Network Operations Advisor

1 month ago

St Louis, Missouri, United States The Cigna Group Full time
The job profile for this position is Network Operations Advisor, which is a Band 4 Senior Contributor Career Track Role.

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

Our people make all the difference in our success.

POSITION SUMMARY:

The Network Operations Advisor is a newly created position within the pharmacy credentialing team that will be responsible for translating credentialing processes into evolving business requirements that will further progress technology solutions, assisting with application feature prioritization, and understanding any analytical needs across the group. This role will also consult with members of the team to identify opportunities to leverage existing data sources and develop reporting that will allow the team to more efficiently and accurately perform standard tasks, as well as bring new insights to assist with decision-making and process improvement. This role will have responsibility to develop network products and strategy designed to drive margin initiatives as well as anticipate and meet client customization needs. Finally, the role will also focus on improved service to providers through innovative communication and technology functions.

ESSENTIAL FUNCTIONS:

  • Responsible for partnering with the Network Compliance leadership team to transform business operations and process improvements into technology requirements to gain efficiencies within system applications and advance automation efforts
  • Coordinate or participate in cross functional/departmental collaboration with other internal teams, including but not limited to, Network Compliance, Retail Network Operations, Retail Strategy and Contracting, the Pharmacy Special Investigations Unit, and Sales and Account Management in order to develop solutions for strategic business needs
  • Generate credentialing and re-credentialing reports as needed for specific clients to support contractual commitments and compliance audits
  • Identify and act upon opportunities to enhance the provider onboarding and re-credentialing experience by creating solutions to improve team timeliness, efficiency, accuracy, and service.
  • Recognize opportunities to improve on existing communication pathways to support providers through the credentialing and network compliance processes
  • Perform ad hoc analyses and special projects, when needed
  • Research best practices and improvements involving analytics, tools, and process improvement
  • Provide support for questions and issues raised by teammates and internal network partners. Provide answers as quickly as possible, supporting the timeliness of the review or outreach.

IDEAL CANDIDATES WILL HAVE A COMBINATION OF THE FOLLOWING:

  • Bachelor's degree and 2+ years of experience working with relational databases required
  • Knowledge of pharmacy provider networks, contracting and credentialing requirements, network systems, and terminology
  • Pharmacy benefit management experience preferred, including familiarity with the regulatory environment and compliance issues (i.e., URAC accreditation maintenance, credentialing, delegation and oversight standards, etc.)
  • Strong analytical, planning, problem identification and resolution skills required
  • Ability to work in a fast-paced environment and multi-task across multiple deadlines and deliverables, often under uncertain or ambiguous circumstances
  • Excellent communication, organizational, and time management skills essential
  • Comfortable communicating concerns, questions, and risk at all levels of the organization
  • Consistently maintain a positive, helpful, engaged attitude
  • Self-starter that can independently support and resolve issues and conflicts with minimal management oversight
  • Microsoft Office – Advanced Excel skills, including experience with formulas, data analysis, and/or pivot tables; fluent with PowerPoint, Word, etc.
  • Interest in learning SQL and other data related systems preferred.

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.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.

Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.

  • Network Operations Advisor

    1 month ago

    St Louis, Missouri, United States The Cigna Group Full time

    POSITION SUMMARY:The Network Operations Advisor is a newly created position within the pharmacy credentialing team that will be responsible for translating credentialing processes into evolving business requirements that will further progress technology solutions, assisting with application feature prioritization, and understanding any analytical needs...

  • Network Advisor

    3 weeks ago

    St Louis, Missouri, United States The Cigna Group Full time

    The job profile for this position is Account Management (Non-IC) Advisor, which is a Band 4 Senior Contributor Career Track Role.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...

  • Network Advisor

    3 months ago

    St Louis, Missouri, United States The Cigna Group Full time

    POSITION SUMMARY:The Network Advisor is responsible for initiating maintenance and strategy solutions for all Centene Lines of Business. Responsible for the planning, internal coordination, maintenance, and communication of client Network activities and performance for Line of Business initiatives while maintaining key client relationships. Utilizes...

  • Risk and Underwriting Advisor, Retail Network

    1 month ago

    St Louis, Missouri, United States The Cigna Group Full time

    The job profile for this position is Risk & Underwriting Advisor, which is a Band 4 Senior Contributor Career Track Role.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...

  • Network Operations Manager

    22 hours ago

    St Louis, Missouri, United States Chenega MIOS SBU Full time

    Job SummaryWe are seeking a highly skilled Systems Monitoring Engineer to join our team at Chenega MIOS SBU. As a key member of our infrastructure team, you will be responsible for coordinating with network engineers to support the configuration and access of our enterprise infrastructure.Key ResponsibilitiesNetwork Engineering Operations Support: Provide...

  • Risk Management Control Advisor

    5 days ago

    St Louis, Missouri, United States WELLS FARGO BANK Full time

    About this Position:Wells Fargo is seeking a Risk Management Control Advisor to become a part of our Financial Network (FiNet) within the Branch Infrastructure and Operations division as part of Wealth & Investment Management. Discover more about our career areas and lines of business.Key Responsibilities:Engage in discussions regarding policies, procedures,...

