A leading healthcare company seeks a Market Vice President of Pharmacy Professional Practice to ensure compliance with pharmacy regulations across various locations. This role requires a licensed pharmacist with over 5 years of leadership experience in pharmacy compliance environments. Responsibilities include overseeing regulatory compliance, providing strategic guidance, and leading a high-performing team in a remote work setting. This position allows travel as needed, with competitive compensation and benefits.
#J-18808-Ljbffr
$66k-80k yearly est. 4d ago
Looking for a job?
Let Zippia find it for you.
Risk Adjustment Risk Lead & Compliance Strategist
Humana Inc. 4.8
Boston, MA jobs
A leading health services company is seeking a Risk Management Lead responsible for oversight of risk adjustment operations. The role includes advising on risk management strategies, compliance, and project management. The ideal candidate should have significant experience in project leadership and risk analysis, with a passion for enhancing consumer experiences. This remote position requires strong initiative and the ability to manage multiple projects simultaneously. Interested candidates are encouraged to apply for a rewarding opportunity focused on health improvement.
#J-18808-Ljbffr
A leading health insurance provider is seeking an Actuary for their Financial Planning & Analysis team in Juneau, Alaska. This role involves analyzing and forecasting financial data, ensuring data integrity, and supporting business intelligence efforts. Candidates should hold a Bachelor's Degree, preferably have FSA or ASA designations, and possess strong communication skills. This position provides flexibility and opportunities for career advancement, along with competitive pay and benefits.
#J-18808-Ljbffr
$77k-99k yearly est. 3d ago
Healthcare Economics Consultant - Remote
Unitedhealth Group 4.6
Minnetonka, MN jobs
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. 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:
Support internal clinical, financial and quality data analysis to support value-based care agreements with various provider types at a national and local level
Create and support standard financial, utilization and quality reporting in accordance with contracting guidelines
Support ad-hoc analysis through gathering claims, financial, or membership data and summarizing key findings clearly with limited guidance
Support internal data analysis and other deliverables through data troubleshooting and data validation with guidance
Understand conceptual strategies and be able to present key deliverables, answer questions, participate in discussions, and make recommendations via meetings and emails
Lead projects to completion by contributing to the analysis and creation of financial reporting or the automation of reporting
Proactively manage routine processes and anticipating customer needs through independent prioritization
Serve as a resource to executive leadership in support of value based contracting strategy
Solve complex and ambiguous problems with broad impact on the business through critical thinking and resourcefulness
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:
3+ years of experience in an analytics capacity with evidence of proactive critical thinking and creative problem solving
Experience in the healthcare insurance industry with exposure to medical claims data
Intermediate or higher level of proficiency in MS Excel and Pivot Tables
Beginner or higher level of proficiency with coding in Snowflake, Toad, Snowsight, SQL, or SAS
Demonstrated highly effective verbal and written communication skills for a variety of audiences
Demonstrated ability to effectively manage multiple priorities
Preferred Qualification:
Demonstrated familiarity with SMART or other claims platform
*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 $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
$72.8k-130k yearly 4d ago
Actuarial Principal - Strategic FP&A Leader (Remote)
Humana Inc. 4.8
Annapolis, MD jobs
A leading healthcare company seeks an Actuarial Analytics/Forecasting Principal in Annapolis, Maryland. This role involves analyzing financial data and collaborating with senior leadership to support business decisions. The ideal candidate has over a decade of technical experience, strong leadership abilities, and ideally, expertise in Medicare Advantage pricing. Humana offers competitive compensation, including a salary range of $156,600 to $215,400 per year along with comprehensive benefits.
#J-18808-Ljbffr
$156.6k-215.4k yearly 2d ago
Senior Infra Ops Lead: Cloud & GenAI Enablement (Remote)
Humana Inc. 4.8
Boston, MA jobs
A leading healthcare company is seeking an experienced Infrastructure Operations leader to drive innovation in AI and cloud technologies. The ideal candidate will have over 10 years in infrastructure, with a strong background in AI/ML, leading cloud operations for Azure and AWS. Key responsibilities include overseeing cloud strategy and governance, enhancing operational performance, and fostering partnerships across teams. This role offers a competitive salary and benefits focused on well-being.
#J-18808-Ljbffr
$114k-139k yearly est. 5d ago
Senior PPI Professional - Inpatient Coding Disputes
Humana 4.8
Columbus, OH jobs
**Become a part of our caring community and help us put health first** The Senior Payment Integrity Professional - Inpatient Coding Disputes on the Disputes Team consults and collaborates with coding professionals across departments to ensure high accountability of coding disputes outcomes for timeliness, compliance and quality.
