Jobs in Cigna Dental

 

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About Company:

Cigna is more than a health insurance company. Cigna is your partner in total health and wellness. And we’re here for you 24/7 – caring for your body and mind.

As a global health service company, Cigna’s mission is to improve the health, well-being, and peace of mind of those we serve by making health care simple, affordable, and predictable.

• We make it easy to get care – letting you choose how, when, and where you want it.
• We make health care more affordable by partnering with providers who provide quality, cost-effective care.
• Our goal is to provide you with comprehensive health care coverage with “no surprises.”

 

 

 

 

Career in Cigna:

 

Actuarial Associate – Work From Home

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About Careers:

Provides expert analysis and professional leadership on complex Actuarial assignments/projects. Prepares actuarial analyses of rating factors, premium rate values, claim reserves, profitability estimates. Works with actuarial management to communicate results of actuarial research and influence business strategy. Has thorough knowledge of actuarial statistics and assumptions used for modeling cost, risk and revenue trends. Very skilled in the use of PC spreadsheet applications. Exercises considerable creativity, foresight, and judgment in conceiving, planning, and delivering initiatives. Uses deep professional knowledge and acumen to advise functional leaders. Recognized internally as a subject matter expert.

 

Locations    :

• Austin, Texas, United States of America
• Bloomfield, Connecticut, United States of America
• Denver, Colorado, United States of America
• Nashville, Tennessee, United States of America
• Philadelphia, Pennsylvania, United States of America

 

 

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LPN/LVN Case Management Analyst (Specialty Care Options)

 

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Location: Work from Home, Anywhere, USA

 

About Career:

Assists/collaborates with RN Case Manager on customers that require specialty drug redirection to meet an individual’s healthcare needs. Through communication and available resources, the LPN will complete administrative medical duties such as outreaching/collaborating with MD offices, confirming sites of care have all clinical information needed, authorization entry, medical cost savings details, and limited customer/patient outreach. Using available internal resources and through collaboration with Medical Directors, the LPN will assist in network adequacy reviews for medical specialty drugs.

This position services calls in a warm and empathetic manner as the calls can be sensitive in nature. Problem solving skills are critical to success within the role along with intelligent judgment of assessing the caller’s needs and collaborating with the RN for direction and intervention as necessary. Based upon the call type and requests, the LPN should be able to use customer service skills, knowledge of the specialty pharmacy processes and Cigna training to effectively address caller’s needs and/or issues/concerns. Incumbents will utilize telephonic communication, web based documentation and resources, and internal materials to assist in achieving successful redirection and coordination.  Collaboration and regular communication with the customer, prescriber, and alternate site of care is critical to ensure timely coordination of redirection and customer needs.  Time management skills are crucial.

 

Requirements:

• Graduate of approved LPN/LVN program
• An uninhibited Licensed Practical Nurse/Licensed Vocational Nurse (LPN/LVN) License in respective state

 

Preferred Requirements:

• Excellent time management, organizational, research, analytical, and interpersonal skills.
• Ability to communicate needs effectively to RN Case Manager, physicians’ offices, and interdisciplinary team members
• Ability to meet deadlines, promote team concepts, manage multiple priorities, and effectively adapt and respond to complex, fast-paced, rapidly growing, and results-oriented environments
• Ability to adapt to new workflows and tasks quickly
• Knowledge of the insurance industry and knowledge of claims processing and specialty pharmacy
• Effective listening and organizational skills
• Ability to manage multiple tasks, setting priorities where needed
• Ability to work independently, problem solve, and function without constant supervision
• Prior experience in managed care/healthcare environment ideal.
• Excellent typing/computer skills with the ability to learn new computer software systems
• Strong telephonic communication skills
• Working knowledge of Cigna prior authorization an medical management systems

 

Responsibilities:

