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Senior Business Manager jobs at HCSC - 32 jobs

  • Sr Mgr Pharmacy Underwriting

    HCSC 4.5company rating

    Senior business manager job at HCSC

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job SummaryInterpret and describe BCBS products and financial arrangements as well as those provided by competitors. Interact with BCBSA and member plans. Required Job Qualifications: * Bachelor Degree and 5 years' experience underwriting small and/or large accounts and dealing directly with key customers, consultants and/or brokers OR 6 years of experience underwriting small and/or large accounts and dealing directly with key customers, consultants and brokers. * 3 years of underwriting of higher complexity cases (if responsibility includes one or more of the following segments: large/major/national/and or special accounts (Labor Union, Student Health, IL Hospital, Co-operatives, Private Exchange, etc.) or OR Demonstrated capability to meet required job responsibility. * Successfully demonstrated skills and experience in underwriting and pricing of various funding options and products and making sound decisions. * Operational knowledge of renewal and prospective group health underwriting processes and procedures. * Knowledge of underwriting methodologies including mathematical and financial group health underwriting funding. * Extensive experience applying consortium procedure and pricing (if applicable). * Extensive experience and knowledge of managed care/health care, group insurance products and group health underwriting financial arrangements and knowledge of state and federal legislation to underwriting practices and making sound decisions. * Work management skills in prioritizing and assigning work and project assignments. * Demonstrated highly effective Presentation skills for addressing customers and senior management. * Demonstrate skills for developing presentations, building and maintaining positive relationships internally and externally, interacting with representatives of large and strategic accounts, coordinating initiatives across departments, interacting with senior management, lead staff. * Project management skills and experience, including designing and leading projects. * Verbal and written communication skills, including correct grammar, appropriate word choice, precisions, structure, and appropriate tone and level of detail for audience. * Interact with BCBSA and member plans. * Interpret and describe BCBS products and financial arrangements as well as those provided by competitors. * Successfully demonstrated interpersonal skills in establishing and maintaining positive business relationships. * Independent judgment and problem resolution skills. * Work and project management skills including the ability to multi-task, prioritize, and manage time and workload to meet deadlines. * PC proficiency to include Word and Excel. * Successfully demonstrated skills and experience in presenting to external clients. * Process management and process improvement experience and skills to identify and implement process changes. Preferred Job Qualifications: * Pharmacy Underwriting experience * Experience leading pharmacy underwriters Please note that this role is HYBRID with an in-office requirement of 3 days a week #LI-LK1 #LI-Hybrid #INJLF Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! Pay Transparency Statement: At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************** The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. HCSC Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. Base Pay Range$100,000.00 - $180,700.00 Exact compensation may vary based on skills, experience, and location.
    $100k-180.7k yearly Auto-Apply 44d ago
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  • Senior Director, Medicare Part D Actuarial

    Health Care Service Corporation 4.1company rating

    Chicago, IL jobs

    A leading healthcare organization seeks an Executive Director for their Medicare Part D Actuarial function, based in Chicago, IL. In this role, you will lead the actuarial strategy, oversee bid development, and provide financial management for Medicare products. The ideal candidate will possess a strong background in actuarial science, extensive leadership experience, and exceptional communication skills. This position offers a comprehensive benefits package and professional development opportunities. #J-18808-Ljbffr
    $127k-187k yearly est. 2d ago
  • Senior Care Manager (RN)

    Centene Corporation 4.5company rating

    Springfield, IL jobs

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. **THIS IS A HYBRID POSITION, WILL BE BASED OUT OF MOUNT SINAI HOSPITAL ON THE WEST SIDE OF CHICAGO TO SUPPORT MEDICARE AND MEDICAID ADMITTED MEMBERS WORKING WITH HOSPITAL STAFF TO FACILITATE DISCHARGE COORDINATION/PLANNING.** **THE WORK SCHEDULE IS MONDAY - FRIDAY 8AM - 5PM WORKING FROM THE HOSPITAL BASED ON MEMBER CENSUS 3 - 4 DAYS A WEEK AND WORK FROM HOME 1 - 2 DAYS A WEEK.** **IDEAL APPLICANTS WILL RESIDE WITHIN NO MORE THAN A 30 MINUTE COMMUTE FROM THIS HOSPITAL LOCATION; ZIP CODE 60608.** **Position Purpose:** Assesses, plans, and implements complex care management activities based on member activities to enable quality, cost-effective healthcare outcomes. Develops a personalized care plan / service plan for care members, addresses issues, and educates members and their families/care givers on services and benefit options available to receive appropriate high-quality care. + Develops and continuously assesses ongoing care plans / service plans and collaborates with providers to identify providers, specialist, and/or community resources needed to address member's unmet needs + Coordinates and manages as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services + Monitors care plans / service plans and/or member status, change in condition, and progress towards care plan / service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan / service plan as necessary to meet the member's goals / unmet needs + May identify problems/barriers for care management and appropriate care management interventions for escalated cases + Reviews member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations + Reviews referrals information and intake assessments to develop appropriate care plans/service plans + May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources + Collaborates with healthcare providers as appropriate to facilitate member services and/or treatments and determine a revised care plan for member if needed + Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators + Provides and/or facilitates education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits + Partners with leadership team to improve and enhance care and quality delivery for members in a cost-effective manner + May precept clinical new hires by fostering and building core skills, coaching and facilitating their growth, and guiding through the onboarding process to upskill readiness + Provides guidance and support to clinical new hires/preceptees in navigating within a Managed Care Organization (MCO) and provides coaching and shadowing opportunities to bridge gap between classroom training and field practice + Engages and assists New Hire/Preceptee during onboarding journey including responsibility for completing competency check points ensuring readiness for Service Coordination success + Engages in a collaborative and ongoing process with People Leaders and cross functional teams to measure and monitor readiness + Other duties or responsibilities as assigned by people leader to meet business needs + Performs other duties as assigned + Complies with all policies and standards **Education/Experience:** Requires a Degree from an Accredited School or Nursing or a Bachelor's degree in Nursing and 4 - 6 years of related experience. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact State Licensure required Pay Range: $73,800.00 - $132,700.00 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
    $73.8k-132.7k yearly 4d ago
  • Director of Business Process Transformation

