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Cigna Medicare Population Health Operations Clinical Vendor Oversight Case Management Senior Analyst

4 months ago

Nashville, Tennessee, United States The Cigna Group Full time
The job profile for this position is Case Management 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 right for you, we encourage you to apply

Our people make all the difference in our success.

Provides expert content/professional leadership on complex Clinical Program Management assignments/projects. Exercises considerable creativity, foresight, and judgment in conceiving, planning, and delivering initiatives. Uses deep professional knowledge and acumen to advise functional leaders. Focuses on providing thought leadership within Clinical Program Management but works on broader projects, which require understanding of wider business. Recognized internally as a subject matter expert.

Represents company externally and serves as conduit to educate and enable care coordination between stakeholders resulting in an optimal healthcare experience and customer satisfaction. Serves as clinical advisor to the sales organization, providing ongoing product and industry knowledge/education that positively influence cost, quality and customer satisfaction. Registered Nurse with a current active licensure and clinical practice experience. Skilled in working with Microsoft Office. Ie: Excel, PowerPoint, etc.

Also, serves as initial contact for clients and their eligible dependents requesting services related to assigned clinical programs. Responsible for customer service and relevant standards such as telephone response time. May make referrals within stated limits. Supports and assists with training for employees. May provide guidance around procedures and workflows. Completes day-to-day tasks without immediate supervision but has ready access to advice from more experienced team members. Tasks involve a degree of forward planning and anticipation of needs/issues. Resolves non-routine issues escalated from more junior team members.

Responsibilities:

  • Day to day management of assigned clinical programs
  • Serves as SME for assigned clinical programs
  • Point of contact/liaison with our internal and external partners for assigned clinical programs to remediate questions and issues
  • Weekly report related to status of assigned clinical programs
  • Reviewing, opening and closing of referrals to clinical programs as needed
  • Monitoring vendor mailbox
  • Responsible for managing all reports related to assigned clinical programs
  • Management of internal & external referrals for assigned markets
  • Providing training to other internal teams about clinical programs as needed/requested

Requirements:

  • Active RN License
  • Minimum 2 years experience

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.