Operating Effectiveness Lead Analyst - eviCore - Remote

Want to improve the health and vitality of those we serve? EviCore, a line of Business within the Cigna Group is hiring an Operating Effectiveness Lead Analyst. In this leadership role, you’ll be the point person and subject matter expert providing concierge level, expert guidance to our providers to ensure that their unpaid claims are remediated.

What you’ll do to make a difference:

• Assists program leadership with providing leadership, oversight, and accountability for Claims program operations

• Manage and track all issues from first report to resolution, while coordinating across departments

• Maintains and improves operational performance of program in terms of efficacy for the client and efficiency for eviCore by monitoring and improving workflows

• Collects and analyzes process data to initiate, develop and recommend business practices and procedures that focus on enhanced safety, increased productivity, and reduced cost

• You’ll serve as a claim’s liaison between internal eviCore team and external providers/clients

• Attend provider JOCs and provides proactive updates and deliverables

• Develops clear communication plan and issue/action item tracking

• Position works cross-functionally with client services, IT, compliance, program leads, provider and health plan operations, and implementation teams

• Exercises judgment in the evaluation, selection, and adaptation of both standard and complex techniques and procedures

• Solves complex problems; Supports and provides direction to more junior professionals. Works autonomously, only requiring “expert” level technical support from others.

• Analyzes and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements

• Research best business practices within and outside the organization to establish benchmark data

• Utilizes in-depth professional knowledge and acumen to develop models and procedures, and monitor trends, within Operating Effectiveness

Requirements:

• High school diploma or GED required; bachelor’s degree preferred

• 3+ years of experience leading process and quality improvement initiatives including driving the design and deployment of solutions, strongly preferred

• 3+ years of experience in two or more of the following areas: project management, operations management, health services and managed care, medical claims operations, healthcare economics, or management consulting, strongly preferred

• 3+ years of experience assessing operational risks for enhancements, projects, and integrations, strongly preferred

• 3+ years of experience leading, coordinating and collaborate across multiple levels and departments of an organization to execute on key projects and initiatives, required

• 3+ years of experience in Workflow and standards documentation, required

• Proficient in Microsoft Office Suite; PowerPoint, Excel, Word, Visio, and Project, required

• Proficiency in Smartsheet’s and SQL, preferred

• Excellent verbal and …