    Healthcare Services 4.1company rating

    Remote

    Thank you for your interest in joining Solventum. Solventum is a new healthcare company with a long legacy of solving big challenges that improve lives and help healthcare professionals perform at their best. At Solventum, people are at the heart of every innovation we pursue. Guided by empathy, insight, and clinical intelligence, we collaborate with the best minds in healthcare to address our customers' toughest challenges. While we continue updating the Solventum Careers Page and applicant materials, some documents may still reflect legacy branding. Please note that all listed roles are Solventum positions, and our Privacy Policy: *************************************************************************************** applies to any personal information you submit. As it was with 3M, at Solventum all qualified applicants will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Job Description: Director of Business Process Transformation 3M Health Care is now Solventum At Solventum, we enable better, smarter, safer healthcare to improve lives. As a new company with a long legacy of creating breakthrough solutions for our customers' toughest challenges, we pioneer game-changing innovations at the intersection of health, material and data science that change patients' lives for the better while enabling healthcare professionals to perform at their best. Because people, and their wellbeing, are at the heart of every scientific advancement we pursue. We partner closely with the brightest minds in healthcare to ensure that every solution we create melds the latest technology with compassion and empathy. Because at Solventum, we never stop solving for you. The Impact You'll Make in this Role The Director of Business Process Transformation is accountable for driving the transformation of key Finance business processes to achieve the Finance Modernization Strategic Plan targets. Key processes include FP&A, Finance Data Office, Controllership, Record to Report, Operations Finance, Tax, Treasury, and other financial functions, with a focus on achieving measurable quality, cost, delivery, and scalability improvements. This role requires a dynamic and strategic thinker with deep experience leveraging Lean, Six Sigma, and business transformation best practices to drive top quartile performance in finance. The ideal candidate will possess a high degree of business acumen in interacting with cross-functional teams and executive leaders, excellent communication skills, and a proven track record of finance business transformation leadership. As Director of Business Process Transformation, you will have the opportunity to tap into your curiosity and collaborate with some of the most innovative and diverse people around the world. Here, you will make an impact by: Drive Process Optimization: Work cross-functionally to define and document existing current state end-to-end finance process maps for identified key finance processes across the organization (many of which start outside of finance). Critically assess current processes and business challenges, needs, and gaps, and identify opportunities for efficiencies and improvements through root cause analysis. Lead process mapping workshops, kaizen events, and value stream mapping to support team alignment and problem solving and drive improvements. Develop end-to-end solutions to optimize processes, reduce costs, and strengthen controls, based on Lean Six Sigma methodology and industry best practices for financial processes including outsourcing, shared services, automation, and other efficiency improvements. Document future state process maps and maintain and update process documentation. Drive transformation, as needed, in people, process, data, and technology with cross-functional teams. Approach all aspects of the role with a continuous improvement framework, identifying and mapping key business processes and taking a holistic view. Executive Collaboration & Stakeholder Engagement: Build strong relationships with senior leaders and stakeholders across functions to ensure alignment, buy-in, and support throughout the process changes. Change Agent: Act as a key voice for change, helping to engage and align teams around achieving the Finance Modernization transformation goals and performance metrics. Risk & Readiness Assessment: Conduct impact analyses and readiness evaluations to identify potential risks and develop mitigation strategies. Coaching & Strategic Advisory: Keep abreast of industry best practices and emerging technologies in business process improvement and transformation. Serve as a thought leader to executive and senior leaders on best practices to optimize financial processes. Project Management: Drive overall cross-functional project management of the process transformation initiatives, including managing project plan, deliverables, owners and due dates, RAIDE Register (Risks, Assumptions, Issues, Dependencies, and Escalations), etc Your Skills and Expertise To set you up for success in this role from day one, Solventum requires the following qualifications: Bachelor's degree or higher in Business Administration, Finance, Accounting or related discipline 12 or more years of experience in management of financial processes and/or business process transformation of financial processes Certified Lean Six Sigma Master Black Belt with demonstrated experience driving global finance business process transformations leveraging tools and techniques for mapping and analyzing processes such as value stream mapping and Kaizen Proven track record of driving successful business process transformation initiatives with high impact results and working collaboratively in cross-functional teams, with preference on global organizations and enterprise-wide transformations Additional qualifications that could help you succeed even further in this role include: Strong analytical skills with demonstrated ability to analyze complex processes, identify root causes of problems, and develop data-driven solutions Strong and effective strategic and problem solver with the ability to both recognize and anticipate problems and interpret and summarize data to aid management in achieving strategic and operational goals Excellent leadership, communication, presentation, and interpersonal skills, with ability to work collaboratively with executive and senior leadership and effectively build business relationships and influence without authority as part of a matrix organization Demonstrated ability to translate solutions into viable action plans at a global level Experience working cross-functionally and cross-culturally in support of business processes and/or systems Results oriented, hands-on, and able to roll-up their sleeves to drive completion of necessary tasks Self-motivated, high energy, respectful, honest, hard-working and loyal team member Work location: Remote - United States Travel: May include up to [25%][domestic/international] Relocation Assistance: No Must be legally authorized to work in country of employment without sponsorship for employment visa status (e.g., H1B status). Supporting Your Well-being Solventum offers many programs to help you live your best life - both physically and financially. To ensure competitive pay and benefits, Solventum regularly benchmarks with other companies that are comparable in size and scope. Applicable to US Applicants Only:The expected compensation range for this position is $211,600 - $290,950, which includes base pay plus variable incentive pay, if eligible. This range represents a good faith estimate for this position. The specific compensation offered to a candidate may vary based on factors including, but not limited to, the candidate's relevant knowledge, training, skills, work location, and/or experience. In addition, this position may be eligible for a range of benefits (e.g., Medical, Dental & Vision, Health Savings Accounts, Health Care & Dependent Care Flexible Spending Accounts, Disability Benefits, Life Insurance, Voluntary Benefits, Paid Absences and Retirement Benefits, etc.). Additional information is available at: *************************************************************************************** of this position include that corporate policies, procedures and security standards are complied with while performing assigned duties. Solventum is committed to maintaining the highest standards of integrity and professionalism in our recruitment process. Applicants must remain alert to fraudulent job postings and recruitment schemes that falsely claim to represent Solventum and seek to exploit job seekers. Please note that all email communications from Solventum regarding job opportunities with the company will be from an email with a domain *****************. Be wary of unsolicited emails or messages regarding Solventum job opportunities from emails with other email domains. Please note, Solventum does not expect candidates in this position to perform work in the unincorporated areas of Los Angeles County.Solventum is an equal opportunity employer. Solventum will not discriminate against any applicant for employment on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or veteran status. Please note: your application may not be considered if you do not provide your education and work history, either by: 1) uploading a resume, or 2) entering the information into the application fields directly. Solventum Global Terms of Use and Privacy Statement Carefully read these Terms of Use before using this website. Your access to and use of this website and application for a job at Solventum are conditioned on your acceptance and compliance with these terms. Please access the linked document by clicking here. Before submitting your application you will be asked to confirm your agreement with the terms.
    $211.6k-291k yearly Auto-Apply 6d ago
  • Vice President, Business Operations Automation