+ Will be a SME (Subject Matter Expert) medical coder with in-depth experience in inpatient coding audits (MSDRG/APDRG)
+ Contributes to overall accuracy and compliance of coding disputes reviews ensuring that all appropriate coding guidelines are adhered to and will be able to speak to inpatient coding review outcomes to a variety of audiences
+ Leverages advanced auditing expertise to guide onshore and offshore DRG coding disputes auditors, reviews disputes escalations and clarification requests
+ Manages multiple priorities, collaborates across teams, and ensures timely, accurate inventory management
In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include:
+ Medical Benefits
+ Dental Benefits
+ Vision Benefits
+ Health Savings Accounts
+ Flex Spending Accounts
+ Life Insurance
+ 401(k)
+ PTO including 9 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time
+ And more
**Use your skills to make an impact**
**Required Qualifications**
+ 5+ years holding **one** of these Coding Credentials from AHIMA: **CCS/** **RHIT/ RHIA**
+ 5+ years' work experience reading and interpreting claims
+ 2+ years verifiable experience in MSDRG disputes/audits
+ 2+ years of verifiable SME and/or leadership experience within the last few years in provider/payer inpatient auditing
+ Verifiable experience working with and supporting onshore and offshore MSDRG vendors/ staff
+ Comprehensive knowledge of Microsoft Office Programs Word, PowerPoint, and Excel
+ Excellent communication skills both written and verbal
+ High level of productivity with the ability to turn-around requests quickly and effectively
+ Strong attention to detail
**Preferred Qualifications**
+ Experience leading people, projects, and/or processes
+ Experience in Financial Recovery
+ Experience in a fast paced, metric driven operational setting
**Additional Information**
Work at Home/Remote Requirements
**Work-At-Home Requirements**
+ To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
+ At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended to support Humana applications, per associate.
+ Wireless, Wired Cable or DSL connection is suggested.
+ Satellite, cellular and microwave connection can be used only if they provide an optimal connection for associates. The use of these methods must be approved by leadership. (See Wireless, Wired Cable or DSL Connection in Exceptions, Section 7.0 in this policy.)
+ Humana will not pay for or reimburse Home or Hybrid Home/Office associates for any portion of the cost of their self-provided internet service, with the exception of associates who live or work from Home in the state of California, Illinois, Montana, or South Dakota. Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
**Our Hiring Process**
As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging, and/or Video Interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone or computer. You should anticipate this interview to take approximately 10-15 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.
\#LI-LM1
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$71,100 - $97,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-21-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$71.1k-97.8k yearly 7d ago
Category Management Advisor- Professional Services
Cigna Group 4.6
Saint Louis, MO jobs
The Category Management Advisor is responsible for procuring consulting and professional services for the Information Technology organization. This role partners with leading technology consulting firms to support multiple lines of business. The advisor manages competitive sourcing processes and guides stakeholders in selecting the most suitable suppliers and solutions to meet business objectives.
Success in this position requires expertise in navigating dynamic requirements aligned with strategic business and IT goals. The advisor must be adept at engaging suppliers and influencing stakeholders across various management levels to achieve optimal outcomes.
Key Responsibilities
Draft, redline, and negotiate master service agreements (MSAs) and statements of work (SOWs) with robust information protection provisions.
Negotiate and execute MSAs with technology service providers, ensuring compliance with Cigna's contractual standards to minimize corporate risk.
Establish and maintain supplier performance measurement and reporting mechanisms.
Analyze business requirements, supplier relationships, and processes to enhance performance and deliver greater value.
Recommend sourcing strategies, process improvements, and supplier relationship models for enterprise-wide adoption.
Evaluate supplier market rates and historical cost trends to negotiate consulting rate cards and role definitions.
Develop timelines and coordinate cross-functional teams to implement sourcing strategies and initiatives.
Oversee day-to-day execution of sourcing and contracting processes, leveraging subject matter experts as needed.
Collaborate with business stakeholders to develop RFPs and supplier evaluation tools.
Formulate negotiation strategies, including detailed financial analyses to benchmark costs against market standards.
Lead negotiations in partnership with business teams and Supply Chain Management leadership.
Monitor and report progress against sourcing objectives and performance metrics.
Qualifications
Bachelor's degree strongly preferred, ideally in Business, Supply Chain, Information Technology, or a related field.
Proficiency with SAP Ariba (or similar source-to-pay and contracting platforms) and Oracle financial systems; experience with Icertis or other contract lifecycle tools is a plus.
Exceptional communication, facilitation, and leadership skills with the ability to influence and motivate cross-functional teams.
Strong organizational and time management skills with attention to detail.
Advanced analytical skills and financial acumen.
Proven ability to solve complex problems and make sound decisions in dynamic, fast-paced environments.
Skilled in articulating solutions to senior executives and driving alignment on strategic initiatives.
Demonstrated ability to apply fact-based negotiation principles and perform total cost analyses to support ROI decisions.
