Senior Reimbursement Analyst
Remote Bcbsla job
We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.
Residency in or relocation to Louisiana is preferred for all positions.
POSITION PURPOSE
Independently researches, analyzes, develops and maintains new and existing, complex reimbursement programs. Designs system specifications that support claims payment and criteria for data bases that support analysis as well as training documentation describing programming, billing and payment guidelines for internal and external use. Designated staff may focus primarily on supporting the Medicare Advantage line of business.
NATURE AND SCOPE
This role does not manage people
This role reports to this job: MANAGER, PROVIDER REIMBURSEMENT
Necessary Contacts: In order to effectively fulfill this position the incumbent must be in contact with:
All levels of internal personnel, with primary contacts in Network Administration, IT, Medical Management, Benefits Administration, Actuarial, Legal, Executive, Marketing, and Underwriting. Providers, provider representatives, consultants, provider specialty organizations, AMA, vendor reps, and hospital administrators to exchange or review program information. Other data sources are market research consultants, AMA, St. Anthony, Relative Value Studies for Dentists, Dun and Bradstreet and HIAA, CMS, Blue Cross and Blue Shield Association, Blue Cross and Blue Shield Plans, CMS, DHS, sales and marketing regional offices.
QUALIFICATIONS
Education
Bachelor's degree in statistics, accounting, finance, math or related field is required
Prefer a Master's Degree or pursuit of a Master's degree in Business, Information System and Decision Sciences, Healthcare Administration or Public Health.
Four years of related experience can be used in lieu of a Bachelor's degree.
Work Experience
4 years of experience in the health industry accounting functions including billing, coding, Medicare or statistical analysis of financial information is required
Provider contract analysis and/or reimbursement program implementation experience is strongly is preferred
Skills and Abilities
Must have acquired sufficient knowledge to function autonomously and to know the appropriate contacts within departments to resolve specific issues for all lines of business.
Excellent analytical, oral and written communication, and report preparation skills with highest degree of accuracy are required. Must have the ability to effectively present information to Executive Management and all levels of employees.
Requires strong math/analytical skills including variance analysis, statistical formulas, algebraic formulas, percentages, multiplication and division, fractions and reasonableness tests.
Excellent attention to detail, research, and documentation skills are required.
Proficiency with commonly used database, spreadsheet and word processing software is required. Must have extensive knowledge to select the appropriate database format and structure for the type of information to be captured and reported. Familiarity with relational database software, mainframe capabilities, FOCUS and SQL programming is helpful and preferred. Must be able to create and maintain required databases as determined by supervisor.
A strong understanding of physician charge practices and billing methodologies is helpful.
Minimal travel is required. Travel may involve going to regional offices and/or conferences and exhibits.
Staff dedicated to supporting Medicare Advantage must have working knowledge of Medicare enrollment guidelines and reimbursement.
Licenses and Certifications
Pursuit of coding (CPC or CPHC) designation is preferred
ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS
Serves as provider reimbursement technical advisor and/or committee participant to Information Technology staff, Benefits Administration staff, Provider Audit, Network Administration and/or Medicare Advantage staff, and entry level Reimbursement Analyst by developing and implementing project/program narratives and responding to concerns on new and existing reimbursement programs, billing guidelines, and system requirements to ensure accurate implementation and maintenance of provider reimbursement programs.
Identifies claims and provider reimbursement related system problems, including claims coding and processing issues, coordinates research, audit, and recommendations with Provider Audit, and implements and monitors system changes to resolve any problems.
Researches, designs, implements, and maintains complex hospital or professional provider reimbursement programs for traditional and managed care programs and Medicare Advantage. Contact other plans, consultants, and local providers to assist in program specifications. Proactively monitors health care and health industry developments, including CMS/Medicare eligibility, EGWP and methodology changes. Analyzes and produces management reports to monitor effectives and identify and resolve deficiencies of reimbursement programs in comparison to industry benchmarks, competitors, and Medicare.
Leads in the development of complex financial pricing models and financial data analysis to support modifications to reimbursement programs and monitor effectiveness of pricing logic.
Provides statistical reports to Network Administration, Medical Management, Marketing and Medicare Advantage to support internal strategies and external customer needs, such as contract negotiations and marketing efforts.
Complies with Corporate Objectives on project implementation and schedule deadlines. Ensures proper workflow by assessing reimbursement processes and recommending improvement as well as coordinating projects and time frames with less senior reimbursement staff.
Accountable for complying with all laws and regulations associated with duties and responsibilities.
Additional Accountabilities and Essential Functions
The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions
Perform other job-related duties as assigned, within your scope of responsibilities.
Job duties are performed in a normal and clean office environment with normal noise levels.
Work is predominately done while standing or sitting.
The ability to comprehend, document, calculate, visualize, and analyze are required.
#LI_CB1
An Equal Opportunity Employer
All BCBSLA EMPLOYEES please apply through Workday Careers.
PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)
Additional Information
Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.
If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact ********************* for assistance.
In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.
Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.
Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.
Auto-ApplyDigital Experience Analyst
Bcbsla job in Baton Rouge, LA
We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.
Residency in or relocation to Louisiana is preferred for all positions.
POSITION PURPOSE.
The Digital Experience Analyst is responsible for defining and executing against mass and targeted, member level digital marketing needs and opportunities across all digital channels. This position also works collaboration with analysts and designers, consistently emphasizing user experience to create effective, measurable digital solutions for all Louisiana Blue stakeholders.
How You Contribute to the Company's Mission In This Role
Develops and implements digital strategies based on human-centered design principles with internal partners, while closely following brand standards
Configures, monitors and analyzes the effectiveness of digital marketing strategies, campaigns, and technology services.
Develops and directs digital engagement strategies and objectives to drive customer engagement across digital channels, such as email, SMS, landing pages, push and secure messaging.
Researches, compiles, writes and edits content for internal and external digital channels, coordinating with internal departments and other contributors to ensure that content is consistent in style, tone and quality and conforms to regulatory guidelines and corporate standards
Coordinates and implements website navigation, content, content flow and content presentation for multiple websites, optimizing copy and landing pages for search engine optimization (SEO)
Performs ongoing keyword research including discovery and expansion of keyword opportunities, implements content recommendations to improve organic SEO and site search effectiveness
Establishes and documents best practices, standards, and processes
Coordinates vendor relationships across digital initiatives
Creates user stories and personas applied to digital properties and the full customer journey
Supports Lead and Senior Digital Experience Analysts in managing a specific set of digital marketing capabilities
Required Qualifications
Bachelor's in design, marketing, advertising, business, mass communication, data analytics, healthcare administration or equivalent required. Four years of related experience can be used in lieu of a Bachelor's degree.
2 years of experience with digital marketing strategy, content creation/authoring, campaign execution, design, and creative concepting
2 years of experience analyzing external and internal customer data using database queries (SQL, Access), spreadsheet (Excel) models, web analytics tools, and campaign management software tools require
Experience utilizing a breadth of CX Metrics and analytics (including: NPS, eNPS, CSAT, CES, VoC, and sentiment detection capabilities) to inform business decisions required.
Preferred Qualifications
Healthcare industry experience
ability to build and gain trust quickly
Exceptional communication skills, both verbal and written, with the ability to convey complex technical information in a clear manner
Experience working with enterprise level software
Experience working with Microsoft TFS or Azure DevOps, understanding of health payer regulations such as HIPAA, SAFe, Scrum, Project management, business analysis (IIBA), or lean sigma certifications
Customer Experience Professional Training certification preferred
The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions
Perform other job-related duties as assigned, within your scope of responsibilities.
Job duties are performed in a normal and clean office environment with normal noise levels.
Work is predominately done while standing or sitting.
The ability to comprehend, document, calculate, visualize, and analyze are required.
An Equal Opportunity Employer
All BCBSLA EMPLOYEES please apply through Workday Careers.
PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)
Additional Information
Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.
If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact ********************* for assistance.
In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.
Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.
Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.