    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. Develops and executes the automation strategy across managed care operations. Drives large-scale transformation initiatives, leveraging advanced technologies to optimize processes, improves quality, and enhances employee, member and provider experiences. Collaborates with cross-functional teams, including business process owners, technology leaders, and clinical operations, to ensure automation aligns with organizational objectives and regulatory requirements. Sets the strategic vision for automation initiatives across operational functions, ensuring alignment with corporate goals and industry best practices. Leads the identification, design, and implementation of automation solutions (e.g., RPA, AI, workflow orchestration) to streamline operations, reduce costs, and improve service quality. Partners with business and technology stakeholders to gather requirements, define project scope, and prioritize automation opportunities. Leads vendor evaluation, negotiation of contracts, and build-vs-buy decisions for defined automation solutions. Oversees the integration of automation technologies with existing systems, ensuring seamless operation and minimal disruption. Partners with internal thought leaders to develop guardrails for AI-driven process automation, ensuring appropriate governance of the design, deployment, and life cycle management of all solutions. Establishes and enforces operational integration controls, including standardized workflows, QA checkpoints, exception-handling rules, and human-in-the-loop controls - to ensure automation-enhanced processes run safely, consistently, and in compliance with regulatory requirements. Establishes and monitors key performance indicators (KPIs) to measure the impact of automation on operational efficiency, compliance, and member satisfaction. Fosters a culture of innovation, accountability, and continuous improvement within the automation team and across the organization. Performs other duties as assigned. Complies with all policies and standards. Education/Experience: Bachelor's Degree in Business Administration, Information Technology, Healthcare Administration, or related field required Master's Degree in a related field preferred. 10+ years of progressive leadership experience in managed care, health insurance, or healthcare operations, with a strong focus on automation and process improvement required Strong analytical skills to interpret data, identify trends, and translate insights into actionable strategies. Proactive approach to problem-solving and technical challenges. In-depth knowledge of managed care operations, payer-provider relations, and regulatory requirements (e.g., HIPAA, CMS). Familiarity with claims management, contract negotiation, and compliance tools. Financial and operational awareness to align automation with business objectives. Experience leading digital transformation initiatives and managing complex projects. Demonstrated success in leading large-scale automation or digital transformation initiatives. Excellent communication, collaboration, and stakeholder management abilities. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. Bachelor's Degree in Business Administration, Information Technology, Healthcare Administration, or related field required Master's Degree in Business Administration, Information Technology, Healthcare Administration, or related field preferred 10+ years of progressive leadership experience in managed care, health insurance, or healthcare operations, with a strong focus on automation and process improvement. required.Pay Range: $227,700.00 - $431,400.00 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
    $227.7k-431.4k yearly Auto-Apply 5d ago
  • Finance Operations Senior Director

    Cigna 4.6company rating

    Philadelphia, PA jobs

    The Senior Director of Finance Operations for Cigna Pharmacy will lead a team of approximately 20 professionals plus a dedicated technology team. This role is responsible for driving operational excellence across client performance guarantee (PG) operations, guarantee and ASO agreement automation, data management, and implementation of new initiatives and technology. The position requires strong leadership, attention to detail, and collaboration with cross-functional teams including sales, underwriting, product, and technology. Key Responsibilities: Team Leadership * Manage and develop a staff of ~20 and a dedicated technology team, fostering a culture of accountability and continuous improvement. Client PG Operations * Validate rebate invoice data for Cigna Pharmacy in partnership with ESI * Oversee client pharmacy rebate sharing for over 1,200 clients. * Ensure accurate discount guarantee reporting and reconciliation. * Support sales training and client resolution activities. * Manage audit processes for client guarantees in partnership with the enterprise rebate audit team. ASO Agreement and RFP Support * Drive automation of guarantees and ASO agreements, including broker templates, new language, and market events * Approve client communications and RFP language to ensure compliance and accuracy with capabilities Project Management * Lead implementation of new underwriting and pricing guarantees, exclusions, and related initiatives. * Coordinate cross-functional efforts to deliver projects on time and within scope. Data Operations * Develop and maintain Cigna Pharmacy finance data, consolidating data from ESI, Accredo, ESHD, and CHC Medical. * Advance data visualization and automation initiatives to improve reporting efficiency. * Serve as subject matter expert for compliance reporting * Active engagement with Technology to ensure data accuracy and availability Qualifications: * Extensive experience in finance operations within healthcare or pharmacy benefit management. * Proven leadership skills managing large teams and technology-driven initiatives. * Excellent communication and stakeholder management skills. * Strong problem solving skills involving complex systems and a matrix environment * Knowledge of compliance, audit processes, and client contract management. 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 169,500 - 282,500 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus 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.
    $105k-130k yearly est. Auto-Apply 3d ago
  • Sr Mgr Pharmacy Underwriting