• Establishes a collaborative relationship with the customer, physician(s), and other providers to coordinate care
• Documents findings in a clear concise manner
• Acts as a liaison with the account, client/family, physician(s), internal and external matrix partners, and facilities/agencies.
• Maintains accurate record (system) of interventions including cost/benefit analysis, savings, and data collection. Adheres to quality assurance standards and all case management policy and procedures.
• Interacts with Medical Directors as needed in collaboration with RN Case Manager
• Demonstrates evidence of continuing education, minimally 1 per quarter to maintain clinical expertise.
• The LPN interacts with Care Associates, benefit specialists, Pharmacy Service Center, Accredo Specialty Pharmacy and claims staff for claim payment direction to ensure correct interpretation of current and future cost of care.
• Assists Sales Account Executive in communicating status and/or resolving issues for service center-based customers, as assigned. Participates on committees, task forces and other company projects, as assigned. Supports training initiatives or audits of case files, as assigned.
• Demonstrates sensitivity to culturally diverse situations, clients and customers.
• Ensures the member’s privacy, confidentiality, and safety are maintained, adheres to ethical and accreditation standards, serves as a member advocate, and adheres to legal and regulatory standards..
• Access the various Cigna systems to obtain requested information such as eligibility, benefits, demographic information, discharge and clinical information, available customer programs.
• Ensures complete an thorough research and documentation in network adequacy reviews for medical specialty drugs
• Any other assigned tasks as deemed necessary to meet business needs.

 

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2. Sales Administration Lead Analyst

 

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Location : Work from home, United States

 

About careers:

The Strategic Partnerships, Retail Events Lead Analyst will implement alternative distribution pipelines through strategic partners that primarily drive Medicare Advantage sales. The Retail Events Lead Analyst role is a dynamic position, with a high degree of independence. This individual will care for relationships with currently affiliated retail partners, manage day-to-day logistics and the operational needs of the Cigna Medicare Advantage Retail Program, while also providing substantial support for Sales.  Additionally, this individual will explore prospective new partners under the guidance of their manager.

 

Excited to grow your career?

We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!

 

Qualification Required:

• Bachelor degree or equivalent, relevant work experience
• Experience in Medicare, preferred
• Strong organizational and time management skills
• Excellent written and oral communication skills
• Strong customer service skills, with dedication to anticipating and exceeding the expectations of business partners
• Attention to detail
• Demonstrated ability to learn quickly
• Experience working with teams across multiple organizations
• Ability to thrive while working independently with limited guidance
• Expertise in Microsoft office products: Excel, Word, PowerPoint, Outlook, well as other software applications, including Salesforce
• Project management skills, preferred

 

Responsibilities:

• The main purpose of this role is to support Medicare Advantage event programs with strategic partners in the retail and community space.
• The work primarily involves the daily operations of the Retail program to drive Medicare enrollment growth, including maintaining retail partner relationships, providing tracking and data analysis, and continually working to improve the program itself. This may require cross-functional work with Marketing, Legal, Compliance, Product, Operations, and other departments, as needed.
• Evolving our ability to track results from the program will be an early focus for this role.
• Success in this role requires flexibility to the changing needs of the program.

 

• Sales and program support
  • Serve as the key point of contact for Sales agents and brokers participating in the retail program
  • Develop special events with Retail partners to add value to our relationship, promote goodwill, raise awareness around senior wellness, and drive Cigna brand recognition in the communities our plans serve
  • Partner with marketing on value propositions and marketing communications for the partner’s employees/customers, as needed, to create audience-specific positioning
  • Partner with operations, as needed, to develop new processes, programs, and tracking
  • Work with vendor management, if needed, to onboard new relationships (regarding technology requirements, payment, etc.)
  • Evaluate and evolve the program over time by reviewing results, obtaining input from key internal partners and by gaining agreement from external partners around desired updates and new paths

 

• Training and Communication
  • Work with appropriate people to ensure training is aligned with the program design.  Supplies SME information and needed documentation to support partner work around the development of the training materials
  • Communicate the strategy, expansion plans and value proposition to necessary partners, including Sales
  • Communicates the program success, challenges and needs to the department and beyond

 

• Partner relationship lead
  • Act as Cigna’s primary point of contact for the partner – for existing relationships and in developing relationships (excepting in categories, such as broker, where a broader overall relationship already exists)
  • Lead discussions with new and established partners around current and upcoming enrollment periods in the Medicare sales cycle to set expectations, provide transparency and maintain our business pipeline
  • With manager guidance, identify the best approach for each partner to maximize relationship potential: where we can provide the most value to our partner, and where partners can provide the most value to Cigna

 

• Strategy
  • Support development of the overall affinity strategy
  • Define retail partner specific approaches that create value for the partner and Cigna through revenue, retention, customer/employee value adds
  • Partner with marketing, sales, product and others to explore new methods of reaching retail partner audiences

 

 

3. LPN/LVN Case Management Analyst – Precertification (Cigna Medicare Clinical Operations)

 

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Location :  Work from Home, Anywhere, USA

 

About Career:

Responsible for collaborating with healthcare providers, members, and business partners, to optimize member benefits, evaluate medical necessity and promote effective use of resources.  Medical necessity reviews may include: planned elective services, surgical and diagnostic procedures, durable medical equipment and out of network services.  Conduct reviews in compliance with medical policy, member eligibility, benefits, and contracts.

