Job Description
Job Description T he Operations Advisor i s res po nsib le f or providing opera ti on a l management of work requests to drive satisfactory results for cross functional partners and our clients. Po siti on re q u i r e s strong client acc o un t and PBM opera ti onal kn owl edg e. Position is a cc o un ta b le f or assigned work with a focus on client satisfaction, quality, timeliness, performance guarantees and the effective use of cross-functional partnerships . Position requires strong analytical skills to drive resolution of complex issues . Role may be client facing, requiring strong communication, presentation and business relationship skills. Role is empowered to identify and drive solutions and improvements for client and ESI processes. Role participates in peer mentoring and special projects as assigned. Position requires proactive approach to ensure workload remains at full capacity based on accomplished cross-training.
Responsibilities - Manages assigned service and operational deliverables, including but not limited to: analysis, capture of client intent, cross-functional project management, management of complex and escalated assignments, and handling of member service and client operational initiatives. Assignments may fall across various Client Optimization work streams. Supports designated clients as assigned. Meets all defined service standards to ensure Account Management and client satisfaction.
- Independently determines direction for resolution of any service or escalated issue. Appropriately escalates as needed.
- Actively par tici pate on c r os s -f unc ti onal t e am s t o id en ti fy op po rtu ni t i e s to address global client issues, pr es en tin g re comm en d a ti o n s t o lea d er shi p.
- Leads s pe ci al p r o j e ct s a s a ssign e d .Shares best practices and knowledge of the business with peers to improve service levels. Assists with peer training and support.
- Adheres to all organizational SOPs and Compliance standards; provides subject matter input as it relates to checklists and SOPs
- Manages and leads complex projects as assigned, multitasking effectively to ensure daily requirements requests are completed and turned around within required timeframe/SLA/PG's.
Demonstrates initiative and ability to use proper discretion to execute assigned tasks
- Accurately analyzes, translates, validates and triages complex client requests related to product requirement adds and changes across all business units to ESI systems.
- Provides consultative support to cross functional partners and clients.
- Collaborate through the IMT triage team on resolution of critical issues.
- Identifies, influences and communicates the need for standard or creative solutions to support client benefit requirements.
Qualifications - High School Diploma and GED required
- Bachelors degree preferred
- 2 plus years of professional experience
- Experience in h e alt hc are or P B M ind us try p r e ferre d
- S t r ong fo c us on quality, effective communication, and customer service
- De m onstra t ed a bili ty ma n a gin g p ro j e c t s ut ilizin g p roven pro j e c t m ana gem ent p ro cess e s
- Abili ty t o w o r k and build partnerships c ro ss - f uncti onally t o p ro a ctiv e l y c omm u nic ate a n d to r es olve issu es wi th t h e h ighes t s e ns e of ur g enc y
- Ability to handle analysis from issue identification to solution delivery
- Demonstrated initiative with commitment and ability to work under pressure and meet tight deadlines
- Client facing experience preferred
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.
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.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
Job Tags
Permanent employment, Local area, Remote job, Work from home,