    Health Care Service Corporation 4.1company rating

    Chicago, IL jobs

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** Interpret and describe BCBS products and financial arrangements as well as those provided by competitors. Interact with BCBSA and member plans. **Required Job Qualifications:** * Bachelor Degree and 5 years' experience underwriting small and/or large accounts and dealing directly with key customers, consultants and/or brokers **OR** 6 years of experience underwriting small and/or large accounts and dealing directly with key customers, consultants and brokers. * 3 years of underwriting of higher complexity cases (if responsibility includes one or more of the following segments: large/major/national/and or special accounts (Labor Union, Student Health, IL Hospital, Co-operatives, Private Exchange, etc.) or OR Demonstrated capability to meet required job responsibility. * Successfully demonstrated skills and experience in underwriting and pricing of various funding options and products and making sound decisions. * Operational knowledge of renewal and prospective group health underwriting processes and procedures. * Knowledge of underwriting methodologies including mathematical and financial group health underwriting funding. * Extensive experience applying consortium procedure and pricing (if applicable). * Extensive experience and knowledge of managed care/health care, group insurance products and group health underwriting financial arrangements and knowledge of state and federal legislation to underwriting practices and making sound decisions. * Work management skills in prioritizing and assigning work and project assignments. * Demonstrated highly effective Presentation skills for addressing customers and senior management. * Demonstrate skills for developing presentations, building and maintaining positive relationships internally and externally, interacting with representatives of large and strategic accounts, coordinating initiatives across departments, interacting with senior management, lead staff. * Project management skills and experience, including designing and leading projects. * Verbal and written communication skills, including correct grammar, appropriate word choice, precisions, structure, and appropriate tone and level of detail for audience. * Interact with BCBSA and member plans. * Interpret and describe BCBS products and financial arrangements as well as those provided by competitors. * Successfully demonstrated interpersonal skills in establishing and maintaining positive business relationships. * Independent judgment and problem resolution skills. * Work and project management skills including the ability to multi-task, prioritize, and manage time and workload to meet deadlines. * PC proficiency to include Word and Excel. * Successfully demonstrated skills and experience in presenting to external clients. * Process management and process improvement experience and skills to identify and implement process changes. **Preferred Job Qualifications:** * Pharmacy Underwriting experience * Experience leading pharmacy underwriters Please note that this role is **HYBRID** with an in-office requirement of 3 days a week \#LI-LK1 \#LI-Hybrid \#INJLF **Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!** **Pay Transparency Statement:** At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************* . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. **HCSC Employment Statement:** We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. **Base Pay Range** $100,000.00 - $180,700.00 Exact compensation may vary based on skills, experience, and location. **Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.** **Join our Talent Community. (******************************************** PA8v\_eHgqFiDb2AuRTqQ)** For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at ************** to request reasonable accommodations. Please note that only **requests for accommodations in the application process** will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.
    $100k-180.7k yearly 43d 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 17d 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 41d ago
  • Sr. Director, Pharma Contracting, Business Development, and Account Management - Accredo

