FreshRemote.Work

Operation Lead Analyst - Express Scripts - Remote

New Jersey Work at Home

Job Summary:

Delivers specific delegated tasks assigned by a Manager in the Operations Management job family. Identify ways to streamline operational procedures between or within departments. Manages program and project implementation and makes significant contributions to department goals and planning efforts. May assist in business processing, service levels and reporting. Is responsible for preparing and reviewing key statements and document related to Business Operations/Finance Operations or key accounts. May gather results and prepare reporting for distribution to clients. Ensure that production levels and targets are achieved and effective processing controls are in place. Completes day-to-day Business Operations / Finance Operations tasks without immediate supervision, but has ready access to advice from more experienced team members. Tasks involve a degree of forward planning and anticipation of needs/issues. Resolves non-routine issues escalated from more junior team members.

Job Description:

The Operations Lead Analyst completes assigned operational tasks using standard appropriate tools and provides support to client requests under the direction of the Client Benefit Managers and other team members. Responsibilities include handling daily request tracking, researching operational issues and running reports for internal and external clients upon request; providing documentation related to completion of assigned tasks and identifying operational or productivity enhancements. The Operations Lead Analyst will provide project and administrative support to the team and escalate issues, risks, concerns as needed.

ESSENTIAL FUNCTIONS:

· Provide operational support for assigned ESI Markets (Commercial, Medicare, Health Plan, etc.) for going plan changes, new implementations, and renewal activity.

· Review, analyze and verify intent of assigned benefit set-ups as they relate to products and programs. Identify and communicate need for customization to support client benefit requirements; attend client calls/meetings as needed; attend internal validation meetings; run customized and scheduled reports, manage performance guarantee tracking and report distribution for internal/external clients as requested.

· Adhere to all organizational SOPs and Compliance standards; provide subject matter input as it relates to checklists and SOPs.

· Assist with operation input related to new product development; identification, research and resolution of operational issues; provide training and mentoring for new team members, off-shore and contingent employee resources.

· Comply with ESI document and retention requirements.

SCOPE OF JOB

• Develops competence by performing structured work assignments.

• Uses existing procedures to solve routine or standard problems.

• Receives instruction, guidance and directions from others.

• Help support day to day volume & system function within the job family

MINIMUM QUALIFICATIONS:

• High School Diploma required (Bachelor's degree preferred)

• 5 plus years of experience relevant to the healthcare and/or pharmacy benefits manage field required up to 2 years benefit set up knowledge preferred.

• Knowledge of Lean Six Sigma preferred.

• Strong PC skills and knowledge of Microsoft Office Suite and SharePoint, email and Internet preferred.

• Excellent verbal and written communication and presentation skills highly desirable.

• Strong analytical problem solving skills.

• Knowledge of the health care and PBM industry and its products and services.

• Detailed oriented with strong analytical and problem solving skills.

• Ability to manage timelines and meeting tight deadlines.

• Ability to adapt in a dynamic work environment and make independent decisions.

• Good organizational, prioritizing skills and ability to multi-task.

• Strong customer service focus.

• Demonstrated ability to work with other departments/teams to resolve issues

• PC Skills including Microsoft Office and SharePoint

• Independently develop standardized new group benefit design requests in the ESI system.

• Assist with more complex setups or projects as needed.

• Track and report progress to team to ensure deadlines are met.

• Perform verification/QA and system testing before implementation and within contractual timeframe agreements.

· Provide consultative support to internal & external clients by researching & assisting with resolution of benefit design and claims issues.


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 61,200 - 102,000 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 Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. 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.

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