Remote, Work from home, St. Louis, MO area.

POSITION SUMMARY

The Network Operations Senior Analyst will assist internal and external business partners in all aspects of Pharmacy operations including: Credentialing, re-credentialing, provider compliance, provider contracting, network support, and day to day pharmacy inquiries. The Sr. Analyst will provide support, strategic direction, and operational oversight, including process improvement, automation, new technology solutions, audit support, adherence to internal process and procedures, and compliance with new and existing regulations.  

ESSENTIAL FUNCTIONS

• Works closely with our Independent providers assisting with day to day operations, including but not limited to: application and credentialing support, Network participation, Network rejects, claims research, and triage.

• Participate in internal and cross functional meetings, assisting with development, design, and testing of our new business applications. 

• Assist with team development, training, and reviewing SOP’s/P&P’s to ensure processes are accurately documented and followed through day to day business interactions. 

• Identify and align business process efficiencies between our teams and cross functional partners

• Focus on process improvement, automation, technology, and cross-functional partnerships to drive change and deliver operational excellence.

• Ensures network providers adhere to and maintains compliance with state and federal regulations.

• Provides support to client and internal audit functions.

• Perform ad hoc analyses and assigned special projects, as needed

QUALIFICATIONS

• Bachelor’s Degree preferred

• Pharmacy benefit management experience preferred, including familiarity with the regulatory environment and compliance issues (i.e., URAC accreditation maintenance, credentialing, delegation and oversight standards, etc.)

• Strong analytical, planning, problem identification and resolution skills required

• Ability to work in a fast-paced environment and multi-task across multiple deadlines and deliverables, often under uncertain or ambiguous circumstances

• Excellent communication, organizational, and time management skills essential

• Comfortable communicating concerns, questions, and risk at all levels of the organization

• Consistently maintain a positive, helpful, engaged attitude

• Self-starter that can independently support and resolve issues and conflicts with minimal management oversight

• Microsoft Office – Advanced Excel skills, including experience with formulas, data analysis, and/or pivot tables; fluent with Microsoft Access, PowerPoint, Word, etc.

This role is WAH/Flex which allows most work to be performed at home. Employees must be fully vaccinated if they choose to come onsite.

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.