Expertise in market and industry analysis, including cost structures and strategic implications of industry trends.
Commitment to enterprise vision, values, and goals.
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.
$80k-106k yearly est. Auto-Apply 25d ago
Manager, Member and Administrative Operations, Remote in WA
Unitedhealth Group 4.6
Seattle, WA jobs
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together
The Member and Administrative Operations Leader is responsible for overseeing all elements of the Health Plan member experience along with assigned administrative functions including policies and procures, audit readiness, contract compliance and business continuity. While the role will give preference to candidates living in Washington and familiar with Washington Medicaid programs, this is not a requirement. This position will require limited travel to Washington (10%).
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Washington preferred. 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:
Member Operations Leadership:
Lead a team of professionals primarily focused on member and provider materials
Create and execute the member experience strategy. This includes maintaining awareness of current member sentiment, creating strategies to improve experience within budget limitations, collaborating across the health plan and UHG enterprise to execute that strategy, and monitoring outcomes to adjust future iterations of the plan
Maintain situational awareness of local market factors that may impact members and create and implement member engagement strategies to address
Responsible for state required reporting on a monthly, quarterly and annual basis
Create new solutions to address difficult and long-standing challenges in improving health care outcomes including development and oversight of value added benefits
Oversee value added benefits (VABs) for Washington Medicaid. Maintain awareness of market dynamics and member needs. Understand and communicate strategic advantage of VABs. Advocate to leadership for VABs. Partner with national procurement teams to implement VABs. Track utilization of VABs
Set priorities to ensure task completion and performance goals are met for Enrollment Services
Oversee member call center functions and member materials creation and execution, including member handbook, ID card, welcome kit materials and member website
Communicate any observed enrollment issues to Washington Health Care Authority (HCA) state partners and ensure the adoption of policies, processes and best practices required for success
Partner with UHC policy team to create member experience and enrollment advocacy strategy. Represent that strategy directly to HCA and equip other Health Plan leaders to do so
Maintain awareness of all contract elements related to member experience and create and execute business plans to manage those requirements
Responsible for all elements of member materials, including creation, HCA approval, and publication. Responsible for selected provider materials, including, but not limited to Provider Manuals
Administrative Operations Leadership:
Oversee Health Plan Policy and Procedure committee and process
Represent Health Plan in regulatory audits for assigned business areas
Partner with enterprise resiliency team to oversee Health Plan Business Continuity requirements, including simulation facilitation, recovery team contact testing, and completion of related HCA reports
Partner with Compliance Officer and COPA Director to lead Health Plan leaders in the creation and maintenance of contract compliance business plans
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 Medicaid experience
3+ years project management or strategy development and execution
2+ years representing Health Plan to regulators, such as HCA or other Medicaid agencies
1+ years of supervisory/leadership experience with direct responsibility for managing performance of employees
Proficiency with MS Office, which includes the ability to navigate and learn new and complex computer system applications
Solid history of quickly gaining credibility, partnering with business leaders and exhibiting executive presence
Proven ability to articulate business strategies and formulate concise solutions to complex problems
Ability to travel to Washington periodically (no more than 4 times annually)
Preferred Qualification:
Resident of Washington and familiarity with Washington Medicaid
*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 $89,900 to $160,600 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.
Join us as a Healthcare Strategy Advisor and help shape the future of care delivery. In this role, you will influence strategies that improve health outcomes, affordability, and innovation. We are looking for a collaborative thinker who thrives on turning insights into action and driving meaningful change.
**Job Responsibilities**
+ Lead strategic initiatives that align with organizational goals and market needs, ensuring measurable impact on health outcomes and affordability.
+ Analyze market trends and internal performance to identify opportunities for innovation and improvement.
+ Collaborate across clinical, product, analytics, and finance teams to design solutions that deliver value.
+ Translate data and insights into clear recommendations for leadership, influencing decisions at the highest level.
+ Develop executive-ready presentations and reports that communicate progress and strategic priorities.
**Required Qualifications**
+ Minimum 5 years of experience in healthcare strategy, management consulting, or related strategic planning roles.
+ Proven ability to conduct research, analyze complex data, and translate findings into executive-facing recommendations. actionable strategies.
+ Track record of building trust and relationships, collaborating cross-functionally, and driving actionable strategies in large, matrixed organizations.
**Preferred Qualifications**
+ Bachelor's degree in a relevant field (preferred). Advanced degree such as MPH, MBA, or MHA is a plus.
+ Experience in payer, provider, or integrated delivery systems.
+ Familiarity with value-based care models, population health, or digital health tools.
+ Exposure to strategic planning and healthcare innovation.
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 94,700 - 157,800 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here (********************************************** .
