- The Cigna Group (Bloomfield, CT)
- …goals, and service levels + Proficient knowledge of policies and procedures, Medicare , HIPPA and NCQA standards; + Professional demeanor and the ability to ... a regulated environment preferred + Minimum of 2+ years clinical experience + Strong customer orientation + Strong organizational,...details on our employee benefits programs, visit Life at Cigna Group . **About Cigna Healthcare** … more
- The Cigna Group (Bloomfield, CT)
- …member of the clinical senior leadership team, the Chief of Staff for the Medicare Clinical Strategy team will report directly to the Vice President (VP) and ... Chief Medical Officer for Cigna Medicare (CMO), and will be responsible...role will assist in the management process for the Clinical Quality, Strategy and Solutions leadership team, including facilitating… more
- The Cigna Group (Bloomfield, CT)
- …initiatives and demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate. Demonstrates sensitivity to culturally ... States. Compact RN license a plus. Two years full-time equivalent of direct clinical care to the consumer. Ideal candidate would have previous case management… more
- The Cigna Group (Bloomfield, CT)
- …and sophisticated value-based reimbursements with hospitals and other providers for Cigna 's Medicare product lines (eg, Hospital systems, ancillaries, and ... This job posting encompasses two **Regional Medicare ** **Provider Contracting Senior Managers** serves as an...but not limited to, local market provider engagement, claims operations , clinical , Legal, analytics, compliance, sales, and… more
- The Cigna Group (Bloomfield, CT)
- …and sophisticated value-based reimbursements with hospitals and other providers for Cigna 's Medicare product lines (eg, Hospital systems, Ancillaries, and ... with matrix partners including but not limited to, Claims Operations , Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and… more
- The Cigna Group (Bloomfield, CT)
- …and this position involves extensive interaction with PPE staff as well as other Cigna Medicare departments. Position is exposed to all aspects of a Coordinated ... Pima County based - Medicare Provider Performance Enablement (PPE) Senior Analyst provides...providers, provider staff, and/or physician leadership. + Manage joint operations committee (JOC) meetings. This includes: formulating meeting agenda,… more
- The Cigna Group (Atlanta, GA)
- …a cross-functional, collaborative organization (which includes Market Provider Performance, Sales, Clinical Operations , Stars & Risk Adjustment, Finance , ... Relations, and Network Development & Solutions). Reporting to the Network Operations Senior Manager or Director, this individual ensures the effective performance… more
- The Cigna Group (Maitland, FL)
- …organization (which includes Market Provider Performance, Sales, Health Services, Clinical , Stars & Risk Adjustment, Finance, Marketing, Cross-Segment Contracting, ... + All market team members contribute to the growth and profitability of the Medicare Advantage (MA) business in their market in the following aspects: + Growing the… more
- The Cigna Group (Bloomfield, CT)
- …This hybrid role will require the incumbent candidate to come into a local Cigna office 3 days per week.** The **Provider Network Contractor** serves as an integral ... with matrix partners including but not limited to, Claims Operations , Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and… more
- The Cigna Group (Nashville, TN)
- …objectives and financial goals. + Supports teams across CM Department and throughout Clinical Operations as needed. + Active participation and completion of all ... and management of medical cases + Proficient knowledge of policies and procedures, Medicare , HIPAA and NCQA standards + Professional demeanor and the ability to work… more
- The Cigna Group (Bloomfield, CT)
- …Experience with Medicare Advantage - Supplemental Benefits, CMS guidelines, FDR Operations , Clinical Programs, STARS ratings, etc. + A broad, enterprise-wide ... This is a ** Medicare Advantage position** WORK LOCATION: REMOTE position The...Provider Contracting Senior Advisor** is a critical contributor to Cigna 's enterprise quality and affordability initiatives. The National Ancillary… more
- The Cigna Group (Plano, TX)
- …for fee for service and sophisticated value-based reimbursements with providers for Cigna 's Medicare product lines (eg, Hospital systems, Ancillaries, and large ... in Houston, San Antonio, Dallas or Plano** The **Director, Provider Contracting - Medicare ** serves as an integral member of the Network Development and Strategy… more
- The Cigna Group (Bloomfield, CT)
- … experience in acute setting for 2 or more years. + Experience with Medicare Advantage clinical reviews for claims, disputes or appeals. + Experience with ... **Major Job Responsibilities** + Responsible for leveraging clinical and/or coding experience and perform facility and provider medical record reviews in support the… more
- The Cigna Group (Nashville, TN)
- …groups. In addition, this person will be responsible to identify opportunities for our clinical partners to work with our providers to meet our goal of reducing ... of data used to analyze trends + Deliver monthly analytics packages to Network Operations , Finance and other business partners + Create reports and other tools to… more
- The Cigna Group (Birmingham, AL)
- …groups. In addition, this person will be responsible to identify opportunities for our clinical partners to work with our providers to meet our goal of reducing ... of data used to analyze trends + Deliver monthly analytics packages to Network Operations , Finance and other business partners + Create reports and other tools to… more
- The Cigna Group (Nashville, TN)
- …explore a wide variety of career paths following the program. **About Managed Care** Cigna Medicare focuses on "managed care." Rather than keeping costs down by ... in any of these business lines. **Why choose The Cigna Group's MCLDP?** + Medicare Advantage is...work in a variety of cross-functional roles, such as operations , strategy, marketing, finance and project management to create… more
- The Cigna Group (Nashville, TN)
- **Job Summary:** The Operations Supervisor is responsible for the daily activities of the Patient Assistance Program (PAP) team which provides a vital service by ... and submitting applications, tracking applications and refills for patient care. The Operations Supervisor will be responsible for a wide variety of business… more
- The Cigna Group (Anaheim, CA)
- …and sophisticated value-based reimbursements with hospitals and other providers for both Cigna 's US Commercial and Medicare product lines (eg, Hospital systems, ... with matrix partners including but not limited to, Claims Operations , Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and… more
- The Cigna Group (Nashville, TN)
- …chronic disease management and palliative care support, as we further extend our operations serving a variety of Medicare Advantage, Medicaid, and Commercial ... decrease unnecessary healthcare cost. We are an interdisciplinary group of clinical professionals that understand the needs of patients, medical professionals,… more
- The Cigna Group (Bloomfield, CT)
- …Expense FP&A Senior Manager will manage projection and results analysis for core Medicare Advantage Part C medical claims expense processed and paid on a ... but not limited to FP&A centralization, Market Finance, Product, Pricing, Reserving, Operations , and external Audit Firms. Given the close partnership between this… more