4 days old

Medicare Part D Operations Risk Sr. Analyst- Work from Home

Cigna
Phoenix, AZ 85003
  • Job Code
    21009559
Role Summary:

This role monitors risks and issues within the Medicare Part D Pharmacy Operations area and assists business owners with effective remediation by logging issue details, keeping track of action plan timeliness, monitoring progress, identifying obstacles, and facilitating cross-functional communications. Working with Compliance partners, this role will ensure remediation is aligned to regulatory requirements. This role will have a special focus on monitoring industry and other downstream business entity communications and processes.

Core Responsibilities:

  • Monitors self-reported items, prepares and maintains risk and issue action plans in reporting tool(s) to ensure complete, accurate and timely information is available to all stakeholders; establishes a cadence of regular update cycles for communication with business partners with clear expectations and timelines on next steps as well as regular updates with Compliance.
  • Works with Pharmacy Operations leaders toward effective root cause identification and remediation; leads and facilitates regular issue tracking meetings with business owners.
  • When root cause of an issue is determined to be outside of the Pharmacy Operations team, this role may assume the ownership of that action plan and will collaborate with the appropriate leaders and cross-functional subject matter experts to triage the issue and assist with driving effective remediation and closure.
  • This role monitors system reliability and outage or performance notifications to identify areas of repeated concern and raises them to leadership for potential action planning.
  • Reconciles issues from multiple work streams to ensure all issues have Compliance visibility and works to ensure non-duplication of issues.
  • Monitors and communicates monthly Compliance Program Effectiveness reporting requirements and performs action planning reconciliation.
  • Assists with projects as directed by Pharmacy Operations management.
  • Develops tools, job aids or other items, as needed, to support risk management processes along with assisting business teams with those items.

Minimum Qualifications:

  • Minimum 3 years pharmacy claims experience and/or Medicare Operations experience
  • Solid understanding of Prescription Benefit Management and Medicare Part D Operational functions
  • Ability to plan, coordinate and drive multiple dozens of tasks and keep clear and concise updates from business owners and Compliance.
  • Ability to analyze business process and identify risks
  • Ability to build collaborative relationships with business, IT and Compliance partners
  • Ability to explain complex issues in a concise manner and understand communication styles for different levels of management or business partner relationships
  • Ability to work independently as a detail- and results-oriented self-starter who is a team player with an ability to achieve build and manage business relationships
  • Ability to deal and manage multiple, diverse priorities with deadlines in an environment that can be fast-paced during peak times
  • Strong working knowledge of Microsoft Excel, Word, Visio, Outlook and SharePoint
  • Process engineering experience preferred
  • CPhT preferred
  • Familiarity with Medicare CPE reporting preferred

This position is not eligible to be performed in Colorado.

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, 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 us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives. What difference will you make?

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.





Posted: 2021-06-09 Expires: 2021-07-08
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Medicare Part D Operations Risk Sr. Analyst- Work from Home

Cigna
Phoenix, AZ 85003

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