**About 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._
$81k-102k yearly est. 60d+ ago
Fraud and Waste Investigator
Humana 4.8
Remote
Become a part of our caring community and help us put health first The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud and Waste Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
Where You Come In
The Fraud and Waste Professional 2 coordinates investigation with internal and external entities including compliance, internal business partners, and law enforcement. Assembles evidence and documentation to support successful adjudication, where appropriate. Prepares complex investigative and audit reports. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.
What Humana Offers
We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company values associate engagement & your well-being. We also provide excellent professional development & continued education
Use your skills to make an impact
WORK STYLE: Remote anywhere in US, work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
WORK HOURS: Monday-Friday, 8 hours/day, 5 days/week, ideally, associates will work on EST (regardless of their home time zone). Must start between 6AM-9AM (in the employee's time zone), some flexibility might be possible, depending on business needs.
Required Qualifications - What it takes to Succeed
Bachelor's degree or equivalent work experience
Minimum 2 years of investigative and/or claims experience
Knowledge of healthcare payment methodologies
Strong organizational, interpersonal, and communication skills
Inquisitive nature with ability to analyze data to metrics
Computer literate (MS Word, Excel, Access)
Strong personal and professional ethics
Ability to travel up to 5%, to attend trainings and meetings, as required
Preferred Qualifications
Bilingual in Spanish
Bachelor's degree and/or additional degrees and/or certifications (MBA, J.D., MSN, Clinical Certifications, CPC, CCS, CFE, AHFI).
Understanding of healthcare industry, claims processing and investigative process development.
Experience in a corporate environment and understanding of business operations
Additional Information
Work at Home Requirements
• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
• Satellite, cellular and microwave connection can be used only if approved by leadership
• Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Interview Format
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Hire Vue (formerly Modern Hire) to enhance our hiring and decision-making ability. Hire Vue (formerly Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$65,000 - $88,600 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 01-22-2026
About us
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Part‑Time Staff Pharmacist - CO/NV The Part‑Time Staff Pharmacist, based in a Cigna office in Denver, CO or Las Vegas, NV, provides telepharmacy services to multiple hospital clients across various states. This role enhances clinical team performance, supports quality patient care, and ensures safe and compliant medication practices. This part‑time position includes evening, overnight, and/or weekend shifts.
Shifts available:
Saturday and/or Sunday: 6:00 AM - 6:00 PM PST
Possible other shifts available:
Monday-Friday: 12:30 PM - 8:30 PM PST
Monday-Friday: 2:00 PM - 9:00 PM PST
Monday-Friday: 7:30 PM - 6:00 AM PST
Responsibilities:
Telepharmacy
Perform remote order entry, order verification, drug verification, and patient/staff counseling.
Support multiple clients and operate within various pharmacy information systems (PIS).
Clinical Excellence
Provide proactive clinical pharmacy services and adhere to all client‑specific and Cigna policies.
Deliver drug information and therapeutic recommendations, including dosing adjustments, interactions, compatibilities, and infusion guidance.
Maintain working knowledge of IV fluids, TPN, narcotic/cardiac drips, IV antibiotics, chemotherapy, and more.
Understand considerations for special populations (pediatric, geriatric, pregnant/nursing, renal/hepatic impairment, HIV).
Counsel patients, nurses, and medical staff on safe medication use.
Investigate and resolve medication variances within 48 hours.
Operational Excellence
Learn and work in multiple hospital pharmacy systems.
Obtain and maintain multiple state pharmacist licenses.
Document orders, interventions, and recommendations in PLRX by end of shift.
Ensure compliance with all applicable pharmacy laws, regulations, and internal policies.
Technical Excellence
Perform basic troubleshooting during system or connectivity issues.
Work effectively with VPNs, PIS platforms, automation systems, and common software (Microsoft Office, Snagit, etc.).
Training & Development
Participate in ongoing training, including clinical updates, PIS enhancements, and policy changes.
Maintain all required access credentials, licenses, and reciprocity.
Productivity
Achieve and maintain company productivity metrics.
Qualifications:
B.S. in Pharmacy required, PharmD preferred.
Active and in good standing Colorado or Nevada pharmacist license.
Additional state licenses preferred (AL, LA, MS, MI, SC, NY).
2+ years of inpatient hospital experience preferred.
Strong written and verbal communication skills.
Demonstrated customer service skills.
Knowledge of formulary management and P&T procedures.
Familiarity with client/server applications.
Proficiency in MS Office, Google Drive, internet, and email.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an hourly rate of 54 - 91 USD / hourly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
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.