    Cigna Group 4.6company rating

    Saint Louis, MO jobs

    The Senior Director, Pharma Contracting, Business Development & Account Management provides enterprise leadership in strategy, client management, and innovation across pharma partnerships. This role leads a team responsible for developing and executing strategies that strengthen client renewal and retention, create innovative solutions, and drive sustainable growth. The position collaborates with internal and external stakeholders to ensure expectations are consistently exceeded, while guiding multiple departments to identify new opportunities and support organizational change. This leader will shape and execute pharma client management and innovation strategies, overseeing business development and account management services across the portfolio. The position drives interdepartmental alignment, leads teams toward achieving client satisfaction and strategic growth targets, and supports contracting initiatives and long‑term client retention. The Senior Director also manages new business development within their existing book of business and guides the team in identifying and implementing innovative solutions. ESSENTIAL FUNCTIONS Guide and advise on strategic product opportunities to ensure growth across Accredo and CuraScript SD portfolios as subject matter expert driving towards value creation Spends a significant amount of time negotiating internally and externally leveraging an enterprise mindset to address key client & market opportunities to innovate Identifies and creates a pathway to year over year value for key strategic clients Spends time developing talent across the team with a goal of developing future leaders Helps team prioritize and focus on key market dynamics and opportunities that drive value Builds and maintains executive level relationships with pharma partners and internal stakeholders Establishes long-term strategies for manufacturers & key therapeutic focus areas to drive value Partners across Evernorth to support strategic complex initiatives Has a passion for the specialty pharmacy business and views challenges as opportunities to enhance the process and challenge the status quo Partner with leadership on strategic goals and emerging trends Analyze and recommend potential opportunities, leveraging detailed financial analysis, and emerging specialty trends Communicate complex material succinctly and effectively to multiple audiences Build and develop key relationships across the enterprise to help build internal enthusiasm and momentum for innovation Represent Accredo/CuraScript SD at industry events and conferences as required. Support and promote the company values through positive interactions with both internal and external stakeholders on a regular basis Work collaboratively with management team to provide career development opportunities, evaluate performance and provide feedback to promote employee growth and retention Assists Managing Director in managing profit, revenue, and margin for assigned clients Assists Managing Director in developing strategic work plan goals to include, but not limited to, gross margin, client retention, renewal, and novel growth opportunities Work cross functionally and at multiple levels both internally and externally with key stakeholders QUALIFICATIONS PharmD or 10+ years of professional experience & bachelor's degree in related field (pharma contracting, analytics, formulary development, product development, business development, pharma strategy). Experience leading or managing people preferred, including leading cross-functional groups. Pharma negotiation experience. Pharma contracting experience. Thorough understanding of industry financials and market dynamics. Proven experience mentoring and coaching others, both cross-functionally or directly. Strong problem-solving and business analysis skills. Naturally inquisitive with a desire to solve problems and dig into detailed analysis. Experience working cross-functionally and promoting collaborative partnerships to drive results. Proven ability to communicate effectively to various audiences/levels including leadership through various mediums. Ability to take a complex product/financial/pricing issue(s)/problem(s) and deconstruct it into a concise, impactful message(s). Ability to present and convey material both formally and informally to all levels of the organization. High-level of confidence, integrity, enthusiasm, and executive presence. Comfortable working with complex data sets and queries. Demonstrated ability to prioritize and manage workload and meet project deadlines. Interest and ability in mentoring other team members as applicable. Strong MS Office, web conferencing, AI, and internal communication software experience. Detail oriented and organized. Travel is anticipated up to 30% of the time for business meetings and industry events. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* 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.
    $114k-145k yearly est. Auto-Apply 10d 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: $227,700.00 - $431,400.00 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 3d ago
  • Managing Director, Enterprise Organizational Enablement

    Cigna 4.6company rating

    Philadelphia, PA jobs

    We are seeking a visionary and experienced leader to serve as Managing Director, Enterprise Organizational Enablement. This role will lead the enterprise organizational development (OD) and change function, an internal consulting group positioned to drive organizational effectiveness, high performance, and change adoption across The Cigna Group. The successful candidate will partner with senior leaders to address complex organizational challenges, build internal capability in organizational design, systems thinking, team effectiveness, and change management, and foster a culture of agility, resilience, and innovation. Key Responsibilities Enterprise Enablement Strategic Leadership * Serve as a strategic advisor on organizational effectiveness, organizational design, culture, change readiness, and stakeholder engagement to senior HR Business Partners and executive leaders. * Develop and execute integrated organizational development and change management strategies aligned with enterprise goals to drive business outcomes. * Lead the design and implementation of complex OD interventions (e.g., organizational design, culture transformation, team effectiveness). * Develop and execute comprehensive change strategies aligned with enterprise talent strategy priorities and critical business initiatives, working with key partners to manage decision-making, risk mitigation, and project delivery accordingly. * Assess and manage change saturation and readiness across the enterprise portfolio, elevating critical risks and mitigation strategies to senior leadership. Team Leadership & Development * Bolster and lead a high-performing internal consulting practice that partners with business and HR leaders to diagnose organizational needs, design tailored OD and change interventions and deliver measurable business outcomes. * Coach and mentor team members to build expertise in needs assessment, systems thinking, consulting, and strategic thinking while supporting career growth and development. * Define clear goals and performance metrics for the team, ensuring alignment with enterprise priorities and client needs. * Establish a consulting center of excellence, promoting best practices, knowledge sharing, and continuous improvement across the team and with key matrix partners. Capability Building & Methodology Development * Continue to refine existing OD methodologies and resources, aligning to current best practices and business needs. * Establish and scale enterprise-wide change management methodologies and resources, in partnership with Leadership Development and Learning teams. * Build internal OD and change capability across HR and business units through training, coaching, and knowledge-sharing. Stakeholder Engagement & Communication * Facilitate executive team interventions and design sessions to address organizational health, engagement, and performance. * Partner with executive sponsors, business leaders, and project teams to assess change impacts, drive alignment and readiness, and develop tailored change plans. * Design and execute communication strategies that foster transparency, engagement, and alignment across all levels of the organization. * Facilitate leadership alignment sessions, employee forums, and feedback loops to ensure inclusive and responsive change efforts. Measurement & Continuous Improvement * Partner with talent analytics to define KPIs and leverage advanced analytics, dashboards, and digital tools to monitor organizational health and change adoption. * Use data-driven insights to refine OD and change strategies and ensure sustained outcomes. * Conduct post-implementation reviews and lessons-learned sessions to inform future initiatives. Qualifications * Advanced degree in Organizational Development, Industrial/Organizational Psychology, or related field strongly preferred. * 10+ years of progressive Human Resources leadership experience, including significant experience in OD, change management and transformation. * Demonstrated ability to build and lead high-performing consulting teams. * Experience in both change management and OD within large, complex, matrixed organizations. * Deep expertise in OD theory and practice (e.g., systems thinking, group dynamics, culture transformation, leadership assessment) and leading OD interventions at-scale. * Proven success in leading enterprise-wide, large-scale, complex change initiatives in a global, matrixed organization is required. * Certification in OD (e.g., organizational design, team effectiveness tools), change management methodologies (e.g., PROSCI, ADKAR, Kotter) highly desirable. * Strong business acumen, strategic thinking, and stakeholder management skills. * Exceptional communication, facilitation, and relationship-building abilities. * Experience with HR technology such as ServiceNow, Workday, or SAP SuccessFactors preferred. * Demonstrated ability to manage multiple projects and priorities in a fast-paced, dynamic environment. * Strong analytical and problem-solving skills, with a data-driven approach to decision-making. * Ability to work collaboratively and build strong relationships across diverse functions and geographies in a highly matrixed organization. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. 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.
    $90k-118k yearly est. Auto-Apply 12d ago
  • Sr. New Business Manager, 0500(Hybrid; Newton, MA)