Auto-ApplyOperations Senior Supervisor -Express Scripts
Remote or Saint Louis, MO job
The Operations Senior Supervisor is responsible for day-to-day operations of a team of technicians, pharmacists and contract workers. Manages and improves productivity and performance standards, plans and directs workflow and project assignments. Responsible for attaining or exceeding production goals for their respective area daily. Conducts hiring, training, and evaluation of front-line team members. Responsible for team's adherence to employment policies and corporate values. Works with the Pharmacy senior leadership team to establish team and site standards and expectations, operational processes and procedures, and the business work plan for the team. Recognizes and recommends operational improvements.
Work Schedule: Shift will be Mon - Thurs 3:30pm - 2:00am
Location: 4600 North Hanley Road; St. Louis, MO 63134
What you will do:
+ Develop, track and monitor employee's safety, compliance to quality, service and production standards.
+ Monitor prescription turnaround time so that internal standards and client performance guarantees are met.
+ Assist Pharmacy senior leadership team in monitoring costs to ensure compliance with cost to fill goals.
+ Address staff concerns and day to day operational, system, customer service, quality, and professional issues.
+ Work in production as needed.
+ Implement programs and process improvements to enhance the level of internal and external customer service provided.
+ Work with Pharmacy senior leadership team to analyze operations and overall efficiencies of the pharmacy.
+ Serve as a point of escalation for issues requiring a higher degree of expertise or discretion to resolve.
+ Represents pharmacy operations in cross-functional meetings and projects.
+ Other special projects and tasks as assigned.
What you will need:
+ High school diploma or GED
+ BA/BS degree preferred.
+ Minimum of two years operations experience (i.e., pharmacy, warehouse, distribution, production, manufacturing, or engineering)
+ Must be eligible to maintain a pharmacy technician license issued through the Missouri State Board of Pharmacy throughout time in position.
+ Demonstrated leadership skills and the ability to effectively develop, train and coach less experienced team members; supervisory experience preferred.
+ Knowledge of lean or process improvement methodologies
+ Excellent oral and written communication skills
+ Ability to adapt in a dynamic work environment, make independent decisions.
+ Advanced problem-solving skills and the ability to work collaboratively with other departments to resolve complex issues with innovative solutions.
+ Willingness to work a flexible schedule for peak times.
+ Monitors daily operations of a unit and actively assists or provides direction to subordinates as required.
+ May perform, especially in staff or professional groups ongoing operational tasks of organization units (typically not more than 40% of time performing the work supervised)
+ Ensures that projects are completed on schedule following established procedures and schedules.
+ General PC knowledge including Microsoft Office, Internet, and email.
**Why join us?**
+ Health coverage effective day 1 (including medical, dental, vision)
+ Holiday Pay and Paid Time Off (PTO)
+ 401K with company match
+ Tuition reimbursement
+ Growth Opportunities
+ Fun, friendly and unique culture - bring your whole self to work every day!
**This is an onsite position.**
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._
Pharmacy Packaging and Shipping Associate- Accredo
Remote or Fernway, PA job
Up to $2500 sign on bonus paid out over a 12 month period based on shift. Hours: Varied Mon-Thur 4 X10 hr shift and Mon-Fri 8 hour shift Are you ready for a new job that allows you to make an impact and improve the lives of others? Join our dynamic team as a Pharmacy Packaging and Shipping Associate! In this crucial non-patient-facing role, you will be responsible for picking and packing medications, labeling them for shipment, and sorting by shipping carrier and destination. This position offers an excellent opportunity to develop skills in logistics, inventory management, and pharmaceutical handling. Using a high level of attention to detail, as well as your organization, time management, and problem-solving skills, you'll help ensure the accuracy of each prescription order for each patient we serve.
For more than 30 years, Accredo Specialty Pharmacy has delivered dedicated, first-class care and services for patients. We partner closely with prescribers, payers, and specialty manufacturers. Bring your drive and passion for purpose. You'll get the opportunity to make a lasting impact on patient lives.
How you'll improve the lives of others:
* Dispense and pack prescriptions in preparation for shipment
* Copy, fax, and process prescriptions
* Follow-up with patient issues
* Data entry and reference database as needed
Requirements:
* Basic math skills
* General computer skills
* General computer program knowledge including Microsoft Office and use of the internet and email
* Flexibility to adapt to a dynamic work environment; willingness to work a flexible schedule when needed
* Ability to lift 40 pounds
* Effective communication skills both written and verbal
* HS diploma or equivalent required.
Why Choose Us?
* Behind-the-Scenes Role Focus on operational and logistical tasks without direct patient interaction.
* Skill Development: Gain valuable experience in a growing field with opportunities for professional growth.
* Collaborative Team: Work with a supportive team to ensure the accurate and timely delivery of medications.
* Meaningful Impact: Play a vital role in the healthcare system by ensuring patients receive medications promptly.
* Work-Life Balance: Enjoy flexible working hours and a comfortable, controlled work environment. Competitive Holiday, Paid Time Off (PTO), and Overtime Compensation.
* Comprehensive Health Coverage from Day One (including medical, dental, vision).
* Robust 401K Plan with Company Match.
Join us in shaping the future of pharmacy operations while enjoying a supportive and enriching work environment that fosters professional growth and fulfillment. If you are detail-oriented, enjoy working in a non-patient-facing role, and are passionate about contributing to patient care indirectly, we encourage you to apply!
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.
Auto-ApplyStrategic Account Executive; U500 (Hybrid/Atlanta, GA)
Remote or Atlanta, GA job
As a Strategic Account Executive, you are the face of Cigna to the client. Your focus is on spending time with clients in person to cultivate the relationship, addressing client issues, selling annual renewal rate increases in addition to new products and services to expand the relationship. You will be the trusted advisor and go-to partner for your clients, helping them navigate their business challenges and opportunities by offering strategic insights and ensuring an exceptional client and customer experience.
Key Responsibilities:
* Client Partnership: Act as a key influencer and trusted advisor, cultivating strong, personal relationships with decision-makers and other key stakeholders.
* Industry Expertise: Deeply understand your clients' businesses, their industries, and their unique challenges. Continuously learn and adapt, offering tailored recommendations that address both their immediate needs and long-term goals.
* Relationship Building: Engage at all levels with both decision-makers and those who influence the decision-making process, ensuring Cigna's voice is heard and valued.
* Market Insights: Keep clients informed about the latest industry trends, helping them stay ahead of the curve and leveraging Cigna's solutions to meet their evolving needs.
* Financial & Underwriting Expertise: Strengthen your understanding of financials and underwriting to guide clients in managing their costs. Demonstrate the value of Cigna's solutions, including specialty products, and offer creative, proactive solutions to meet their needs.
* Portfolio Management: Drive growth, earnings and retention across your client portfolio, meeting targets for both new business and renewals. Work to expand Cigna's relationships through cross-selling additional products and services.
* Collaboration: Work closely with underwriting teams to ensure alignment, build trust, and ensure clients receive tailored, strategic solutions.
* Client Experience: Oversee client service requests, ensuring seamless execution and swift resolution by directing them to the right team for problem-solving.
* Channel Management: Manage key partner relationships to ensure client budgets align with reality, holding internal partners accountable and leveraging resources as needed to maintain success.
What You Bring:
* Strong relationship-building skills and a passion for developing deep client connections
* Expertise in financials, underwriting, and providing strategic solutions
* A collaborative mindset with the ability to work effectively across teams
* Proactive, creative thinking to develop tailored solutions for each client
* A desire to grow with a company that's committed to delivering innovative solutions in an ever-changing industry
At Cigna, we value people who bring both strategic insight and a hands-on approach to client management. If you're driven by client success and want to work for an organization that values both innovation and personal relationships, we want to hear from you!
Qualifications
* Bachelor's degree or equivalent experience.
* Experience: 3+ years of experience in health benefits or client management
Skills:
* Strong communication, sales negotiation, and relationship-building skills.
* Proven ability to manage and grow client relationships, particularly with clients
* Experience in sales, marketing, underwriting, or operations is preferred.
* Financial acumen with the ability to identify and drive growth opportunities within the book of business.
