Medicare Issue Management Senior Advisor - Cigna Healthcare - Remote (cigna)

Job Description

The Medicare Issue Manager is responsible

for leading and managing cross-functional issue resolution through the issue management process for all operational related matters including those with compliance implications.  This role is expected to understand the needs of various business functions, coordinate highly matrixed challenges, and influence solutions.  This individual must be an accomplished communicator leading cross-functional meetings which drive root cause identification and timely remediation that includes management controls to limit recurrence.  Provide strategic partnership in analytics, to identify and prioritize opportunities for improvement, and to support decision making and execution based on data and analytical findings across the segment. 

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Own the end-to-end cross-functional issue management and resolution process and be accountable for timely issue remediation and/or challenge and risk escalations to Senior Leadership.
• Collaborate with upstream and downstream business partners to identify the key stakeholders within the process necessary to drive remediation.
• Collaborate with cross-functional business partners to identify the problem, outline the root cause, and develop plans for action to eliminate and remediate issue.
• Coordinate high priority P2 communications regarding issues among cross-functional teams ensuring that all communications are consistent with content and distributions.
• Utilize system platform to manage issues and accurately capture/categorize all necessary trend information.
• Review submitted data for quality and accuracy.
• Champion and implement process improvements to improve turn-around time on issue identification and resolution.
• Assist in training, documentation, and other duties required to sustain and improve process performance.
• Facilitate escalated and complex issues.
• Ensure all necessary parties are informed of issue status.
• Develop collaborative partnerships with business operations and leadership, providing value-added perspective, insights, guidance, and tools. 
• Apply an agile approach to all engagements, constantly assessing and refining efforts as new information and/or requirements come to light.
• Support weekend coverage for Managed Incidents on rotating basis.

QUALIFICATIONS, EDUCATION and/or EXPERIENCE

• Is certified in and/or has at least 5 years of experience with concepts and tools associated with Incident Management, Project Management, Change Management, and Process Engineering/ Process Improvement /Lean Six Sigma
• High School Diploma required, higher level education preferred
• 5+ years of experience in Medicare/Medicaid experience strongly preferred, including a strong comprehension of basic regulatory requirements.
• Strongly prefer a candidate with experience with FACETS and/or Symplr
• Strongly prefer a candidate with experience with ServiceNow
• The position requires proficiency Microsoft Office (Word, Excel, PowerPoint, and Outlook.)
• Is an effective communicator, proficient in both verbal and written communications. (E.g., email, PowerPoint).
• Is highly experienced in facilitating meetings, as well as in engaging 1:1 with individuals at all levels of the organization.
• Is a skilled influencer in the absence of direct reporting relationships.
• Is “organizationally agile”, able to independently seek out and make connections with individuals on operational, management and executive levels. Readily leverages those connections to further Audit Readiness outcomes.
• Is highly independent, demonstrating an ability to identify and pursue opportunities that align with the enterprise strategy.
• Has extensive experience with data collection, analysis, interpretation, application and reporting.

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 109,600 - 182,600 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 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.