatives **Customer Engagement** + Enhance team engagement strategies to position Optum AI as a trusted partner with deep collaboration and understanding + Ensure AI services anticipate customer needs and deliver measurable value + Establish executive-level relationships to foster trust and long-term engagement **Operating Model & Governance** + Influence adoption models and workflows within designated business units + Partner with technical leads and business leaders to ensure alignment between AI strategy, execution, and corporate objectives + Create mechanisms for continuous learning and co-innovation so teams can confidently adopt AI **Team Collaboration & Capability Building** + Enhance engagement strategies between AI teams and business units + Create mechanisms for continuous learning and co-innovation so teams can confidently adopt AI **Enterprise AI Integration & Innovation** + Collaborate with CIO's, AI Center of Excellence, and business leaders to embed AI into core organizational processes and platforms + Drive initiatives such as Clinical Health Data Platform development, AI call center modernization, and digital acceleration aligned with corporate strategy + Advise commercial teams to inform readiness and positioning for AI-driven products and services, leveraging partnerships and market insights **Transformation Leadership** + Redesign team structures and engagement models to shift from technical delivery to strategic adaption and growth enablement + Lead a team of Technical Product Managers with a focus on redefining their function to serve as customer engagement leaders and drivers of business value realization You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Proven leadership in AI strategy, digital transformation, and customer engagement at an enterprise scale + Demonstrated ability to influence executive stakeholders and align AI initiatives with business objectives + Ability to bridge technical and business domains, influencing senior stakeholders and driving cross-functional collaboration + Solid understanding of AI/ML trends, applications, and governance best practices + Experience in complex environments (regulated preferred) + Exceptional communication skills, with the ability to simplify complex concepts for diverse audiences + Track record of leading cross-functional teams and driving organizational change + Expertise in operating model design, governance, and portfolio management **Preferred Qualifications:** + 15+ years in technology leadership roles, with significant experience in AI/ML strategy and implementation + Track record of delivering growth through AI initiatives in healthcare or similar regulated industries + Experience managing large, distributed teams and complex stakeholder environments *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $196,600 to $337,100 annually based on full-time employment. We comply with all minimum wage laws as applicable. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
    $196.6k-337.1k yearly 11d ago

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