* Additional: Demonstrated success in managing large, complex client accounts with a focus on relationship-building and revenue growth.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in 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.
Auto-ApplyPart time Driver / Health Fair Attendant - Evernorth - St Croix USVI
Remote job
Professional Drivers/Health Event Assistant - Part time 24 hours/week - Evernorth Workplace Care * Must currently reside in St Croix - US Virgin Islands * 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
Duties and Responsibilities
* Operate the Company vehicle to transport Evernorth Health Coaches to and from destinations in St. Croix
* Report 20 min early to shift to ensure the vehicle is prepped
* Arrive at Evernorth office and field destinations on schedule
* Research and plan for traffic, construction, and weather delays
* Use navigation applications to determine the best route
* Maintains a safe driving and working environment, including PPE (Personal Protective Equipment)
* Maintain a clean vehicle, including clean and refill water container at all times
* Follow all company policies, procedures, dress code, and management direction, including privacy/confidentiality, and all fleet and safety policies
* Perform daily check of vehicles to ensure safe operating conditions
* Know how to and ability to change a tire, jump a battery and carry jumper cables
* Ensure all maintenance services are completed as scheduled (including oil change, gas, emergency service, etc.)
* Coordinate mobile detailing schedule and take the vehicle to get cleaned when not in use (inside and out)
* Fulfill administrative needs and maintain all service records
* Assists with set up and break down at each site and office
* Ensure everything is shut off at end of shift: lights, A/C, generator (if applicable), etc.
* Assist with flow and organization at the field/site events to ensure successful operations
* Submit all expense reports in a timely manner (within 30 days)
* Must possess superior interpersonal skills necessary to support excellent customer service
* Ability to work independently with little to no supervision
* Ability to provide clear verbal and written information via in-person, email, and phone to customers, co-workers, and leadership
* Ability to complete special projects or other duties as assigned
Qualifications:
* Must have a valid driver's license with no moving violations
* Minimum 5 years of driving experience
* High school graduate or GED
* Ability to load, move, and lift heavy objects (including bending and frequent lifting of 50 to 75 pounds)
* Ability to perform basic computer tasks; Microsoft Outlook, WebEx and data entry functions
* Ability to work a flexible schedule including weekends and/or evenings as needed
* Excellent communication and decision-making skills
* Outgoing personality
* Must be reliable and professional
* Ability to pass our background checks including employment, criminal and drug screens
This role is part time 24 hours a week with the potential to move to full time in the future, based on business need.
This role is based in St Croix USVI. Must be a current resident of St Croix USVI and understand the culture and islands.
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.
Auto-ApplySenior Database Administrator
Remote or Lees Summit, MO job
G.E.H.A (Government Employees Health Association, Inc.) is a nonprofit member association that provides medical and dental benefits to more than two million federal employees and retirees, military retirees and their families. We celebrate diversity and are committed to creating an inclusive environment for all employees.
G.E.H.A has one mission: To empower federal workers to be healthy and well.
Offering one of the largest medical and dental benefit provider networks available to federal employees in the United States, G.E.H.A empowers health and wellness by meeting its members where they are, when they need care. We serve our members with products they value and a personalized customer experience, sustained by a nimble and efficient organization.
We are seeking a Senior Database Administrator to enhance and secure enterprise database systems across both on-prem and cloud environments. This is a senior-level technical role focused on ensuring optimal performance, availability and security of high-profile databases through proactive maintenance, troubleshooting, and operational excellence. The ideal candidate brings deep expertise in relational databases, NoSQL, and cloud platforms, with a passion for leveraging emerging technologies to drive operational excellence and innovation.SKILLS
Duties and Responsibilities
Database Administration & Optimization
Administer, maintain, and optimize relational databases (e.g., SQL Server, Azure SQL, Snowflake, PostgreSQL).
Lead performance tuning, indexing, query optimization, and root cause analysis to ensure high availability and data integrity.
Monitor system health and proactively resolve bottlenecks, blocking issues, and anomalies.
Track and analyze key performance indicators (KPIs) to support capacity planning and system health.
Cloud Environment Management
Support and manage cloud-based database environments across all platforms.
Lead migrations, integrations, and operations in cloud ecosystems using best practices for scalability, reliability, and cost-efficiency.
Utilize cloud-native tools for monitoring, automation, and diagnostics.
Security, Compliance & Governance
Partner with security teams to design and enforce robust database security protocols, including encryption, access controls, and cloud IAM policies.
Ensure compliance with HIPAA, PII, PHI, and other regulatory frameworks.
Conduct audits, implement remediation plans, and maintain secure data workflows across environments.
Backup, Recovery & Disaster Preparedness
Develop and maintain backup, recovery, and disaster recovery strategies for on-prem and cloud platforms.
Implement encryption, compression, off-site retention, and long-term archival policies.
Design high-availability architectures and phased environment controls for non-production isolation.
Data Integration & ETL Operations
Support ETL and batch processing systems, ensuring timely and accurate data movement.
Collaborate with development teams to integrate secure, cloud-native data pipelines and workflows.
Architecture, Infrastructure & Automation
Administer Windows on virtual machines and attached storage
Contribute to physical and logical database design, network topology, and system monitoring.
Automate operations using scripting tools like PowerShell and Terraform
Documentation & Change Management
Create and maintain comprehensive documentation for configurations, procedures, recovery plans, and deployment models.
Oversee code promotion, change control, and configuration management across environments.
Use source control systems to manage database scripts and participate in release planning.
Collaboration & Mentorship
Work closely with cross-functional teams (Infrastructure, DevOps, Application Development, Architecture) to support deployments and troubleshoot issues.
Mentor DBAs and provide guidance on database architecture.
Lead strategic technical initiatives and contribute to enterprise data management planning.
Research & Continuous Improvement
Conduct business analysis and gather requirements to recommend cost-effective solutions and enhancements.
Evaluate existing systems and recommend improvements using current technologies.
Research emerging trends, including NoSQL, vector databases, and LLM-oriented platforms to support AI-driven initiatives.
Knowledge, Skills and Abilities
Bachelor's degree in Computer Systems or related field; equivalent experience or certifications may be considered.
7+ years of experience in database administration, including mastery of relational database systems (e.g., Microsoft SQL Server, Azure SQL, Snowflake, PostgreSQL).
Strong understanding of HIPAA data privacy regulations
Strong understanding of database security principles, access control, and compliance frameworks.
Proficiency in SQL, Snowflake, and scripting tools such as PowerShell and Terraform.
Proven experience supporting cloud-based database environments and cloud-native monitoring and automation tools
Deep technical knowledge of database internals including indexing, query plans, statistics, buffer/cache behavior, and performance tuning.
Experience with ETL tools and processes including design and support of data warehouse structures and reporting systems.
Skilled in change management and code promotion across non-production environments; experienced with source control tools like Git.
Strong understanding of server operating systems (Windows/Linux), server hardware, storage systems (SAN, RAID), physical database design, network topologies, and system monitoring.
Effective verbal and written communication skills to document procedures, explain technical concepts, and collaborate across teams.
Demonstrated ability to work independently, prioritize tasks, and resolve complex technical issues with minimal supervision.
Proven ability to contribute to strategic technical initiatives without direct management responsibilities.
Bonus Skills and Experience
Azure or Snowflake certifications (e.g., Azure Database Administrator Associate, SnowPro Core)
Knowledge of data lakehouse architecture, real-time analytics, or AI systems
Familiarity with NoSQL databases (e.g., Cosmos DB, MongoDB) and exposure to LLM-related architectures
Experience in health insurance, healthcare, or regulated industries
Work-at-home requirements
Must have the ability to provide a non-cellular High Speed Internet Service such as Fiber, DSL, or cable Modems for a home office.
A minimum standard speed for optimal performance of 30x5 (30mpbs download x 5mpbs upload) is required.