    Cigna Group 4.6company rating

    Newton, MA jobs

    Develops and implements sales strategies for targeted key accounts in a plan, a territory, or a specified geographic area. Very knowledgeable of complete line of products/services and clients' issues and needs. Primarily focuses on seeking out new clients. Typically has at least three years of related sales experience. Responsibilities Obtain new accounts through direct or brokerage channels for sales. Meet or exceed annual business plan as measured by new firms, revenue, membership and profitability objectives. Maintain prescribed weekly activity levels. Manage the sales process for Medical, Dental, Pharmacy, Behavioral products. Review and respond to RFP's, manage internal strategy and present quotations. Manage database of prospects and assigned producers. Qualifications 5+ years sales experience strongly preferred Prior Insurance experience in Underwriting, Operations or Proven sales track record 1-2+ years' experience in managed care sales Highly motivated with excellent organizational skills Self-starter with ability to work independently or as a team to achieve goals and objectives Excellent presentation skills, verbal and written communication skills Ability to work strategically with matrix partners to design presale strategies and proposals Ability to obtain necessary licenses Acceptable driving record 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. This role is also anticipated to be eligible to participate in an incentive compensation 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.
    $94k-121k yearly est. Auto-Apply 4d ago
  • Patient Financing Business Manager - Remote

    Unitedhealth Group 4.6company rating

    Lincoln, NE 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. Job Summary: The Patient Financing Business Manager is responsible for the strategy, development, and management of elective medical financing products, overseeing their lifecycle from conception to launch and optimization. Key duties include understanding patient borrower needs, defining product features/benefits, end-to-end customer experience, developing business cases, setting pricing strategies, ensuring regulatory compliance, and collaborating with various departments like marketing, operations, engineering and risk management to drive product growth and performance. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. **Primary Responsibilities:** + Product strategy and development: + Define and execute the product vision and roadmap, aligning with business objectives + Conduct market research, competitive analysis, and customer needs analysis to identify opportunities for new or improved products + Develop business cases and financial models partnering with Finance to support new product initiatives + Translate business requirements into formal design and requirements documentation for new and enhanced products + Product lifecycle management: + Manage products throughout their lifecycle, from ideation through to ongoing optimization + Monitor and manage product performance, including financial performance and key metrics + Implement and manage changes in product or marketing strategy based on performance data + Risk and compliance: + Ensure all products comply with relevant laws, regulations, and internal policies + Develop and update product policies and procedures to address regulatory changes + Go-to-market and sales: + Partner with Marketing and Sales teams to develop and implement marketing, sales, and channel strategies + Collaborate with marketing to develop customer communication plans and campaigns + Provide training and support to internal teams, such as sales and customer service + Collaboration and stakeholder management: + Work with cross-functional teams, including engineering, IT, risk, operations, marketing, and sales, to ensure successful product execution and support + Build and maintain relationships with internal and external stakeholders, including partners and third-party vendors + Reporting and analytics: + Develop and produce reports and dashboards to track product performance + Use data analysis and insights to make informed, data-driven decisions 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:** + 5+ years of experience in business, product, marketing management or operations roles + 2+ years of experience of consumer and/or point-of-sale lending + Experience working in a highly regulated industry preferably a financial industry + Demonstrated ability to work in a fast-paced environment + Proven solid analytical and problem-solving skills + Proven persistent and results focused - must be able to deliver results + Proven ability to work with all levels of the organization + Proven excellent verbal and written communication skills + Proven excellent organizational skills and attention to detail + Proven excellent time management skills with a proven ability to meet deadlines + Proven entrepreneurial mindset + Willing or ability to travel up to 10% based on business needs *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 $xx,xxx to $xx,xxx 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._
    $58k-67k yearly est. 24d ago
  • Patient Financing Business Manager - Remote

    Unitedhealth Group Inc. 4.6company rating

    Lincoln, NE 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. Job Summary: The Patient Financing Business Manager is responsible for the strategy, development, and management of elective medical financing products, overseeing their lifecycle from conception to launch and optimization. Key duties include understanding patient borrower needs, defining product features/benefits, end-to-end customer experience, developing business cases, setting pricing strategies, ensuring regulatory compliance, and collaborating with various departments like marketing, operations, engineering and risk management to drive product growth and performance. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. Primary Responsibilities: * Product strategy and development: * Define and execute the product vision and roadmap, aligning with business objectives * Conduct market research, competitive analysis, and customer needs analysis to identify opportunities for new or improved products * Develop business cases and financial models partnering with Finance to support new product initiatives * Translate business requirements into formal design and requirements documentation for new and enhanced products * Product lifecycle management: * Manage products throughout their lifecycle, from ideation through to ongoing optimization * Monitor and manage product performance, including financial performance and key metrics * Implement and manage changes in product or marketing strategy based on performance data * Risk and compliance: * Ensure all products comply with relevant laws, regulations, and internal policies * Develop and update product policies and procedures to address regulatory changes * Go-to-market and sales: * Partner with Marketing and Sales teams to develop and implement marketing, sales, and channel strategies * Collaborate with marketing to develop customer communication plans and campaigns * Provide training and support to internal teams, such as sales and customer service * Collaboration and stakeholder management: * Work with cross-functional teams, including engineering, IT, risk, operations, marketing, and sales, to ensure successful product execution and support * Build and maintain relationships with internal and external stakeholders, including partners and third-party vendors * Reporting and analytics: * Develop and produce reports and dashboards to track product performance * Use data analysis and insights to make informed, data-driven decisions 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: * 5+ years of experience in business, product, marketing management or operations roles * 2+ years of experience of consumer and/or point-of-sale lending * Experience working in a highly regulated industry preferably a financial industry * Demonstrated ability to work in a fast-paced environment * Proven solid analytical and problem-solving skills * Proven persistent and results focused - must be able to deliver results * Proven ability to work with all levels of the organization * Proven excellent verbal and written communication skills * Proven excellent organizational skills and attention to detail * Proven excellent time management skills with a proven ability to meet deadlines * Proven entrepreneurial mindset * Willing or ability to travel up to 10% based on business needs * 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 $xx,xxx to $xx,xxx 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.
    $58k-67k yearly est. 24d ago
  • Senior Director, Affordability Strategy