$107k-133k yearly est. Auto-Apply 13d ago
Electro-Mechanical Controls Engineer (Automation Engineer Lead Analyst) - Express Scripts
The Cigna Group 4.6
Newark, DE jobs
Help us automate and maintain our future. Get ready for a job that encourages you to think strategically yet stay connected with your teams. Do you have problem-solving or strategy experience? If so, prepare to innovate, create, and inspire. The Pharmacy Automation Engineer (Automation Engineering Lead Analyst) is primarily responsible for providing first-level electrical and process Controls support for a highly-automated pharmaceutical filling and packaging system. Perform emergency, corrective, and preventive maintenance activities to restore equipment. In addition, key responsibilities will involve implementing equipment and system upgrades, engineering change controls, and continuous improvements. The position will support equipment installations, upgrades, or equipment expansions. Automation engineer also trains, mentors, and supports the development of other team members
**Responsibilities**
+ Performs advanced level maintenance and service on automated equipment by using and understanding electrical, mechanical, and pneumatic drawings and schematics, and using special test equipment and tools.
+ Maintains reliability of the pharmacy automation equipment by executing preventive, corrective, and emergency work orders.
+ Troubleshoot, service, install and repair automated production equipment, to include equipment modifications, upgrades, and spare parts inventory
+ Utilizes knowledge and skill to monitor and improve the Mean Time Between Failures (MTBF) of the electro-mechanical equipment, and supporting application software systems.
+ Observe system for degraded performance using routine inspections, maintenance rounds, and diagnostic equipment.
+ Use a computerized maintenance management system (MAXIMO) to record labor hours, repair parts, and monitor pharmacy equipment performance.
+ Recommend alterations to developers and designers to improve the quality or performance of processes and/or machines.
+ Interpret the output of the reporting systems and take appropriate action that will result in the removal of the root cause problem from the system on a permanent basis.
+ Document all emergency, corrective, and preventive maintenance work via work orders associated with Computerized Maintenance Management System (CMMS - MAXIMO).
+ Operates on-site in an on-call capacity.
**Qualifications**
+ High School diploma; Associates degree preferred.
+ Associate's degree in Industrial Maintenance or related technical field or 2+ years of maintenance experience in an industrial setting preferred.
+ 0+ years of relevant experience with a Bachelor's Degree and mechanical electrical experience related to automated, industrial equipment preferred.
+ Experience working in high volume production or pharmaceutical environment.
+ Experience in troubleshooting complex PLC/computer-operated electro-mechanical equipment; PLC's, I/O, and field devices; repairing, setting up, adjusting, and tuning mechanical systems and pneumatic systems.
+ Experience using of all tools and procedures needed to repair precision electro-mechanical machinery successfully the first time.
+ Experience using preventive and predictive maintenance techniques.
+ Experience using Maintenance Management Systems (CMMS) to report and follow-up on maintenance procedures and work orders.
+ Flexibility to occasionally work outside of normal shift hours, including occasional weekends, as needed to satisfy operational requirements in support of customer demand.
+ Minimal travel to other ESI facilities or vendor sites is possible.
+ **Shift schedule:** **Sunday - Thursday (6am-2:30pm).**
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._
$98k-122k yearly est. 60d+ ago
Software Engineer - Remote
Unitedhealth Group 4.6
Irvine, CA jobs
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
The Enterprise Information Security (EIS) team is responsible for cybersecurity across our organization. We support our business and members by reducing risk, rapidly responding to threats, focusing on business resiliency and securing new acquisitions.
Hiring a Quality Engineer who has a passion for learning, is a solid problem solver, and a critical thinker with broad technical experience. We need someone who has a background and experience with both legacy and new product development utilizing DevOps delivery. This role is for an individual contributor on an Agile team requiring hands-on technical skill and problem-solving for a large, complex Microsoft .NET full stack application development project. This is a Software Development Engineer in Test (SDET) role and requires skills with solid Microsoft .NET, C# Software Engineering to design and build advanced automated test suites using object-oriented methodologies. The role will cover development and testing (manual and automated) activity across all technology functions that ensure we deliver code with high quality for our application, product and services and to understand customer needs.
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:
The role includes, but is not limited to: Analyze User Stories / Bugs, Design / Design Review, Document, Code / Code Review, Test (Unit, Assembly, System & Regression), Deployment, & Post-deployment Support
Delivery requires automated test (manual testing as needed) mindfulness
Engineering focus on enriching the Customer Experience through high quality functional delivery, efficiency, testability, reliability, scalability, availability, and security of applications.
