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Coverage Policy Unit (CPU) Program Management Advisor - Work from home, Chattanooga, Tennessee

CategoryProject Management
Job typeFull Time
CountryUnited States
Remote, Work from home

As a Total Cost of Care (TCC) program management lead of the Coverage Policy Unit (CPU) you will be responsible for TCC proposal development to support enterprise (TCC) savings goals with a focus on coverage, reimbursement, administrative, drugs and biologics policy, prior authorization and clinical code editing. As a CPU TCC program management lead you will partner with clinical, coding, code set, prepay, ClaimsXten Business operations, ClaimsXten IT, Healthplan analytics and other matrix partners across the organization to understand how proposed initiatives work and drive value.

Additional principal functions of this role include: identify key process elements, develop/collect process models, support root cause analysis, create & deploy process performance solutions, and monitor process performance. Lead, coordinate and/or support the deployment of process improvement projects as part of larger strategic initiatives. This role requires flexible and creative thinking and approaches to root cause analysis and problem solving, employing a wide range of methods, tools, and techniques to achieve the strategic objectives of the CPU to achieve optimal cross functional/departmental efficiencies. Responsibilities include leading and delivering on cross operational initiatives, clinical governance analysis and work stream support for TCC and business architecture analysis. Drive development and maintenance of initiative work plans with the ability to monitor progress against goals, timely escalation of barriers to success along with identification of potential solutions and providing concise and timely reporting tailored to appropriate stakeholder audiences.

This role is a hybrid role that will share time between Total Cost of Care (TCC) Program Management and Operating Effectiveness activities - the anticipated split is 50/50

Candidate Responsibilities:
  • Work with teams of internal SMEs, project managers, Affordability Policy Implementation Council/Enterprise Affordability Group (APIC/EAG) leads and others involved in the evaluation and creation of TCC initiatives (with a focus on coverage, reimbursement, administrative, drugs and biologics policy and clinical code editing) to assist in the translation of operating unit strategy into capability needs, driving business processes and IT interfacing, when necessary.
  • Clear grasp of affordability strategy priorities and ability to translate high level strategic imperatives into tactics and design for execution
  • Utilizes established processes and methodologies to define scope, create business requirements and solution designs from a subject matter expertise standpoint on all TCC and other proposed opportunities and initiatives.
  • Document existing processes, practices and measurement systems
  • Provide constant, ongoing communication to ensure barriers/obstacles are removed and necessary support is always provided
  • Establish implementation timelines and controls for all project deliverables.
  • Consult stakeholders to develop and maintain process measurements and controls to monitor current processes and project results.
  • Coordinate and support implementation activities, requirements and deliverables according to implementation vehicle (i.e. ClaimsXten, Prepay, Precertification, Pricing, Benefit classing etc.).
  • Identify and develop relationships within Coverage Policy Unit, Internal customers (organizational units, product, contract, etc.), and IT leadership.
  • Assist in forecasting the business performance with the future state business design and contrast it to the current state
  • Assist in assessing the quantifiable and qualitative benefits that the business can obtain by moving from the current state business design to the future state business design.

  • Bachelor's Degree, or equivalent combination of education and work experience required; PMI Certification or Six Sigma training also valued
  • Strong knowledge of Cigna and Cigna Medicare operations preferred
  • Strong statistical analysis, root cause analysis, solutioning, and implementation skills required; Strong proficiency with excel required, knowledge and understanding of Tableau and Minitab a plus
  • Must be proactive and team oriented with ability to foster collaboration, value others perspectives and gain support and buy-in for organizational proposals
  • Familiarity with project management approaches, tools and phases of the project lifecycle
  • Excellent oral, written presentation and communication skills
  • Ability to lead and influence in a matrixed environment is critical
  • Familiarity with change management tools and techniques
  • Proven track record of delivering results of high quality and sustainability
  • Strong business acumen, with proven ability to leverage knowledge base to quickly come up to speed in new business areas and new types of projects
  • Proven ability to develop strong working relationships and establish a high level of credibility across functional and lines of business and organizational levels

This position is not eligible to be performed in Colorado.

About Cigna

Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. We offer an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products. Together, with our 74,000 employees worldwide, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation.

When you work with Cigna, you'll enjoy meaningful career experiences that enrich people's lives while working together to make the world a healthier place. What difference will you make? To see our culture in action, search #TeamCigna on Instagram.

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.
Employer091 Cigna Health & Life Ins. Co.

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