Latency (ping) response time lower than 80 ms
Hotspots, satellite and wireless internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
How we value you
Competitive pay/salary ranges
Incentive plan
Health/Vision/Dental benefits effective day one
401(k) retirement plan: company match - dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution
Robust employee well-being program
Paid Time Off
Personal Community Enrichment Time
Company-provided Basic Life and AD&D
Company-provided Short-Term & Long-Term Disability
Tuition Assistance Program
While this is a remote opportunity, at this time G.E.H.A does not hire employees from U.S. territories or the following states: Alaska, Hawaii, California, Washington, Oregon, Colorado, Wyoming, Montana, New York, Connecticut, Vermont, Pennsylvania, Maine.
Please note that the salary information is a general guideline only. G.E.H.A considers factors such as (but not limited to) scope and responsibilities of the position, candidate's work experience, education/training, key skills, internal peer equity, as well as, market and business considerations when extending an offer.
The hiring range for this position is $108,697 - $137,508 USD. At G.E.H.A, the current maximum salary for this role is $153,223 USD. While initial compensation may vary based on experience and qualifications, there is a path to work toward this top rate through performance and continued growth within the organization.
G.E.H.A is an Equal Opportunity Employer, which means we will not discriminate against any individual based on sex, race, color, national origin, disability, religion, age, military status, genetic information, veteran status, pregnancy, marital status, gender identity, and sexual orientation, as well as all other characteristics and qualities protected by federal, state, or local law. G.E.H.A will not discriminate against employees or applicants because they have inquired about, discussed, or disclosed their compensation or the compensation of another employee or applicant. We are committed to creating an inclusive environment for all employees. Our diversity drives innovation deepens connections and strengthens our organization.
G.E.H.A is headquartered in Lee's Summit, Missouri, in the Kansas City area. We recognize the importance of balance and flexibility and offer hybrid and work-from-home options for many of our roles.
Auto-ApplyCategory Management Advisor
Remote or Bloomfield, CT job
The Category Management Advisor is a strategic sourcing professional responsible for end-to-end sourcing and contracting for technology solutions across Cigna, including software and software-as-a-service (SaaS). This role drives sourcing strategies globally, manages competitive processes, negotiates agreements, and recommends suppliers that best align with business objectives.
You will collaborate with internal stakeholders-including Business, IT, Legal, Information Protection, and Privacy-to negotiate complex technology agreements. The ideal candidate has experience managing multiple negotiations simultaneously, adapting to dynamic requirements tied to strategic business and IT objectives, and influencing stakeholders at various management levels.
Responsibilities:
* Lead and manage the sourcing process from initiation to execution, ensuring stakeholder engagement and alignment.
* Develop category strategies considering market trends, spend analysis, strategic importance, and geographic factors.
* Drive sourcing initiatives across the organization, managing multiple stakeholders and competing priorities.
* Create timelines and organize cross-functional teams to support negotiations and contracting.
* Identify and execute sourcing opportunities that deliver cost savings, risk reduction, improved business outcomes, and enhanced service.
* Draft, review, and revise contracts, SLAs, Statements of Work, and Change Orders to optimize benefits and minimize risk.
* Mentor teams to understand enterprise-wide category needs and evaluate best-in-class suppliers.
* Monitor market conditions and cost drivers to forecast trends and inform sourcing strategies.
* Promote continuous improvement in sourcing and procurement processes.
* Build and maintain strong relationships with suppliers, stakeholders, and internal business partners.
* Act as a change agent and mentor, demonstrating adaptability and resilience.
* Provide analysis and insights to support decision-making and category initiatives.
* Drive total cost of ownership reductions and business improvements through supplier partnerships.
* Establish yourself as a trusted advisor to business units.
Qualifications:
* Bachelor's degree in Business, Supply Chain, or related field preferred.
* 5+ years of relevant experience in sourcing or procurement.
* Proven experience negotiating software and SaaS contracts.
* Strong project management skills with the ability to manage multiple priorities.
* Excellent verbal and written communication skills.
* Demonstrated leadership ability to influence and motivate cross-functional teams.
* Highly organized with strong time management and attention to detail.
* Skilled in structured problem-solving and fact-based negotiation tactics.
* Strong analytical, interpersonal, and collaboration skills.
* Knowledge of procurement and outsourcing principles, theories, and processes.
* Ability to thrive in a dynamic, fast-paced environment with periods of ambiguity.
* Experience drafting and reviewing complex contracts, including MSAs and SOWs.
* Familiarity with eSourcing tools such as Ariba and Icertis.
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.
Auto-ApplyWorkstream Analyst - Platform Efficiency & Delivery Team
Remote or Saint Louis, MO job
We are seeking a strategic, analytical contributor to join the Platform & Delivery Efficiency Team as a Workstream Analyst. This role is pivotal in translating business priorities into clear, actionable deliverables, supporting prioritization, and enabling value realization across delivery strategy and CDP initiatives.
WHAT YOU'LL BE DOING
Partner with business leaders and stakeholders to translate strategic priorities into actionable deliverables.
Document the ask, goals, requirements, measurable outcomes, and success criteria for each initiative.
Provide analysis to support prioritization, value realization, and trade-off decisions.
Identify and align with cross-functional teams required to deliver on strategic deliverables.
Ensure delivery teams have clarity on scope, success criteria, and expected outcomes.
Support intake of new requests and facilitate review and prioritization in Steerco forums.
Participate as a member of the delivery team, adding clarity and a path forward when requirements change or blockers arise.
Funnel shovel-ready work to delivery teams for estimation and scheduling/resource alignment.
Track progress and support reporting on KPIs and value delivery.
RELEVANT SKILLSET
Experience in strategy, portfolio analysis, or business analysis within a cross-functional environment.
Demonstrated ability to translate business strategy into actionable plans and measurable outcomes.
Strong analytical skills; able to assess value, prioritize initiatives, and support trade-off decisions.
Excellent communication and stakeholder management skills.
Experience developing and maintaining roadmaps and dashboards.
Ability to work collaboratively across teams and influence without direct authority.
Familiarity with delivery frameworks, project management tools, and value realization methodologies.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an annual salary of 75,200 - 125,400 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.
About 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.
Auto-ApplyOnsite Health Educator- Evernorth- Arlington, VA
Remote or Arlington, VA job
Evernorth Direct Health is an industry leading business providing custom care delivery and wellness services across four key business lines: Wellness Centers, Health Coaching, Wellness Events and COVID 19 solutions.
Evernorth is built on the recognition that health makes progress possible. Our health services are designed to redefine healthcare as we know it. But we can't do it alone.
True change takes all of us, united in a shared vision. Health is what drives us. But it's just the start. Together, we can solve the problems others don't, won't or can't.
Sound like you? Great! Here's more on how you'll make a difference:
• 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.
This position is with Evernorth, a new business within the Cigna Corporation.
What we expect from you:
• 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.
• Current ACLS/BLS/CPR/AED Certification
• 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.
Bonus points for:
• Registered Dietitian
• CHES (Certified Health Education Specialist)
• Motivational interviewing training/experience.
• Smoking cessation and diabetes experience.
This position is onsite in Arlington, VA approximately 4 days per week and in Alexandria, VA approximately 1 day per week.
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.
Auto-ApplyManaged Care Resident - Express Scripts - Remote (Physician Engagement)
Remote job
The Pharmacy Graduate will participate in a 12-month post-PharmD training program with a primary focus on Physician Engagement, including but not limited to; the use of digital applications, data, and insights to enable informed provider decisions. The Physician Engagement Pharmacy Resident will gain managed care proficiency through in-depth longitudinal rotations and as well as enterprise-wide exploratory rotations, while delivering clinical support to the Provider Engagement, Data and Analytics, and Physician Innovation teams.
LOCATION: VIRTUAL
RESPONSIBILITIES
Recommend medications, including initiation, continuation, discontinuation, and alternative therapies based upon established protocols.
Utilize Express Scripts' multiple data analytics programs and tools to monitor and analyze trends in providers prescribing patterns. Collaborates with client, client's Express Scripts' account team and others to optimize opportunities to inform and influence providers. The goal is to improve clinical and financial outcomes and support trend management including appropriate promotion of generic and formulary prescribing toward client and Express Scripts' strategic goals.