 

Responsibilities:

• Responsible for the effective and sufficient support of all Utilization Management activities to include review of inpatient and outpatient medical services for medical necessity and appropriateness of setting according to established policies and compliance guidelines.
• Uses an established set of criteria to evaluates and authorize the medical necessity of services.
• Provide notification of decisions in accordance with compliance guidelines.
• Coordinate with Medical Directors when services do not meet criteria or require additional review.
• Participation in staff meetings, regular trainings and other collaborative meetings as appropriate.
• Works with management team to achieve operational objectives and financial goals.
• Supports teams across UM Department as needed.
• Active participation and completion of all required trainings.
• Maintain Required Licensures.
• Adherence to regulatory and departmental timeframes for review of requests
• Meet/exceed department Turn Around time, daily established productivity goals, and service levels
• Proficient knowledge of policies and procedures, Medicare, HIPPA and NCQA standards;
• Professional demeanor and the ability to work effectively within a team or independently;
• Flexible with the ability to shift priorities when required
• Other duties as required

 

Qualification Required:

• • Current Licensed Practical Nurse LPN or Licensed Vocational Nurse LVN.
  • Minimum 2-3 years clinical experience.
  • Experience in regulated managed care setting preferred
  • Strong Customer orientation
  • Strong organizational, planning, and communication skills
  • Working knowledge of insurance industry, medical coding (CPT/HCPCS/ICD-10), and overall claims process a plus
  • Knowledge of National Coverage Determinations, Local Coverage Determinations and MCG criteria are a plus.
  • Excellent time management skills
  • Work hours: 8:30 am – 5:00 pm

   

  Skills Required:

  • Excellent interpersonal and communications skills with nursing staff, physicians, nurse practitioners and other health workers involved in the care of a member
  • Ability to meet deadlines and manage multiple priorities, and effectively adapt and respond to complex, fast-paced, rapidly growing, and results-oriented environments
  • Able to work in a dynamic, fast-paced team environment and to promote team concepts
  • Excellent typing skills.

 

More Details   >>>     Click here

 

 

Customer Retention Data Lead Analyst

 

Location : Work from home, United States

Salary:      69,500 – 115,800 USD / yearly

 

About Careers:

Cigna is seeking a highly motivated team member with strong data and analytics background to join our Medicare member retention strategy & analytics team. This individual will be an active contributor in high-visibility large-scale projects that drive one of the organization’s top priorities, member retention. This individual will work with retention and customer experience team members as well as various parts of the organization to create the analytics and reporting that drive strategy.

 

Responsibilities:

Exploratory reporting in to retention related issues using multiple data sources.

Program and campaign support and effectiveness analysis.

Creating tools and processes for regular reporting on retention relating to overall organization performance.

Ad hoc analysis to answer specific business questions and generate insights to support decision making.

Development of dashboards to track operational KPIs to provide lead indicators for retention forecasting.

Support the development of retention goals based on analysis of historical trends.

 

Qualification Required:

Bachelor Degree in Finance, Economics, Engineering, Sciences, Math, Statistics, Actuarial Science or a related quantitative field strongly preferred

Strong technical skills required to explore, extract, organize, transpose and analyze large data sets using SQL and/or SAS/R/Python

Ability to build Visualizations using Tableau and/or SAS/R/Python to tell a Data Story

Self-Starter who enjoys problem solving and creating innovative solutions

At least 2 or more years’ of experience in quantitative analytics or business analytics roles (experience with healthcare data preferred)

Strategic thinker with the ability to develop sophisticated quantitative analyses and synthesize the results into implications and communicate recommendations to senior leadership

Excellent communication and presentation skills, capable of shaping messages appropriately for a senior-level audience and proficiency using MS Excel, Word and PowerPoint

 

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4. Knowledge and Training Project Management Lead

 

Location: Work from home, United States

 

About Career:

The Cigna Medicare Sales Performance Improvement Team is seeking a seasoned learning and performance professional with solid knowledge management and project management skills and experience to join our team of learning and performance enthusiasts. This professional will be responsible for planning, executing and supporting knowledge management activities and processes across the sales organization and will collaborate with trainers, instructional designers and vendors to manage the execution of learning projects.

