Lead Analyst, Enterprise Print & Distribution

Job not on LinkedIn

🔥 3 minutes ago

🇺🇸 United States – Remote

💵 $62.6k - $104.3k / year

⏰ Full Time

🟠 Senior

🧐 Analyst

👻 Ghost score 0%

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The Cigna Group

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1982

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Healthcare • Healthcare Insurance • Pharmaceuticals

The Cigna Group is a global health company committed to improving the health and vitality of its clients, customers, and patients. With its two divisions, Cigna Healthcare and Evernorth Health Services, the company focuses on enhancing quality of life through healthcare services and pharmacy benefits management. The Cigna Group is dedicated to ethical practices in healthcare and artificial intelligence, and strives to create positive change in the healthcare system. It also emphasizes its Environmental, Social, and Governance (ESG) responsibilities, aiming to impact health equity and foster innovation in healthcare delivery.

📋 Description

• Lead and manage resolution of complex issues involving multiple clients and customers reported to the Pharmacy Reliability team • Triage, research, and resolve single-member issues requiring escalation support from business partners • Assess complex client issues using Pharmacy benefit design knowledge, including cost, contractual, and legal implications • Summarize issues and impacts, identify stakeholders, and communicate results • Partner with Customer Service, Claims, Client Implementation & Service, and PBM vendors to ensure timely and accurate reimbursement • Identify barriers and escalate issues to engage appropriate business units and stakeholders • Improve processes, products, and services using best practices • Identify root causes and determine preventive measures for Client Service Issues • Develop partnerships across Pharmacy Operations and coordinate efforts to achieve goals • Calculate impacts to clients, customers, and pharmacies using internal and external claims reports • Submit impact documentation to matrix partners for financial remediation • Maintain and update issue-tracking tickets in SharePoint • Manage and coordinate remediation funding, including DMRs, P&L, and E&O • Provide executive-level communications for escalated issues • Analyze complex inquiries and determine the appropriate technical area or vendor for resolution

🎯 Requirements

• High School Degree or GED required • Bachelor’s degree preferred • 3+ years’ relevant experience in a Pharmacy Benefit Management (PBM) related role required • Working knowledge of internal Cigna systems, including ePro, BPL, and CIT preferred • Expert level understanding of Pharmacy operations • Financial acumen and claim processing knowledge required • Strong analytical skills to assess and understand financial impacts • Strong decision-making skills • Ability to facilitate issue/impact analysis discussions and explain complex topics simply • Proficient technical skills with MS Excel, including formulas and pivots • Strong critical thinking, resolving, and negotiating skills • Experience applying logical problem-solving methodologies such as Six Sigma or Total Quality • Ability to navigate ambiguous scenarios involving multiple organizational areas • Demonstrated issue management and organizational skills • Ability to plan for both long- and short-term priorities • Detail-oriented ability to prioritize multiple tasks and adjust work to meet service standards • Ability to work independently with little supervision • For home working, cable broadband or fiber optic internet service with at least 10 Mbps download and 5 Mbps upload required

🏖️ Benefits

• Annual bonus plan eligibility • Medical insurance • Vision insurance • Dental insurance • Well-being and behavioral health programs • 401(k) • Company-paid life insurance • Tuition reimbursement • Minimum of 18 days of paid time off per year • Paid holidays • Leaves of absence • Remote work arrangement