Provide clinical support for Physician Innovation teams' research and development efforts, predictive capabilities, and reporting and outcomes processes.
Activities and discussions to gain knowledge of Pharmacy Benefit Management (PBM) services, including claims processing, coverage reviews, pharmacy networks, formulary management, and client management.
Effectively participate in and contribute to staff meetings, committees and departmental work groups to share best practices, improve processes and/or other items relating to provider engagement.
Provide patient and health care professional education and medication information.
Design and present education and/or training activities via newsletter publications, clinical journal clubs, and department in-service opportunities.
Minimum Requirements:
4th year (Graduation year) or PharmD. degree from an ACPE-accredited college or school of pharmacy
Pharmacy Licensure in any US State (within 90 days of residency start)
Proficiency in Microsoft office, specifically Microsoft excel and PowerPoint
Proficiency in written and verbal communications
Strong career interest in Managed Care pharmacy
Required: Please upload or email per instructions for each:
CV - Upload/attach to Workday application.
Letter of Intent (max 300 words; Explain why you are interested in our program and managed care) - Upload/attach to Workday application.
Any recommendation letters - Upload/attach to Workday application
Deadline for application for this program is 12/31/2025
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 21 - 36 USD / hourly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.
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.
Auto-ApplyMedical Director- National
Remote or Summit, NJ job
G.E.H.A (Government Employees Health Association, Inc.) is a nonprofit member association that provides medical and dental benefits to more than two million federal employees and retirees, military retirees and their families. We celebrate diversity and are committed to creating an inclusive environment for all employees.
G.E.H.A has one mission: To empower federal workers to be healthy and well.
Offering one of the largest medical and dental benefit provider networks available to federal employees in the United States, G.E.H.A empowers health and wellness by meeting its members where they are, when they need care. We serve our members with products they value and a personalized customer experience, sustained by a nimble and efficient organization.
The Medical Director will support innovation in care delivery, cost containment, and quality improvement. This role focuses on clinical review of escalated claims and appeals, third-party vendor relationships and performance review, and collaboration on enterprise-wide clinical strategy. The Medical Director demonstrates professionalism and leadership skills across clinical and non-clinical teams.SKILLS
Duties and Responsibilities:
Reviews medical and pharmacy cases to ensure compliance with evidence-based medicine guidelines and G.E.H.A clinical programs. Documents rationale for decisions and communicates collaboratively with appropriate staff. Ensures reviews are completed timely and according to policy, as determined by type of review.
Ensures clinical decisions are in compliance with plan documents. Assists clinical staff in the appropriate interpretation of plan documents, as it relates to clinical services.
Provides direction and support for escalated clinical cases. Is available to clinical and pharmacy staff for urgent decisions. Assists program directors in preparing appropriate documentation for OPM.
Determines the need for external review of medical and/or pharmacy cases. Evaluates the external review organizations for quality of reviews and makes recommendations regarding continued use of the organization.
Develops internal guidelines to support internal reviews. Educates clinical and pharmacy staff in consistent application of guidelines.
Protects GEHA from excessive and unnecessary claims by gathering medical data and making medical judgments on unique and/or questionable cases. Interacts with the legal team as needed and clearly documents GEHA's position.
Partners with Quality, Medical Management, Strategic Business Insights (SBI), and Care Management teams to support successful execution of clinical programs.
Serves as an internal medical expert for clinical and nonclinical teams. Collaborates with clinical staff to determine cost-effective membership specific approaches to meet the needs of members within the confines of the plan documents. Meets regularly with case management staff to review high dollar cases.
Provides medical assistance in updating claims payment policy. Researches preventive guidelines and interprets for appropriate coding in the system.
Provides daily medical support to external partners and GEHA staff participating in
Clinical program development and execution.
Assists the Special Investigations Unit in review of cases with utilization management issues. Makes medical necessity decisions and participates in the appeal process as appropriate.
Assists with clinical editor configuration and on-going review of new edits to prevent inappropriate payment or over-payment.
Knowledge, Skills, and Abilities:
Doctor of Medicine or Doctor of Osteopathy degree from an accredited institution.
Current, unrestricted medical license and evidence of completion of required CME credits
Board certification in Family Medicine, Internal Medicine, or General Surgery.
Minimum five years of clinical practice beyond residency training.
Must have experience working in computer systems or EMRs.
Strong verbal and written communication skills
Incumbent must maintain state licensure as a board-certified physician by the American Board of Medical Specialties or equivalent entity.
Preferred Qualifications
Health care payer experience
Work-at-home requirements
Must have the ability to provide a non-cellular High Speed Internet Service such as Fiber, DSL, or cable Modems for a home office.
A minimum standard speed for optimal performance of 30x5 (30mpbs download x 5mpbs upload) is required.
Latency (ping) response time lower than 80 ms
Hotspots, satellite and wireless internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
How we value you
Competitive pay/salary ranges
Incentive plan
Health/Vision/Dental benefits effective day one
401(k) retirement plan: company match - dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution
Robust employee well-being program
Paid Time Off
Personal Community Enrichment Time
Company-provided Basic Life and AD&D
Company-provided Short-Term & Long-Term Disability
Tuition Assistance Program
While this is a remote opportunity, at this time G.E.H.A does not hire employees from U.S. territories or the following states: Alaska, Hawaii, California, Washington, Oregon, Colorado, Wyoming, Montana, New York, Connecticut, Vermont, Pennsylvania, Maine.
Please note that the salary information is a general guideline only. G.E.H.A considers factors such as (but not limited to) scope and responsibilities of the position, candidate's work experience, education/training, key skills, internal peer equity, as well as, market and business considerations when extending an offer.
The hiring range for this position is $227,254 - $287,490 USD. At G.E.H.A, the current maximum salary for this role is $320,346 USD. While initial compensation may vary based on experience and qualifications, there is a path to work toward this top rate through performance and continued growth within the organization.
G.E.H.A is an Equal Opportunity Employer, which means we will not discriminate against any individual based on sex, race, color, national origin, disability, religion, age, military status, genetic information, veteran status, pregnancy, marital status, gender identity, and sexual orientation, as well as all other characteristics and qualities protected by federal, state, or local law. G.E.H.A will not discriminate against employees or applicants because they have inquired about, discussed, or disclosed their compensation or the compensation of another employee or applicant. We are committed to creating an inclusive environment for all employees. Our diversity drives innovation deepens connections and strengthens our organization.
G.E.H.A is headquartered in Lee's Summit, Missouri, in the Kansas City area. We recognize the importance of balance and flexibility and offer hybrid and work-from-home options for many of our roles.
Auto-ApplyBusiness Analytics Lead Analyst (Provider Settlement Lead Analyst) - Remote
Remote or Bloomfield, CT job
Cigna is seeking a highly motivated and innovative team member to join our analytics team as a Business Analytics Lead Analyst. In this role, you will lead contractors and attorneys through the internal provider settlement process and partner closely with the settlement team.
Responsibilities
Manage the settlement team mailbox, responding to internal requests and inquiries
Set up settlement meetings, document take-aways and send out meeting notes
Maintain database inventory of settlements (tracking requests, payments, chargebacks, etc)
Report on settlement activity (bi-weekly, monthly, quarterly and annual reporting).
Enter payments into payment system to issue settlement payments
Review and summarize financial analysis on potential settlements
Lead the client chargeback process once a settlement payment is made
Respond to external financial audits
Collaborate with attorneys and contractors in preparation for quarterly reserve reviews and reporting
Qualifications
Bachelor's degree or higher strongly preferred or equivalent work experience required
3+ years of experience in finance, business analysis or health care/managed care
Strong organizational skills and attention to detail
Excellent communication and documentation abilities required
Understanding of managed care business processes, data, systems, and claim payments
Proficient in Microsoft Office Suite (Microsoft Word, Microsoft Excel and Microsoft Access). VLOOKUPS and pivot tables required.
Ability to work independently while managing multiple tasks and meeting deadlines
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 77,300 - 128,800 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.
We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.
About 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.