 

Responsibilities:

• Content organization, content mapping (from one format to the other) and content migration (from one system to the other)
• Building taxonomies and ontologies
• Conducting analysis to continuously measure quality and effectiveness
• Identifying and capturing undocumented knowledge
• Exploring innovative opportunities to enhance KM
• Prioritize knowledge gaps based on business impact, urgency and value
• Work with other stakeholders and/or disciplines to streamline workflows and improve business processes associated with knowledge sharing
• Work with Instructional Designers to create content
• Create content as needed
• Develop an in-depth understanding of documentation needs for each sales role/process to ensure that provided content meet the need of the intended audience
• Develop and execute a plan for updating or retiring content on expiring and changing processes
• Manage and maintain the Sales Resource Library on Producers’ University
• Define how the Sales Resource Library complements other KM tools including Cigna Knowledge Library and/or C-KIT
• Liaise with Government Business Knowledge Management teams to apply a methodology and approach that is consistent with the rest of the organization
• Ensure that training projects are completed on schedule

• Collaborate with Instructional Designers and Trainers to manage the execution of training delivery, and development projects and ensure timely and effective completion
• Collaborate with training vendors and/or their project management staff to manage execution of learning projects commissioned by Cigna Medicare Sales Effectiveness
• Develop project plan in consultation with stakeholders, including internal customers, staff and vendors, using appropriate planning tool(s)
• Outline the human and material resources required to successfully complete each project
• Assist SPI manager with formulation of resource allocation strategy

• Leadership: You understand that you are a role model to all of sales and demonstrate leadership and professional poise while coaching, mentoring and developing others
• Charisma: You are highly motivated, charismatic and energetic. You bring excitement and enthusiasm to a room

• Self-Starter: You are a go-getter. You uncover new opportunities that others have not even thought of
• Visionary: You are adventurous, imaginative and a builder. You are not afraid to break new grounds
• Coach: You have demonstrated success in coaching others and are a driver of positivity
• Team player: You work as an integral part of a team that works and wins together. You are articulate, persuasive, and willing to listen to and respect the views of others. You confidently engage with colleagues at all levels to define needs and expectations. You collaborate on projects and communicate results
• Comfortable with change: You are comfortable with the inevitable changes that are brought about as a result of rapid growth and development
• Strategic problem solver: You have excellent critical thinking skills, dive into the details, ask intelligent questions, and think like an end user. You are able to effectively identify varying needs and help bring about training solutions that align with business goals and trainee needs
• Strong and articulate communicator: You are confident, articulate and persuasive and possesses excellent presentation and negotiation skills to move projects and situations forward

 

Qualification Required:

• Proficient in the use of Microsoft Office suite of programs
• Demonstrated experience using Microsoft Project to manage tasks and projects
• Proficient in the use of Microsoft SharePoint and Visio
• Proficient in the use of web conferencing tools such as WebEx and Zoom
• Proficient in the use of online survey tools
• Demonstrated experience using Knowledge Management systems or libraries
• Bachelor’s degree required, Masters in Adult Education or similar field preferred
• 5 or more years of  instructional design and/or classroom facilitation experience
• Recognized professional KM certification
• Strong project management skills
• Ability to manage and balance multiple projects of varying size, complexity and visibility simultaneously
• Ability to work under pressure
• Detail oriented, with proven time management and organization skills
• Comfortable with raising questions, issues, ideas or suggestions to co-workers of all levels across the organization
• Knowledge of Instructional Design Models, especially ADDIE
• Excellent presentation skills
• Strong critical thinking skills
• Strong business acumen
• Strong interpersonal skills

 

Preferred Qualification:

• Knowledge of health care
• Experience working in a sales organization
• Project management certification
• Experience liaising with business groups to drive consensus on approach to project activities

 

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5. Medicare Sales Integrity Operational Risk Lead Analyst

 

Location:  Work from home, United States

About Career:

The Cigna Medicare Sales Integrity Operational Risk Lead Analyst will participate in sales operational processes which includes risk assessment, risk decision making, and implementation of risk controls, which results in acceptance, mitigation, or avoidance of risk. This individual will perform sales oversight in connection with First Downstream Related entities (FDR) to ensure all Federal and State regulatory guidance along with Cigna business requirements are met. The Sales Integrity Operational Risk Lead Analyst needs to work in partnership across multiple enterprise functional areas as well.

This individual will support strategies aligned to Cigna Government Business focus areas: achieve customer growth goals, develop/deliver affordable solutions, build strong and diverse teams in an inclusion environment, and partner effectively across the enterprise to create value.