Foster high performance, collaborative technical work
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:
4+ years of experience with testing and test automation development
2+ years of experience with C# and .NET Software Development Life Cycle (SDLC)
2+ years of experience with RESTful Web API Development
2+ years of experience using SQL, Microsoft SQL Server, & SQL profiling skills / performance tuning SQL
Expertise in Agile and DevOps methodologies skills
Proven excellent analytical, problem solving and troubleshooting abilities
Demonstrated skills in active listening with the ability to express oneself clearly and effectively
Demonstrated skills and experience in collaborating, influencing, problem solving and negotiating
Preferred Qualifications:
Git Source Code Management, Test Automation, Azure DevOps Application Lifecycle Management (ALM)
Proven solid organizational skills and focus on accuracy and attention to detail
Identity and Access Management experience
Directory Services Development, Authentication and Provisioning experience
Requirements and technical specification documentation experience
Proficiency in MS Office (Word, Excel, Outlook, PowerPoint, Access, MS Visio)
*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 $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
$72.8k-130k yearly 3d ago
Essential Plan Account Manager - Field Based - Rockland and Westchester, NYCounties
Unitedhealth Group 4.6
New City, NY jobs
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together
Working under the direction of the Sales & Account Management Team and collectively with the Business Development team you will interface with the New York Health Plan to increase marketing synergy and drive overall membership growth. The Account Manager is a field-based role that establishes and cultivates strategic business relationships with key sales and market influencers, potential new customers, and related community institutions. This position requires someone with tenacity to perform sales activities both indoors and outdoors. Function identified will be new Business to Business (B2B) opportunities for the purpose of prospecting and enrolling new Essential Plan eligible including vertical channels (dental, vision, fitness, colleges, trade schools, small businesses, as well as industry sectors identified by your manager) that support growth strategy in key areas in New York. Training on all government programs will be conducted upon hire.
This is an outside/field sales position
If you reside within a commutable distance of Rockland and/or Westchester Counties or surrounding area you will have the flexibility to work remotely*, as well as work in the office as you take on some tough challenges.
Primary Responsibilities:
Enroll eligible members into UnitedHealthcare's Essential Plan, Medicaid Managed Care, and Child Health Plus
Retail current membership with key accounts (provider offices, CBOs, housing, etc.)
The Account Manager presents health plan information to providers, business advocates, potentially eligible and responsible for closing sales and serving as a point of contact for members to provide excellent service and enrollment experience
Responsible for meeting or exceeding sales and enrollment expectations within assigned territory
Conduct product information presentations in multiple settings
Function independently and responsibly with minimal need for supervision
Track and measure various sales event effectiveness and activities, events, leads & lead progress, sales, appointments, contacts, and relationship progress daily through internal systems
Provide input, support and feedback on promotional opportunities, benefits, and other issues
Stay informed on UHC operations, provider network, premiums, member services, claims, explanation of benefits, processes and other services and issues to provide community partners, prospects, and members with accurate information, and provide feedback as appropriate
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:
2+ years of business-to-business (B2B), Business to consumer (B2C) Direct marketing, outside sales or community outreach experience
Ability to travel locally up to 100% of the time within assigned sales territories in this NY market area
Ability to occasionally work nights and weekends
Reside within/commutable distance of the target geography
Valid driver's license, good driving history, reliable transportation, current automobile insurance or access to public transportation
Preferred Qualifications:
Health & Accident Insurance license or ability to obtain a (company-sponsored) state health/life insurance license within 30 days of hire
Experience with New York State health marketplace
*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 $19.23 to $38.46 per hour based on full-time employment. This role is also eligible to receive bonuses based on sales performance. We comply with all minimum wage laws as applicable.
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.
$19.2-38.5 hourly 4d ago
Onsite Mental Health Concierge- Evernorth - Orlando, Florida
Cigna 4.6
Orlando, FL jobs
Disney Mental Health Concierge Organizational Engagement and Strategy * Consult with managers regarding important workplace issues: including, but not limited to, grief and loss in the workplace, job appropriate behaviors, employee/cast member terminal illness impacts and leadership support.
* Facilitate critical incident response by consulting with requesting manager and direct service providers to arrange appropriate clinical services, including onsite services.
* Work closely with EAP providers. Educate EAP providers regarding EAP protocols and expectations, and monitors compliance to standards.
* Co-create and execute on engagement campaigns/promotion in collaboration with broader Evernorth/Cigna.
Cast Member Engagement & Navigation
* Primary point of contact and deployment for critical incident occurrences.
* Collaborate with Matrix Partners to obtain necessary information to provide the most appropriate resources.
* Provide onsite, virtual, and in-person navigation to emotional well-being resources, including EAP referrals, appointment setting assistance, provider searches, work/life programs, health coaching, case management, behavioral case management, etc.
* Provide psychological first aid, assessment, and intervention for crisis situations as needed.
* Ensure the appropriate next steps are put in place for referrals into medical, pharmacy or behavioral coaching programs, in addition to any alignment with a behavioral provider
* Provide follow-up to all Cast Member connections that take place.
* Identify and address SDOH needs such as food, housing medication, and transportation.
* Assist in connecting Cast Members with identified community resources to meet their needs.
* Work closely with Cast Members and Employees to ensure they have the support system they need to recover from their specific need, illness, or injury.