    Cigna 4.6company rating

    Chicago, IL jobs

    The Senior Director, Affordability Strategy will serve as a leader responsible for shaping the affordability roadmap across the national ancillary and payment integrity teams at Cigna Healthcare. This role seeks an experienced strategist with deep healthcare expertise, capable of influencing executive decision-making and driving the ideation, design, and oversight of new affordability initiatives and solutions that align with enterprise and Cigna Healthcare organizational goals. The ideal candidate will bring a consulting-grade toolkit, strong analytical and financial acumen, and a proven ability to operate at the intersection of innovation, business strategy, financial and operational execution. The role will also be responsible for comprehensively looking at the provider and payer landscape to identify and drive innovative approaches to address medical and admin cost trends, provider behavior, billing behavior, and improve health plan operations. Responsibilities Strategic Leadership & Execution * Drive annual strategic refresh cycles, including 3-year outlook planning and initiative prioritization * Defines reimbursement policies and tactical goals and objectives; directs strategy execution * Assists affordability leadership in defining short and long-term strategic needs, and work through multi management levels to track plan progress and execution * Identify emerging trends impacting medical costs to inform new program and product development * Serve as a strategic advisor to Cigna Healthcare senior affordability, clinical and operational leadership, translating enterprise and organizational priorities into actionable initiatives * Act as a catalyst for change, positioning the Cigna Healthcare affordability and payment integrity team as a leading program help with value creation within the organization Affordability programs * Support the design and refinement of affordability programs tailored to address specific trends and populations * Partner with analytics, operations, product, and clinical teams to validate business cases and define success metrics * Identify new and scalability of affordability programs and initiatives * Support go-to-market strategies, communication and enablement efforts for new solutions * Accountable for enabling the strategy set by leadership Cross-Functional Collaboration & Communication * Collaborate with matrix partners across contracting, operations, clinical, finance, product, sales, transformation and innovation teams within Cigna Healthcare and across the enterprise to ensure alignment and execution. * Develop executive-level communications, including strategy memos, presentations, reports, stakeholder updates and create comprehensive narratives Market & Competitive Intelligence * Conduct external scans of the healthcare landscape to identify innovation and affordability opportunities and competitive threats, using data and qualitative performance to advise management relative to the national network and payment integrity strategy * Analyze internal capabilities and gaps to inform strategic priorities and decisions * Synthesize internal and external insights into actionable recommendations that shape enterprise and organizational growth initiatives Execution & Performance Management * Track and report on initiative performance, ensuring alignment with financial, operational clinical impact and experience goals * Synthesize annual and multi-year plans to demonstrate tie back to affordability and enterprise strategies and goals Qualifications * Bachelor's degree required; MBA, MPH, MHA or relevant advanced degree preferred. * 8+ years with progressive experience in healthcare strategy or finance, ideally with exposure to top-tier consulting or payer/provider/integrated delivery system strategy roles * Demonstrated expertise in innovation, product development, and emerging technologies in healthcare * Exceptional strategic thinking, problem-solving, and executive communication skills. * Proven ability to deliver creative solutions to complex challenges * Skilled in managing action items, tracking progress, and ensuring timely follow-ups is preferred * Financial acumen and experience with business case development * Experience working in a matrixed organization with strong internal relationship-building skills * Excellent communication skills with the ability to translate complex topics into clear, actionable insights Preferred Qualifications * Experience in a top-tier strategy consulting firm or in a corporate strategy function within a leading healthcare organization * Experience in payer or integrated delivery system environments * Familiarity with emerging technologies and AI/ML applications in claims settings 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 193,300 - 322,100 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 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 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.
    $136k-185k yearly est. Auto-Apply 5d ago
  • Senior Director, Affordability Strategy