Achievements are dependent on successfully partnering with multiple constituents, which include enterprise teams (including but not limited to Compliance, Legal, Privacy, Sales Effectiveness, and Sales Ops) and sales teams. This is accomplished by maintaining relationships along with implementing best practices to facilitate best solutions to optimize sales processes while remaining compliant to regulations.

 

Responsibilities:

• Reports to the FDR Oversight Manager who has responsibility for overseeing FDR Oversight functions within the Sales and Marketing Integrity department
• Work independently on complex issues related to Cigna business requirements and Federal/State regulatory guidelines related to FDRs.
• Serve as external liaison between Sales FDR delegates, Sales operations, Cigna Legal, Cigna Compliance Department and other Cigna Matrix partners as appropriate.
• Maintain professional knowledge of state and federal regulatory guidance, primarily  the Medicare Communication and Marketing Guidelines to utilize in all functions, processes, and communications with FDR partners
• Ensure Cigna and FDR compliance with Medicare’s Sales and Marketing rules and regulations;
• Ensure Medicare Sales and Marketing regulations are communicated timely and in a clear and concise manner;
• Facilitate the FDR’s understanding of State and Federal regulatory guidance along with Cigna business requirements.
• Collaborate with the business and FDRs to develop process changes that comply with State and Federal Regulatory changes.
• Serve as a point of contact for Cigna employees (e.g. account managers) and FDRs to seek clarification on regulations or to report any noted compliance issues or irregularities;
• Supporting role in administrating the Sales Integrity Oversight Program.
• Maintain collaborative working relationships with internal and external parties to ensure open lines of communications and timely responses related to Sales oversight and operational questions;
• Assist in the management of Corrective Action Plans (CAPs) for CMS related issues;
• Partner with Sales Internal Monitoring and Audit unit on monitoring activities of FDRs to ensure adherence to FDR oversight program and CMS audit readiness.
• Partner with Sales Developmental Action Committee and participate in meetings when appropriate to determine remediation and communications to the FDRs.
• Partner with Business Analytics on tracking and trending of FDR data for monitoring and reporting efforts.
• Effect changes that result in increased efficiency and improved quality in collaborative and Influential role with sales business partners and FDRs;
• Performs other duties as assigned by Sales Integrity Leadership
• Remain aware of industry changes and/or trends.
• Serve as FDR subject matter expert providing consultative advice to FDR partners to effectively support their business.
• Analyze statistical data and reports to identify and determine  compliance related issues with FDRs
• Cultivate a customer-centric atmosphere that is open to and builds upon new ideas and solutions.
• Understand Cigna Medicare sales and operations in order to push for growth initiatives and business objectives.
• Support process improvement projects as needed to champion Sales Integrity.
• Provide regular report-out of status, trends, and potential opportunities.
• Raise concerns/issues to ensure they are properly addressed in a timely manner.
• Look for alternatives instead of simply saying “no” to ensure win-win across all parties.
• Respond to inquiries, using independent judgment and funneling issues to appropriate teams as needed.
• Remain compliant with all company and governmental policies, procedures, and regulations.
• Conduct constructive dialogue with others in an inclusive manner, ensuring diverse perspectives are considered to drive innovation.

 

Qualification Required:

• BA/BS degree or equivalent work experience
• Must be an experienced manager or expert contributor.
• 1 or more years of compliance/regulatory experience or other relevant work experience preferred
• Medicare experience preferred with an understanding of FDR and MCMG requirements
• Ability to work independently and within a team environment.
• Attention to detail.
• Experience in account management and sales operations strategies preferred
• Strong computer skills required (Microsoft Office Suite products preferred)
• Excellent analytical and problem solving skills preferred with the ability to identify and resolve issues
• Excellent listening, written and verbal communication skills preferred
• Background in Managed Care Insurance is highly preferred.
• Background in Managed Care Insurance Sales and Marketing preferred.
• Must handle conflict management well.
• Ability to problem solve and work under tight deadlines with minimal supervision.
• Strong interpersonal and prioritization skills
• Sales and/or training experience recommended
• Adaptable, flexible, and able to manage through change in a fast-paced environment
• Goal oriented, resourceful, personally accountable and self-directed
• Ability to effectively collaborate across the organization
• Process-oriented with organization and planning skills among competing responsibilities and tasks
• Proactively seek opportunities for improvement
• Strong presentation skills and ability to speak to different audiences

 

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