Operations Lead Analyst

🔥 il y a 17 heures

🎸 Tennessee – Distant

🎸 Tennessee – Remote

⏰ Temps Plein

🟠 Senior

⚙️ Opérations

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The Cigna Group

Site WebLinkedInTous les Emplois

10 000+ employés

🏥 Santé

🛡️ Assurance

Healthcare • Insurance

Le Groupe Cigna est une entreprise mondiale de services de santé qui propose des produits et avantages d'assurance médicale, dentaire, pharmaceutique, comportementale et complémentaire aux particuliers, familles, employeurs, courtiers, prestataires de soins et bénéficiaires de Medicare. Il offre des plans de groupe parrainés par l'employeur, des plans individuels et familiaux (y compris les offres d'Inscription Ouverte), Medicare, une assurance maladie internationale couvrant plus de 200 pays, et des services numériques aux membres via la plateforme myCigna (y compris la télésanté et la gestion des réclamations). Ses produits sont fournis par le biais de filiales opérationnelles telles que Cigna Health and Life Insurance Company et d'autres affiliés régionaux.

Description

• Build and maintain Express Scripts relationships with third-party medical providers and health plan clients sharing accumulators for claims processing • Manage day-to-day issues and inquiries, technology and connectivity, performance, and trending analytics • Meet regularly with vendor teams to understand non-data trends and tactical business needs • Navigate complex interactions with vendors and internal partners • Recommend process improvements, systems upgrades, and technology changes to leadership • Work within the CDH Triage team serving the integrated accumulator ecosystem across Express Scripts, Cigna, health plan clients, and third-party medical benefit providers

🎯 Exigences

• High School diploma or GED required • 3+ years of experience in a healthcare setting required; operations or significant cross-functional experience • Understanding of Consumer Driven Health (CDH) products preferred but not required • Working knowledge of Accumulator Benefits and Modular Frames, Eligibility, and Claims Processing preferred but not required • Ability to use data to identify opportunities and drive positive outcomes • Strong communication skills and ability to manage complex relationships among medical providers, account teams, and internal functional/IT resources • Ability to work cross-functionally and manage multiple requests/issues with competing deadlines • Ability to adapt to changing governmental regulatory requirements • Ability to work independently and as part of a team with minimal oversight • Ability to learn the entire end-to-end process • Logical reasoning, attention to detail, problem-solving, and critical-thinking skills • Experience with Microsoft Office software preferred • Demonstrated analytical, strategic planning, communication, problem-solving, initiative, and independent-working skills preferred • Ability to work independently with moderate guidance and within a larger team preferred

🏖️ Avantages

• Remote work option, occasionally or permanently • Minimum home internet requirement: cable broadband or fiber optic service with at least 10Mbps download/5Mbps upload • Tobacco-free policy and smoking cessation program eligibility where applicable