* May facilitate and lead manager and employee mental health trainings.
* Provide on-call and on-site services as needed. Expected to be available via email, text, or phone.
General Expectations
* Culturally trained on Disney Organizational, Cast Member and Employee roles and responsibilities, benefits, programs, and inventory of resources.
* Will work on-site in Walt Disney World Park and be deployed to various locations as needed.
* Will be available to all team members, for consultation.
* Perform additional tasks/projects as needed, requested or assigned.
* Attend all required trainings.
* Comply with all Evernorth Behavioral Health policies and Standard Operating Procedures.
* Take initiative for continued professional development.
* Work closely with the Disney Account Team, Health Coaches, Case Managers, Onsite EAP providers, EACs, Behavioral UM and CM teams to align on cases and hand off appropriately as needed.
* Will work directly with Disney Human Resources and Employee Relations teams as needed.
* Consult with Cigna/Evernorth clinical supervisor when needed.
* Open to suggesting and implementing improvements and enhancements to Mental Health Concierge role and responsibilities.
Qualifications
* Current unrestricted independent licensure in a behavioral health field or a medical field with experience in a psychiatric setting (LCSW, LMFT, LPC, LPCC, Licensed Psychologist or RN)
* Master's Degree in Behavioral Health field
* Knowledge and experience in accessing community resources to help cast members with basic needs.
* Certified in Mental Health First Aid
* CEAP (certified employee assistance professional) required to obtain within 2 years of employment.
* 3+ years post-license mental health experience preferred
* 3+ years experience responding effectively to diverse situations while working across all organizational levels.
* Excellent communication and interpersonal skills with a focus on customer service
* Effective conflict management and negotiation skills
* Ability to adapt to change and problem solve
* Strong time management and organization skills with an ability to set priorities in a fast-paced environment
* Ability to utilize and navigate multiple technology systems
* Bilingual in Spanish or Haitian Creole preferred
* Knowledge of managed care preferred
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
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.
$21k-25k yearly est. Auto-Apply 28d ago
Primary Care Physician - Evernorth Workplace Care - Dalton, GA
Cigna Group 4.6
Dalton, GA jobs
Family Medicine Physician - Evernorth Workplace Care (Dalton, GA)
About Evernorth Workplace Care Evernorth Workplace Care delivers high-quality health care services and population health solutions-both in person and virtually. Our mission is to provide proactive, personalized, and holistic care by leveraging health data and insights to improve the well-being of employees and their families. We bring affordable, accessible care directly to where people work and live.
As an employer-sponsored clinic, our services are exclusive to employees of our host client, fostering strong patient relationships and a level of care that goes beyond traditional community settings. Our clinicians emphasize preventive care, health coaching, and quality interactions, supported by Cigna's integrated data and networks.
Why Join Us?
Benefits start Day 1
Predictable work schedule -
No nights, weekends, or on-call
Competitive salary + annual performance bonus
8 Paid Holidays + 23 PTO Days
Comprehensive benefits: Medical, Dental, 401(k) with company match
CME allowance and paid time
Career growth opportunities across Evernorth and Cigna
Collaborative, patient-focused environment
Position Summary
We are seeking a Board-Certified Family Medicine Physician to provide care for adults and children (ages 8+) in our onsite clinic in Dalton, GA. This is an exciting opportunity to focus on quality over quantity, practicing evidence-based medicine in an employer-based setting.
Average 2-3 patients per hour
Minimal insurance paperwork
Flexible full-time schedule
You'll have the autonomy to develop wellness programs and work closely with our onsite NP(s), supported by regional leadership and the Chief Medical Officer.
Responsibilities
Deliver exceptional outpatient care to Evernorth Workplace Care patients.
Promote preventive care and health improvement opportunities.
Refer patients to high-quality specialists (Cigna Centers of Excellence, Cigna Care Network, etc.).
Utilize state-of-the-art EHR and e-prescribing systems.
Serve as collaborative physician for onsite NP(s).
Contribute to wellness program development.
Required Qualifications
MD or DO degree; Board Certification in Family Medicine.
Active, unrestricted medical license, BLS, and DEA.
Strong clinical skills and patient-focused bedside manner.
Proficiency with EHR systems (Epic preferred) and MS Office.
Ability to dispense medications onsite in compliance with Georgia regulations (must notify the Georgia Composite Medical Board of intent to dispense).
Spanish fluency preferred.
What Sets Us Apart
Employer-based care model focused on relationship-building and holistic health.
Integrated approach combining clinical expertise with data-driven insights.
Opportunity to innovate and shape wellness programs.
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.
