Serve as a member of the Enterprise Operations team who successfully implements and services new and renewing pharmacy clients. The Member of the Enterprise Operations team is a client facing department within the Pharmacy Benefit and Clinical Services organization that will clarify client intent regarding technical business requirements, execute the client specific technical strategy, manage and execute client data file onboarding operations and file analyses, facilitate reporting and communica... more details
Please note: This hybrid role will require the incumbent candidate to come into a local Cigna office 3 full days per week. The incumbent candidate can be based out of the Bloomfield, CT, Scottsdale, AZ, Glendale, CA, Denver, CO, Washington, DC, Sunrise, FL, Chicago, IL, Baltimore, MD, Bloomington, MN, Morris Plains, NJ, Morristown, NJ, Philadelpha, PA, Chattanooga, TN, Tampa, FLor Plano, TX office.
Role Summary:
Serve as a member of the Enterprise Operations team who successfully implements and services new and renewing pharmacy clients. The Member of the Enterprise Operations team is a client facing department within the Pharmacy Benefit and Clinical Services organization that will clarify client intent regarding technical business requirements, execute the client specific technical strategy, manage and execute client data file onboarding operations and file analyses, facilitate reporting and communications, gather specific client technical requirements, map client specific technical requirements in standard, as well as custom file layouts, and translate client specific technical requirements into Cigna operating systems.
This position will serve as the technical liaison between the client and Cigna Enterprise Operations and Pharmacy IT and be responsible for defining client technical requirements to bridge existing client and customer utilization history as part of the new client installation process. This person will be responsible for developing relationships with external clients and customers, as well as internal matrix partners, inside and outside of Cigna Enterprise Operations. Member of the Enterprise Operations will act as the central point of contact for client technical issues and resolution across all clients for all segments of business.
Responsibilities:
Client/Customer Centricity:
Interface with clients to define technical requirements for client implementations and provide overall support for all client technical requirements.
Onboard clients’ transactional data files to facilitate on-going claims adjudication and continuation of care.
Manage new clients’ file and disruption analyses and reporting to facilitate clients’ decisions around member communications and plan/clinical edit overrides.
Support reporting needs for Pharmacy Implementation Managers
Provide leadership using in-depth knowledge of platforms and experience in health care to translate custom business needs into project/systems specifications.
Fully support all aspects of new client system implementations from initial analysis, requirements definition and design through data transfers and file loads to certification, testing, and post-implementation support
Ensure client retention through supporting the client relationships and effectively managing customer issues.
Obtain a positive Cigna client reference for all clients implemented on the success of the implementation deliverable.
Support Cigna Sales strategies by becoming a trusted advisor and providing consultative services regarding operations to Sales and Pharmacy Benefits Advisory Board teams.
Create technical solutions that support the Client Implementation team as they address client issues, risk points and customer requirements.
Operations:
Manage the gathering and interpretation of technical requirements into efficient executable artifacts and drive scalable solutions through the complete software development lifecycle.
Partner with other stakeholders to streamline a corporate process for prioritizing and managing systems service and corrective action requests to improve first pass rate for systemic designs and implementations.
Estimate technical process scope and costs, manage process execution, and coordinate quality assurance and ongoing service support.
Establish economies of repetitive processes to achieve improved efficiencies and effectiveness of new client installations and support services for existing clients.
Improve quality of new pharmacy client implementations by providing input for creating comprehensive technical implementation Standard Operating Procedures
Create, facilitate, and report on all technical implementation metrics including, but not limited to effective date implementation, technical file load submission dates, client implementation survey scores, 100% referenceable clients, and reduction of implementation set-up Reliability tickets.
Develop/design and pull data for dashboard and operational reporting to help answer business/client-specific questions and metrics.
Adhere to Client Service & Operations organizational policies and procedures.
Develop processes and streamline operations to ensure optimal productivity by team, as well as ensure client and customer centricity.
Required Technical Skills:
Intermediate to advanced proficiency in Microsoft Office applications, especially Excel and Access, required.
Intermediate to advanced data analysis and reporting skills managing data files required.
Proficiency with SharePoint tools required.
Ability to understand and map both standard and custom file layouts (e.g., External Claims History Load, Prior Authorization Load (PA), Open Refill File/Tape Load (ORT), Accumulators) required.
Must be a good listener, fast learner and team player.
Qualifications:
Bachelor’s degree or 4 years of relevant work experience required. MBA preferred.
Pharmacy Benefit Management (PBM) or Healthcare implementation operations experience required.
Demonstrated ability to make decisions in a production environment with the ability to gather/synthesize information quickly, assess options, and recommend/implement solutions.
Experience within a high-volume production environment in measuring both productivity and quality are essential.
Highly organized with demonstrated ability to manage multiple priorities and execute tasks with strict timelines. Demonstrated experience in planning, coordinating and tracking multi-functional activities.
Excellent communication and interpersonal skills in order to work effectively with matrix business partners, clients and senior leaders, strong presentations skills to both clients and executive leadership.
Demonstrated ability to work under pressure and take initiative while working autonomously.
Ability to travel up to 25%
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 78,300 - 130,500 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com 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.