Auto-ApplyBindery Tech
Bcbsla job in Baton Rouge, LA
We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.
Residency in or relocation to Louisiana is preferred for all positions.
POSITION PURPOSE:
This position is responsible for providing bindery and finishing services to all areas of the company
NATURE AND SCOPE:
Position Location:
This position reports to the Manager of Printing Services.
Activities of Direct Reports:
This position has no reports.
Necessary Contacts:
In order to effectively fulfill this position the incumbent must be in contact with:
Internal customers, external customers, Corporate Communications, Marketing, Document Mgt, Materials Mgt. outside vendors, service personnel, and all employees as needed.
QUALIFICATIONS:
High school diploma or equivalent.
Five years of high volume printing experience is preferred.
Press Operation experience preferred.
Completion of printing, binding related vocational or technical training is preferred.
Working knowledge of all departmental equipment, paper and chemicals. Must be able to trouble shoot routine equipment problems.
Must be able to establish and maintain priorities and deadlines. Able to ensure the quality and cost effectiveness of projects.
Able to research and clarify specifications for projects as needed.
ACCOUNTABILITIES & ESSENTIAL FUNCTIONS:
Creates job tickets in Pace Print mgt system for all bindery production and records accurate actual time allocated on all jobs in Pace Print mgt system in Data collection to ensure timeliness.
Translates information from job ticket to align, draw out, set up and run all bindery equipment for producing and ensuring quality printing
Perform regular maintenance on all press equipment keeping with the guidelines provided by the Manufacturer to ensure Printing Services equipment stays in excellent running condition.
Accountable for complying with all laws and regulations associated with duties and responsibilities.
Job Duties are performed in a normal and clean office environment with normal noise levels.
Work is predominately done while sitting or standing.
The ability to comprehend, document, and analyze is required.
An Equal Opportunity Employer
All BCBSLA EMPLOYEES please apply through Workday Careers.
PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)
Additional Information
Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.
If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact ********************* for assistance.
In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.
Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.
Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.
Auto-ApplyInserter Operator
Bcbsla job in Baton Rouge, LA
We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.
Residency in or relocation to Louisiana is preferred for all positions.
The hours for this position are Monday - Friday from 7:00 AM - 3:30 PM.
POSITION PURPOSE
Operate a high speed intelligent inserter and perform daily inserting and presorting of outgoing mail in a timely manner, and ensuring compliance of all USPS regulations, HIPAA guidelines, and corporate policies and procedures. Must adhere to established audit controls and guidelines.
NATURE AND SCOPE
This role does not manage people
This role reports to this job: MANAGER, MAIL SERVICES & MATERIAL MGT
Necessary Contacts: In order to effectively fulfill this position the incumbent must be in contact with:
All levels of BCBSLA personnel, employees of the U.S. Postal Service, external vendors and service agents.
QUALIFICATIONS
Education
High School Diploma or equivalent required
Additional education and/or training preferred
Work Experience
2 years of experience with mail procedures and operating inserting equipment required
Experience with other types of mail inserting equipment would be beneficial.
Experience using basic computer operational software, words, excel spreadsheets, windows and e-mail applications, knowledge of USPS regulations, ability to maintain postage logs and knowledge of mail accounting systems preferred
Skills and Abilities
Must be able to operate an intelligent inserter and have an understanding of bar code readers and scanning camera validation.
Must have the ability to accurately set-up inserting system for optimal production.
Must have good verbal and written communication skills, enabling cooperative work relationships with customers and co-workers. preferred
Must possess organizational skills with demonstrated ability to direct multiple tasks and operational functions.
Ability to work overtime and/or weekends as work demands
This job requires working second shift hours
Licenses and Certifications
None Required
ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS
Operate a high speed Pitney Bowes intelligent inserter that uses barcode scanning and camera validation, in a demanding high speed environment.
Performs daily inserting and presorting of outgoing mail according to postal guidelines to obtain the maximum postage discount.
Accurately set-up inserting system and make adjustments for optimal production.
Consistently produce quality output.
Maintain postage meters; replenish money on postage meters as needed.
Review and reconciling postage logs for their particular machines.
Provides assistance to all fellow staff members as workload dictates to promote a team environment and assist all customers, facilitating good customer service.
Physical effort is required to lift, hold, and carry objects up to 60 pounds.
Additional Accountabilities and Essential Functions
The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions
Perform other job-related duties as assigned, within your scope of responsibilities.
Job duties are performed in a normal and clean office environment with normal noise levels.
Work is predominately done while standing or sitting.
The ability to comprehend, document, calculate, visualize, and analyze are required.
Physical effort is required to lift, hold, and carry objects up to 60 pounds.
An Equal Opportunity Employer
All BCBSLA EMPLOYEES please apply through Workday Careers.
PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)
Additional Information
Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.
If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact ********************* for assistance.
In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.
Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.
Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.
Auto-ApplyPharmacy Technician Representative - Express Scripts
Remote or Saint Louis, MO job
As a Pharmacy Technician, you'll help our 95+ million members make the most of our benefit offerings. In this role, you'll set our customers at ease by helping answer their questions and providing solutions to their problems. Above all, you'll make a real impact on the lives of others, day in and day out.
Location: 4600 North Hanley, St. Louis, MO 63134 - Onsite position
Work Schedules available:
PM shift - Mon-Thurs - 3:30PM-2:00AM ( This shift may be eligible for shift differential)
AM shift - Sunday -Wednesday - 5:00AM-3:30PM
What you will do:
Select and retrieve appropriate quantities of medication and prepare the labels that correspond.
Works as part of a team in resolving requests in Pull Department, Pull Rx, Letter processing, and Controls exception across ESI as needed. Pull Department responsibilities require walking, standing, and repetitive up and down lifting of boxes weighing 35lb and repetitive pulling of prescriptions 95% of the work time.
Pull Rx responsibilities will include pull, copy, fax, and processing. Letter processing will need to provide data entry, type customer service notes, and own total member correspondence. Controls exception will include data verification, QA, and exception processing.
Adhere to strict HIPAA regulation especially when communicating to others outside of Express Scripts. All team members will be expected to work as per Policies and Procedures (P &P) and Work Instructions with onsite or offsite departments, internal or external to the company as directed. The weights listed in Essential Functions will vary as size and needs of the department change.
All team members are expected to work with Supervisors and Management to cross-train and develop proficiency across all functional areas of the job.
Process letter requests by manual or automated databases, typing customer service notes in system, pulling Rx, and processing member correspondence.
Pull requests, rescan, and work with RPh to obtain appropriate documentation to resolve request.
Controls work includes data input / validation, Quality Assurance (QA), Prescriber and Patient outreach, and working with RPh and Pharmacy per work instructions, P&P, management direction, or any national or state regulations.
Participate in Lean and Continuous Improvement efforts internal and external to the department.
Perform all QA tasks as identified.
Complete and process data for reporting needs.
Prepare and organize work for storage both on and offsite.
What you will need:
HS Diploma or GED required.
Valid MO Pharmacy technician license registration required.
Minimum of 1 year of relevant experience as a Pharmacy Technician.
Certified Pharmacy Technician or NHA preferred.
Strong computer skills Word and Excel.
Self-motivator with strong organizational skills, attention to detail, and exceptional time management skills.
Effective written and oral communication skills.
What we Offer:
Health coverage effective day 1 (including medical, dental, vision).
401(k) plan with company match.
Holiday Pay and Paid Time Off.
Education/Certification Program (Grow to Thrive).
Career Growth and Advancement opportunities.
Physical Requirements:
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.
Auto-ApplyContract Senior Associate
Remote or Bloomfield, CT job
We know your type. You're driven to make an impact on the business and internally motivated to improve how things are done. You are a quick learner; detail oriented, and can handle multiple priorities at once. You always keep your audience in mind and have a pretty easy time working with all different types of people.
We also know you're looking for an opportunity that lets you get your hands dirty, one that challenges your business acumen and helps your career thrive. It's nice to meet you too. Read on to learn more about our Contract Senior Associate.