    The Cigna Group 4.6company rating

    Chicago, IL jobs

    The **Senior Director, Affordability Strategy will serve as a leader responsible for shaping the affordability roadmap across the national ancillary and payment integrity teams at Cigna Healthcare.** This role seeks an experienced strategist with deep healthcare expertise, capable of influencing executive decision-making and driving the ideation, design, and oversight of new affordability initiatives and solutions that align with enterprise and Cigna Healthcare organizational goals. The ideal candidate will bring a consulting-grade toolkit, strong analytical and financial acumen, and a proven ability to operate at the intersection of innovation, business strategy, financial and operational execution. The role will also be responsible for comprehensively looking at the provider and payer landscape to identify and drive innovative approaches to address medical and admin cost trends, provider behavior, billing behavior, and improve health plan operations. **Responsibilities** **Strategic Leadership & Execution** + Drive annual strategic refresh cycles, including 3-year outlook planning and initiative prioritization + Defines reimbursement policies and tactical goals and objectives; directs strategy execution + Assists affordability leadership in defining short and long-term strategic needs, and work through multi management levels to track plan progress and execution + Identify emerging trends impacting medical costs to inform new program and product development + Serve as a strategic advisor to Cigna Healthcare senior affordability, clinical and operational leadership, translating enterprise and organizational priorities into actionable initiatives + Act as a catalyst for change, positioning the Cigna Healthcare affordability and payment integrity team as a leading program help with value creation within the organization **Affordability programs** + Support the design and refinement of affordability programs tailored to address specific trends and populations + Partner with analytics, operations, product, and clinical teams to validate business cases and define success metrics + Identify new and scalability of affordability programs and initiatives + Support go-to-market strategies, communication and enablement efforts for new solutions + Accountable for enabling the strategy set by leadership **Cross-Functional Collaboration & Communication** + Collaborate with matrix partners across contracting, operations, clinical, finance, product, sales, transformation and innovation teams within Cigna Healthcare and across the enterprise to ensure alignment and execution. + Develop executive-level communications, including strategy memos, presentations, reports, stakeholder updates and create comprehensive narratives **Market & Competitive Intelligence** + Conduct external scans of the healthcare landscape to identify innovation and affordability opportunities and competitive threats, using data and qualitative performance to advise management relative to the national network and payment integrity strategy + Analyze internal capabilities and gaps to inform strategic priorities and decisions + Synthesize internal and external insights into actionable recommendations that shape enterprise and organizational growth initiatives **Execution & Performance Management** + Track and report on initiative performance, ensuring alignment with financial, operational clinical impact and experience goals + Synthesize annual and multi-year plans to demonstrate tie back to affordability and enterprise strategies and goals **Qualifications** + Bachelor's degree required; MBA, MPH, MHA or relevant advanced degree preferred. + 8+ years with progressive experience in healthcare strategy or finance, ideally with exposure to top-tier consulting or payer/provider/integrated delivery system strategy roles + Demonstrated expertise in innovation, product development, and emerging technologies in healthcare + Exceptional strategic thinking, problem-solving, and executive communication skills. + Proven ability to deliver creative solutions to complex challenges + Skilled in managing action items, tracking progress, and ensuring timely follow-ups is preferred + Financial acumen and experience with business case development + Experience working in a matrixed organization with strong internal relationship-building skills + Excellent communication skills with the ability to translate complex topics into clear, actionable insights **Preferred Qualifications** + Experience in a top-tier strategy consulting firm or in a corporate strategy function within a leading healthcare organization + Experience in payer or integrated delivery system environments + Familiarity with emerging technologies and AI/ML applications in claims settings 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 193,300 - 322,100 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 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 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._
    $136k-185k yearly est. 5d ago
  • Vice President, Operations, IHPA

    Centene Corporation 4.5company rating

    Springfield, IL 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. **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 39d ago
  • Home Health Business Manager

    Unitedhealth Group Inc. 4.6company rating

    Memphis, TN jobs

    Explore opportunities with Extendicare Home Health of West Tennessee, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. The Home Health Business Manager is responsible for managing, coordinating, and directing the administrative support and non-clinical operations of the agency, and for ensuring that all duties are performed in a timely manner. The Business Manager is also responsible for ensuring that all administrative support to the Executive Director and/or Clinical Director functions are operating effectively and efficiently. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Overseeing and maintaining contracts, binders, and HR/medical files for all agency employees and contract staff in accordance with policy and applicable regulations * Reviewing, reconciling, and submitting invoices to Home Office in accordance with LHC Group policy. This also includes ensuring payment is issued timely, following up on concerns, and maintaining a positive relationship with all vendors * Performs and or manages billing audits per policy and follows-up with corrections * Manages clerical staff and manages all non-clinical workflow and process in the office. This includes timely completion of all clerical tasks, as well as providing input into hiring, disciplinary, and separation decisions 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: * Must possess at least one of the following: * 3+ years of healthcare experience * 3+ years of experience in an office administration role * Bachelor's Degree * Computer proficiency, including Microsoft Office suite Preferred Qualifications: * Demonstrated solid organizational, written, verbal communication, and time management skills * Demonstrated computer proficiency, including Microsoft Office suite * Demonstrated ability to work independently * Demonstrated solid process and people leadership abilities * Experience with payroll process, supply management, and basic financial knowledge * 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 hourly pay for this role will range from $20.38 to $36.44 per hour 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.
    $20.4-36.4 hourly 4d ago
  • Home Health Business Manager

    Unitedhealth Group 4.6company rating

    Tennessee jobs

    Explore opportunities with Extendicare Home Health of West Tennessee **,** a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.** The Home Health Business Manager is responsible for managing, coordinating, and directing the administrative support and non-clinical operations of the agency, and for ensuring that all duties are performed in a timely manner. The Business Manager is also responsible for ensuring that all administrative support to the Executive Director and/or Clinical Director functions are operating effectively and efficiently. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Overseeing and maintaining contracts, binders, and HR/medical files for all agency employees and contract staff in accordance with policy and applicable regulations + Reviewing, reconciling, and submitting invoices to Home Office in accordance with LHC Group policy. This also includes ensuring payment is issued timely, following up on concerns, and maintaining a positive relationship with all vendors + Performs and or manages billing audits per policy and follows-up with corrections + Manages clerical staff and manages all non-clinical workflow and process in the office. This includes timely completion of all clerical tasks, as well as providing input into hiring, disciplinary, and separation decisions 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:** + Must possess at least one of the following: + 3+ years of healthcare experience + 3+ years of experience in an office administration role + Bachelor's Degree + Computer proficiency, including Microsoft Office suite **Preferred Qualifications:** + Demonstrated solid organizational, written, verbal communication, and time management skills + Demonstrated computer proficiency, including Microsoft Office suite + Demonstrated ability to work independently + Demonstrated solid process and people leadership abilities + Experience with payroll process, supply management, and basic financial knowledge *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 hourly pay for this role will range from $20.38 to $36.44 per hour 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._
    $20.4-36.4 hourly 4d ago

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