$194k-268k yearly est. Auto-Apply 44d ago
Bilingual Onsite Health Educator - Evernorth - Miami, FL
Cigna 4.6
Miami, FL jobs
Bilingual Spanish Onsite Health Coach - Evernorth Workplace Care - Miami FL Evernorth Workplace Care offers health care delivery services along with population health and health coaching solutions, conducted in person. Our mission is to deliver proactive, personalized, and holistic patient care and coaching by acting on health data and insights to improve the overall health and wellness of our clients' employees, and those they care about most, by providing access to high quality, affordable services where they work and live.
Our Evernorth Workplace Care solution isn't a one-size-fits-all model. Using data-driven insights, we'll customize a solution that addresses your organization's most pressing needs-creating a more affordable, predictable, and simple health care experience.
Evernorth Workplace Care - Personalized Care Where You Are
Our experienced Health Coach will:
* Provide onsite face-to-face customer coaching and support
* Identify customer health education needs through targeted health assessment activities.
* Collaborate with customers to establish health improvement plans, set personalized evidence-based goals, and support customers in achieving those goals.
* Empower customers to become an active participant in their own health outcomes.
* Assist Customer in overcoming barriers to better health
* Lead and support a variety of Health and wellness promotional activities, such as group coaching, wellness challenges and Health related seminars.
* May perform biometric screenings, including finger sticks, blood pressure, body composition, etc.
* Utilize biometric values and motivational interviewing techniques to collaborate with customer to drive to improve clinical outcomes.
* Provide support for health-related site events, which include open enrollment, wellness committee facilitation, flu shot events, health fairs, etc.
Qualifications:
* Strong Clinical skills with at least 3 or more years of experience health coaching, health education and health promotion
* Bachelor's degree in a health-related field. Master's degree preferred.
* Registered Dietitian licensed in respective state is preferred
* CPR/BLS certification through the American Red Cross or American Heart Association is required.
* High energy level, with dynamic presentation skills is required.
* Positive role model in demonstrating healthy behaviors
* Passion for health improvement
* Ability to work independently
* Customer-centric focus
* Ability to proactively collaborate professionally with the client and other matrix partners.
* Understand and own a variety of clinical targets and outcome measurements. Develop action plans that drive clinical value for the customers and clients.
* Proven administrative abilities, with strong computer and software application skills.
* Bilingual Spanish and ability to pass oral and written assessments
Bonus points for:
* CHES (Certified Health Education Specialist)
* Motivational interview training/experience.
* Smoking cessation and diabetes experience.
This role is based in person in Miami FL.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, 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.
$30k-39k yearly est. Auto-Apply 14d ago
Pharmacy Technician Representative - Accredo
Cigna Group 4.6
Tempe, AZ jobs
Excited to grow your career?
We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position, you see is right for you, we encourage you to apply!
Our people make all the difference in our success. This role is Worksite dependent and can only be performed onsite.
Are you passionate about working for a company on a mission to make medicine safer, more affordable, and accessible for millions of Americans? Accredo is looking for high-energy, positive individuals to join our pharmacy technician team. Members of this team are tasked with ensuring prescriptions are processed and shipped appropriately so they can arrive in the hands of the 100 million patients whose health depends on their delivery. Join us in our mission to change lives!
Shift:
Monday - Friday
10:30am -7:00pm
How you'll make a difference:
Be a superstar in the eyes of your team and the patient. Select and retrieve appropriate quantities of medication and prepare the labels that correspond.
Use your expert problem solving skills to help our patients be at their best every day. Work with a skilled team to ensure patients get the medication they need in a timely manner.
Gain new knowledge with our systems and new relationships with your peers. You'll start with training, but you're not doing it alone. You'll enjoy a supportive environment with your peers and other teams who want you to succeed.
Why join us?
Health coverage effective day 1 (including medical, dental, vision)
Holiday, PTO and OT pay
401K with company match
Tuition reimbursement
Quarterly Bonuses based on team achieving key metrics
Fun, friendly and unique culture - bring your whole self to work every day!
What you should have:
High School Diploma / GED required
Arizona State Board of Pharmacy license required; Certification preferred.
1+ years of relevant experience as a Pharmacy Technician, preferred.
Basic math skills and General PC knowledge including Microsoft Office, use of the internet and email
Excellent verbal and written communication skills.
Physical Requirements:
Sit and/or stand for lengthy periods.
Lift up to 50 lbs. occasionally and 20 lbs. frequently
Perform repetitive motion with fingers, hands, and arms.
Work may be in confined areas close to machinery.
Work may be performed in an environment with varying levels of noise.
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.
A leading healthcare provider in Hawaii seeks an Actuary Analytics/Forecasting professional. The role involves analyzing and forecasting financial data to support strategic decisions. Ideal candidates will hold relevant degrees and possess strong communication skills with experience in modeling and pricing. This remote position offers a competitive salary range between $129,300 and $177,800, along with comprehensive benefits and a bonus incentive plan.
#J-18808-Ljbffr