Let us tell you a little more. We're a global health service company dedicated to helping people improve their health, well-being and peace of mind of those we serve. But we don't just care about your well-being; we care about your career health too. That's why when you work with us, you can count on a different kind of career - you'll make a difference, learn a ton, and share in changing the way people think about healthcare.
You will manage contract production by interpreting source documentation and relating it to appropriate contract language. As part of this role, you will act as a liaison between business owners, legal, and our client. You will work to drive resolution of client questions by working with matrix partners to obtain appropriate client specific answers. Proactively, you will develop internal and external relationships that leverage operations expertise, improve current processes, and assess value added and non-value added tasks. Beyond core production, you are expected to embrace a high performance culture through teamwork, personal development, accountability, and involvement in special projects.
What you'll do:
* Manage and maintain an assigned book of business. Review and analyze implementation materials to create legal documents for new and existing business.
* Collaborate. Partner with internal partners to complete contract documents accurately and timely.
* Use your project management skills. Assists with special projects (annual contract review, process implementation, etc.).
* Always keep your customer in mind. Demonstrates approachability and openness with regard to delivering consistent customer service.
Qualifications:
* 2+ years of contracts analysis experience.
* Sales force experience would be preferred.
* Must be able to prioritize and manage multiple tasks/projects simultaneously.
* Excellent written and verbal communication skills.
* Proficient in Microsoft Office applications including experience in Word document reformatting.
* Quality review experience preferred.
* Strong analytical and problem solving skills.
* Strong attention to detail.
* Must be a strong team player.
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.
Auto-ApplyLearning Strategist
Remote or Summit, NJ job
G.E.H.A (Government Employees Health Association, Inc.) is a nonprofit member association that provides medical and dental benefits to more than two million federal employees and retirees, military retirees and their families. We celebrate diversity and are committed to creating an inclusive environment for all employees.
G.E.H.A has one mission: To empower federal workers to be healthy and well.
Offering one of the largest medical and dental benefit provider networks available to federal employees in the United States, G.E.H.A empowers health and wellness by meeting its members where they are, when they need care. We serve our members with products they value and a personalized customer experience, sustained by a nimble and efficient organization.
G.E.H.A is seeking a highly skilled and impeccably detail-oriented Learning Strategist to join the Organizational Talent and Effectiveness team. This position requires advanced expertise in instructional design and content development, advanced proficiency in project management and deep knowledge and application of strategic human resource management. The Learning Strategist supports stakeholder relationships, designs and implements training strategies and readiness plans, change management plans and ensures alignment with company performance goals. The successful candidate collaborates with internal partners to develop high-quality innovative business solutions to advance our organizational strategies and initiatives, and collects, analyzes, and uses data to inform continuous improvement of learning.SKILLS
Duties and Responsibilities:
Partner with SMEs and stakeholders to identify training needs, develop comprehensive training plans, content, and programming to drive organizational performance, outcomes and belonging.
Engage and effectively collaborate with cross-functional teams to ensure consistency in training delivery and messaging.
Own, recommend, implement, and monitor improvements to learning content and delivery based on workforce metrics / KPIs and unobtrusive, secondary data analysis.
Monitor and evaluate learning effectiveness and outcomes, and report impact through quantitative and qualitative data analysis and feedback mechanisms.
Remain current and apprised of industry trends and best practices.
Knowledge, Skills, and Abilities:
Master's degree in instructional design, educational technology, or a related field.
Seven (7) to Ten (10) years of professional experience in education designing, developing, and/or teaching courses, including proven experience with managing projects or instructional services in a corporate setting.
Problem solving and critical thinking.
Advanced proficiency in e-learning development and authoring tools (Articulate 360, Rise, Adobe Captivate, or similar platforms) and learning management systems (LMS).
Advanced understanding of andragogy to create and deliver best-in-class instructional design strategies.
Utilize technology to enhance learning experiences and personalize learning pathways. Knowledge and application of best practices using technology for design and learning, including but not limited to, multimedia development, web conferencing, learning management systems, online collaborative tools, and high impact practices for learning and outcomes.
Deep knowledge and application of instructional design methodologies (e.g., ADDIE, SAM).
Proficient in visual and graphic design (Adobe, Shutterstock); video and multimedia editing (Premiere Pro, Audacity, Camtasia); UX/UI design principles and accessibility/UDL.
Direct experience with AI-based onboarding technology to facilitate and streamline remote onboarding processes.
Knowledge and application of Section 508 requirements and digital accessibility.
Exceptional writing, editing, and proofreading skills, relationship management and people skills, including the ability to collaborate with all levels of the organization and work across organizational boundaries, particularly in the area of instructional design.
Other duties as assigned.
Preferred Qualifications:
Certification in instructional design and project management.
10+ years of experience in instructional design and project management, including proven experience managing several programs and projects in a corporate setting.
Experience in the health insurance or healthcare industry.
Work-at-home requirements
Must have the ability to provide a non-cellular High Speed Internet Service such as Fiber, DSL, or cable Modems for a home office.
A minimum standard speed for optimal performance of 30x5 (30mpbs download x 5mpbs upload) is required.
Latency (ping) response time lower than 80 ms
Hotspots, satellite and wireless internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
How we value you
Competitive pay/salary ranges
Incentive plan
Health/Vision/Dental benefits effective day one
401(k) retirement plan: company match - dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution
Robust employee well-being program
Paid Time Off
Personal Community Enrichment Time
Company-provided Basic Life and AD&D
Company-provided Short-Term & Long-Term Disability
Tuition Assistance Program
While this is a remote opportunity, at this time G.E.H.A does not hire employees from U.S. territories or the following states: Alaska, Hawaii, California, Washington, Oregon, Colorado, Wyoming, Montana, New York, Connecticut, Vermont, Pennsylvania, Maine.
Please note that the salary information is a general guideline only. G.E.H.A considers factors such as (but not limited to) scope and responsibilities of the position, candidate's work experience, education/training, key skills, internal peer equity, as well as, market and business considerations when extending an offer.
The hiring range for this position is $92,379 - $116,865 USD. At G.E.H.A, the current maximum salary for this role is $130,221 USD. While initial compensation may vary based on experience and qualifications, there is a path to work toward this top rate through performance and continued growth within the organization.
G.E.H.A is an Equal Opportunity Employer, which means we will not discriminate against any individual based on sex, race, color, national origin, disability, religion, age, military status, genetic information, veteran status, pregnancy, marital status, gender identity, and sexual orientation, as well as all other characteristics and qualities protected by federal, state, or local law. G.E.H.A will not discriminate against employees or applicants because they have inquired about, discussed, or disclosed their compensation or the compensation of another employee or applicant. We are committed to creating an inclusive environment for all employees. Our diversity drives innovation deepens connections and strengthens our organization.
G.E.H.A is headquartered in Lee's Summit, Missouri, in the Kansas City area. We recognize the importance of balance and flexibility and offer hybrid and work-from-home options for many of our roles.
Auto-ApplySenior Software Engineer (Louisiana)
Remote Bcbsla job
We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.
Residency in or relocation to Louisiana is preferred for all positions.
Only candidates located in Louisiana or willing to relocate to Louisiana will be considered
POSITION PURPOSE
Under minimal supervision (with wide latitude for independent judgment) design, develop, document, test, and debug new and existing software systems and/or applications for market sale or large-scale proprietary software for internal use. Service as technical expert on development projects. Participate in full development life cycle including requirements analysis and design. Write technical specifications based on conceptual design and stated business requirements. Support, maintain, and document software functionality. Identify and evaluate new technologies for implementation. Analyze code to find causes of errors and revise programs as needed. Participate in software design meetings and analyze user needs to determine technical requirements. Consult with end user to prototype, refine, test, and debug programs to meet needs. Accountable for complying with all laws and regulations associated with duties and responsibilities.
NATURE AND SCOPE
This role does not manage people
This job reports to: Departmental Leadership
Necessary Contacts: To do this job effectively the incumbent has to be in contact with all levels of BCBSLA personnel.
QUALIFICATIONS
Education
Bachelor's degree in Computer Science or a related field required
Four years of related experience can be used in lieu of a Bachelor's degree.