  • Risk Management Control Advisor

    1 week ago

    St Louis, Missouri, United States WELLS FARGO BANK Full time

    About this Position:Wells Fargo is seeking a Risk Management Control Advisor to become a vital part of our Financial Network (FiNet) within the Branch Infrastructure and Operations division, contributing to Wealth & Investment Management. Discover more about our career opportunities and business lines.Key Responsibilities:Engage in discussions regarding...

  • Network Operations Senior Analyst

    4 weeks ago

    St Louis, Missouri, United States The Cigna Group Full time

    The job profile for this position is Network Operations Senior Analyst, which is a Band 3 Senior Contributor Career Track Role.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...

  • Client Engagement Advisor

    1 week ago

    St Louis, Missouri, United States Edward Jones Full time

    Position OverviewAt Edward Jones, our clients are at the heart of everything we do. The Service and Operations divisions play a crucial role in ensuring that our clients receive the best possible experience. We advocate for our extensive client base through effective communication, safeguarding against fraud, and managing investment distributions. Our goal...

  • Commission Operations Specialist

    1 week ago

    St Louis, Missouri, United States Larson Network Services, LLC Full time

    The Commission Operations Specialist at Larson Network Services, LLC, is essential in guaranteeing the precise and effective management of commission processes within our company. This role encompasses overseeing and preserving vital policy and client information, inputting and verifying commission statement data, and facilitating the overall commission...

  • Network Operations Senior Analyst

    1 month ago

    St Louis, Missouri, United States The Cigna Group Full time

    The job profile for this position is Network Operations Senior Analyst, which is a Band 3 Senior Contributor Career Track Role.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...

  • Customer Service Operations Manager

    1 week ago

    St Louis, Missouri, United States Seronda Network Full time

    Customer Service Operations Manager at Seronda Network Are you prepared to elevate your professional journey? At Seronda Network, we are in search of dedicated and creative individuals to become part of our vibrant team. Job Type: Full-time Salary: $16 to $19 per hour Job Overview: As a Customer Service Operations Manager at Seronda Network, you will be...

  • Operating Effectiveness Senior Advisor

    3 weeks ago

    St Louis, Missouri, United States The Cigna Group Full time

    The job profile for this position is Operating Effectiveness Senior Advisor, which is a Band 4 Senior Contributor Career Track Role.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...

  • Operating Effectiveness Senior Advisor, PBM Operations

    1 month ago

    St Louis, Missouri, United States The Cigna Group Full time

    The job profile for this position is Operating Effectiveness Senior Advisor, which is a Band 4 Senior Contributor Career Track Role.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...

  • Mortgage Loan Advisors Wanted

    1 week ago

    St Louis, Missouri, United States Ultimate Staffing Full time

    Ultimate Staffing is looking for dedicated Mortgage Loan Advisors to support our client's operations. Location: On-SiteDuration: Long-Term ContractCompensation: $20 - $22/hour (Dependent on Experience)Working Hours: 8am-5pm (Monday to Friday) Key Responsibilities:The Mortgage Loan Advisor will play a crucial role in assisting various channels. This...

  • Operating Effectiveness Senior Advisor, PBM Operations

    1 month ago

    St Louis, Missouri, United States The Cigna Group Full time

    The job profile for this position is Operating Effectiveness Senior Advisor, which is a Band 4 Senior Contributor Career Track Role.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...

  • Senior Financial Advisor

    1 week ago

    St Louis, Missouri, United States Kelly Services, Inc. Full time

    Position OverviewAs a Senior Financial Advisor, you will take charge of all financial operations for the designated site and its associated business. Your responsibilities will encompass:Ownership of Financial Outcomes: You will manage the Profit and Loss (P&L) statements and Balance Sheet results, ensuring financial health and sustainability.Collaboration...

  • Service Advisor Assistant

    1 week ago

    St Louis, Missouri, United States Suntrup Automotive Group Full time

    We are looking for an enthusiastic and customer-oriented individual to become part of our team as a Service Advisor Assistant. This position plays a crucial role in delivering outstanding customer service by greeting service clients upon arrival, gathering essential information, verifying the purpose of their visit, and responsibly driving their vehicles...

  • Senior Financial Advisor

    1 week ago

    St Louis, Missouri, United States Kelly Services, Inc. Full time

    Position OverviewAs a Senior Financial Advisor, you will take charge of all financial operations for the designated site and business unit, ensuring comprehensive management of the Profit and Loss (P&L) and Balance Sheet outcomes.Key ResponsibilitiesStrategic Collaboration: Work closely with site leadership to align financial strategies that enhance...

  • IT Operational Auditor Lead

    1 day ago

    St Louis, Missouri, United States Spectrum Full time

    About the RoleSpectrum is seeking a highly skilled IT Operational Auditor Lead to join our team. As a key member of our internal audit department, you will be responsible for executing operational IT internal audits over infrastructure, applications, and processes with significant exposure to multiple areas of the company and management teams.Key...