As part of the Network Strategy & Solutions leadership team, this role will be responsible for the redesign of our Prior Authorization, Utilization Management (UM), and Electronic Medical Record (EMR) solutions. This leader will work with matrix partners in the Clinical organization to evolve our UM programs and management processes. This role also has accountability for the financial performance of our UM programs, which will require a balancing of benefits (e.g. Affordability and clinical outcomes) vs. cost (e.g. OPEX, client/customer abrasion, etc.). The execution of the newly established strategy will require close partnership with the product and pricing teams to determine go to market implications.
This role will also be responsible for our EMR roadmap, investment, delivery, and provider recruitment. The individual will be responsible for working directly with providers to establish EMR connectivity across numerous use cases, including UM. The role will build out a multi-year roadmap and investment choices with the expectation of growing connections with EPIC as well as other EMRs. Tied directly to EMR integration, the individual will establish our gold carding strategy, which will include identification, monitoring, incentives, etc. to ensure we are maximizing outcomes for our clients and customers.
Primary responsibilities include:
Leadership Responsibilities
Qualifications:
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 177,400 – 295,600 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 and long term incentive 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 Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
Apply
To help us track our recruitment effort, please indicate in your cover/motivation letter where (jobsinusa.pro) you saw this job posting.
Company Description This is a fully remote position. Candidate must be based in the Philadelphia, PA…
Ceco Concrete Construction is the nation’s largest concrete subcontractor. Ceco was founded in 1912 and has…
Location Address: 910 Back Road, Berwick, Pennsylvania 18603 Work Shift: 8hr-1st Shift (United States of…
Overview Filtration Group is on a mission to make the world safer, healthier and more…
Ceco Concrete Construction is the nation’s largest concrete subcontractor. Ceco was founded in 1912 and has…
Connecticut Children’s is the only health system in Connecticut that is 100% dedicated to children.…
This website uses cookies.