Work Experience
4 years of software development experience required
Must have a minimum of three years of IT experience using general development technologies (i.e., C#, SSRS, SSIS, SQL Coding, XML).
Preferred Qualifications for IT Claims Back Office: .NET Development, SSIS, SSRS, Azure (DevOps, Logic Apps, Service Bus, Functions).
Skills and Abilities
Ability to think strategically, balance long and short-term priorities. Requires the knowledge and ability to analyze and solve complex, logical problems
Ability to establish and maintain a high level of trust and confidence with clients; establish strong working relationships with business and technology partners at all levels; exercise sound judgment; collaborate effectively with peers, subordinates and superiors
Must understand and have experience in all aspects of the software development lifecycle (SDLC)
Ability to multitask and prioritize a heavy workload in a fast paced, dynamic environment
Understanding of business operations and key business drivers (or aptitude to develop understanding quickly)
The candidate must be flexible in terms of working practices as the role requires on call rotation which might include some evening, weekend and holiday work
Licenses and Certifications
None Required
ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS
Gather information from stakeholders to document functional, system, and data requirements
Assess available technologies and create detailed technical specifications or data models for development of new or modifications to existing internal applications or systems
Designs, codes, tests, maintains, trouble shoots, and documents on new or existing core administration integrated information systems with moderate supervision at various levels of complexity to maintain quality enterprise business solutions of application architectures
Produces quality enterprise information systems of application architectures that meet or exceed client expectations on operations and strategic projects
Develops and maintain internal systems or applications involving various programming languages
Maintains existing applications by fixing defects, adding new functionality, and upgrading components
Performs testing, analysis, and debugging on applications and systems to identify and fix problems
Uses development specifications to create detailed test cases. Analyze results of testing to ensure technology solution matches the organization's business needs
Trains or contribute to training of stakeholders and evaluate the effectiveness of implemented technologies
Researches and remain informed of new technology and development tools
Provides support to the testing team on an as needed basis
Documents system problems and resolutions for future reference
Provides technical support and troubleshooting assistance on software application related issues
Maintains configuration management
Additional Accountabilities and Essential Functions
The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions
Perform other job-related duties as assigned, within your scope of responsibilities.
Job duties are performed in a normal and clean office environment with normal noise levels.
Work is predominately done while standing or sitting.
The ability to comprehend, document, calculate, visualize, and analyze are required.
An Equal Opportunity Employer
All BCBSLA EMPLOYEES please apply through Workday Careers.
PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)
Additional Information
Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.
If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact ********************* for assistance.
In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.
Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.
Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.
Auto-ApplySenior Solution Architect (Baton Rouge, LA)
Bcbsla job in Baton Rouge, LA
We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.
Residency in or relocation to Louisiana is preferred for all positions.
POSITION PURPOSE
Guided by BCBSLA Reference Architecture & Standards, Senior Solution Architect is responsible for leading development of Architecture Solution Blueprints for all business and IT projects. Ensure sound, sustainable and economically viable design, striking the right balance between enterprise and functional needs with a focus on increased operational efficiency, reliability, predictability and long-term economic viability while reducing technical debt. Accountable for complying with all laws and regulations associated with duties and responsibilities.
NATURE AND SCOPE
This role does not manage people
This job reports to: Departmental Leadership
Necessary Contacts: To do this job effectively the incumbent has to be in contact with:
All levels of BCBSLA personnel, Blue Cross and Blue Shield Association, other Blue Plans, and a limited number of external community/industry organizations.
QUALIFICATIONS
Education
Bachelor's of Computer Science or other technical programs including mathematics, applied physics and or Business Administration required
Four years of related experience can be used in lieu of a Bachelor's degree.
Work Experience
4 years technical leadership and hands-on technology implementation to include four years' experience in software development, DevSecOps engineering, systems administration, systems architecture, data architecture or data engineering Requires advanced knowledge of Solution Architecture practice, Application Architecture practice, ALM, Software development best practices and standards, and demonstrable experience in leading business application solution design, and implementation of complex business initiatives.
PREFERRED QUALIFICATIONS:
Healthcare industry experience
Understanding of infrastructure and security requirements, such as HIPAA preferred.
TOGAF certifications
ITIL certifications
Vendor Certifications
Skills and Abilities
Must have expertise in one and intermediate knowledge in three of the following competencies:Business ArchitectureBusiness Intelligence ArchitectureInformation ArchitectureApplication ArchitectureData ArchitectureIntegration ArchitectureInfrastructure ArchitectureDigital & Digital Marketing ArchitectureSecurity ArchitectureHealthcare Core Administrative Systems (Trizetto Facets) Care & Disease Management Systems (Zeomega Jiva) Enterprise Resource Planning - Finance or Human Resources (Oracle Peoplesoft, Workday) Microsoft AzureAmazon Web ServicesDevSecOps
Must have intermediate / advanced knowledge in at least three of the following technical competencies:.NET Framework or Core, or JavaJavaScriptWeb Services / API development Informatica Power CenterMicrosoft SSISMicrosoft BizTlkSingle Page Applications / Progressive Web ApplicationsWeb site / services management and security Data ModelingData IntegrationSQLRelational / NoSql Database SystemsBig DataTableau / Power BI / Qlik
Additional advanced skills in the following areas:
Excellent interpersonal skills in areas such as teamwork, facilitation and negotiation Strong leadership skills Excellent analytical and technical skills Strong written and verbal communication skills Excellent planning and organizational skills Ability to understand the long-term ("big picture") and short-term perspectives of situations Ability to estimate the financial impact of alternatives Ability to apply multiple technical solutions to business problems Ability to quickly comprehend the functions and capabilities of new technologies Knowledge of information principles and processes Basic knowledge of financial models and budgeting Understanding of the political climate of the enterprise, and how to respond to political challenges Facilitate formal training for architects, engineers and analysts
Licenses and Certifications
None Required
ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS
Have Accountability and/or Responsibility to following key operational DeliverablesSolution Architecture ProcessDevelopment, and publishing of Solution Blueprint document
Ensures alignment, adherence and application of all applicable BCBSLA Reference Architecture components are properly reflected in the Solution Architecture Blueprint deliverable including Enterprise Application Architecture & Software Development Standards and FrameworksEnterprise Technical Architecture and Infrastructure StandardsEnterprise Data Architecture and StandardsAll Enterprise Architecture Roadmaps and Life-cycle Management Plans
Facilitation of deep-dive technical discussions around design and an intellectual curiosity to always keep your technical skills current while maintaining a pulse on industry trends.Defines, collects, synthesizes, analyzes and works with IT Data Analytics team to publishes all related and relevant Metrics associated with Solution Architecture practice to demonstrate increasing maturity and value.Project portfolio level review and assessment report for enterprise-level opportunities to maximize shared services and re-use Understanding business application and industry trends in relation to the Payer Market, identifying, building a business case for and socializing select and relevant innovation opportunities with likelihood of success, and performing POC as warranted Architecture SME (and designated Chair as needed) for Architecture Review Board (ARB) and facilitation of review, impact analysis, documentation, recommendation and formal publication of BCBSLA Technical Standards and measurement of adherence to these Standards.Provide architectural leadership for development efforts by integrating various technologies such as web applications, relational databases, information security, servers, networking, etc.Provide high-level analysis and design reviews to solve conceptual problems and avoid duplication of efforts of same errors within different applications.Work with vendors to integrate their technologies within organization's structure.Evaluate new technologies and recommend extension, expansion, and update of technology standards, practices, and methodologies.Mentoring engineers and analysts
Additional Accountabilities and Essential Functions
The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions
Perform other job-related duties as assigned, within your scope of responsibilities.
Job duties are performed in a normal and clean office environment with normal noise levels.
Work is predominately done while standing or sitting.
The ability to comprehend, document, calculate, visualize, and analyze are required.
An Equal Opportunity Employer
All BCBSLA EMPLOYEES please apply through Workday Careers.
PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)
Additional Information
Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.
If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact ********************* for assistance.
In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.
Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.
Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.
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