Provider Relations Analyst

3 weeks ago

Memphis, Tennessee, United States The Cigna Group Full time

Ready to improve the health and vitality of those we serve? Accredo, a business line within The Cigna Group, is hiring several Provider Relations Analysts. You'll be responsible for promoting our Specialty Pharmacy Services to; Physicians, Nurses, Social Workers, Office Managers, and Case Managers. You'll be the Single point of contact for our clients that will assist existing and new patient accounts with questions or escalations regarding referrals, order status, prior authorizations, clinical summary reports, and assist with triaging and resolving order processing issues while maintaining HIPPA regulations.

What you'll do to make a difference:

  • Serves as the main point of contact to assigned physician offices providing the highest level of service via phone calls and written inquiries
  • Ensures physician requests are processed in a timely manner and to the satisfaction of the physicians
  • Provides information to clients, participants, pharmacists and doctors regarding participants pharmacy benefit, drug coverage and provide accurate procedures for medication exceptions
  • Act as liaison service to other Accredo departments
  • Responsible for managing day to day activities for assigned region, including, working cross functionally with internal partners and stakeholders (i.e. pharmacy, patient access, sales), fostering and developing prescriber and their office staff relationships, and interfacing with payer when necessary
  • Distributes work requests to team members and monitors for completion
  • Processes prior Authorization requests, new referrals and answers general questions
  • Follows prescription order from beginning of process to the end of processing
  • Leads the development and creation of customized scheduled reports for prescribers in assigned region and maintains reports
  • Educates physicians on Portal options
  • Upon request, will travel to assigned territory and collaborate with field sales force to provide general program information and concierge service
  • Work closely with the Pharmacy Sales Team
  • Provide information to clients, participants, pharmacists and doctors regarding pharmacy benefit, drug coverage and provide accurate procedures for medication exceptions

What you need to be successful:

  • High school diploma or GED, required, bachelor's degree preferred
  • 3+ years of experience with Accredo Specialty Pharmacy products and services, strongly preferred
  • 3+ years of experience with Pharmacy processes, required
  • Strong PC skills including Microsoft Office products, (Excel, Word, Outlook, PowerPoint) and website navigation, required
  • Excellent verbal and written communication and presentation, required
  • Strong analytical and problem-solving skills, required
  • Ability to multi-task, resolution focused, ability to manage timelines and meet tight deadlines required
  • Ability to work cross functionally to resolve patient issues, required
  • Strong focus on customer service, collaboration with others and relationship building, required
  • 10 % Travel may be required (local & overnight)

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.

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. 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: for support. Do not email 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.

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