Posted in General Business 13 days ago.
Type: Full-Time
Location: Philadelphia, Pennsylvania
This role is responsible for supporting Cigna Medicare Advantage risk adjustment prospective programs, solutions, and performance in aligned operational region serving as a liaison between Markets and Provider Performance Enablement teams, Provider Education, and the Risk Adjustment Operations teams.
The Prospective Program Solutions & Performance Advisor works with aligned region supporting prospective risk adjustment initiatives and programs aimed at improving the accuracy and completeness of risk adjustment, advising the market on risk adjustment strategy based on knowledge of Cigna MA's overall Risk Adjustment programs, with a strong focus on alternate prospective programs and bi-directional data exchange initiatives, and overseeing regional and market program performance. This work includes support in initial provider engagement on prospective programs, bridge to implementation, continual workflow optimization and successful prospective program participation. The expectation will be solutioning for short term and longer team participation in Cigna RA programs.
The role will work under the direction of the Senior Manager - National Lead Provider Education to reach overall operational market goals in conjunction with market Provider Performance Enablement teams and the Risk Adjustment Operations team. The role requires expertise in areas that include performance management/analytics, data exchanges, electronic medical record systems, provider workflow and processes, health information management, risk adjustment operations (particularly on the prospective side), value-based care, ICD-10, CPT and HCPCS coding principles and guidelines, and population health management.
Incumbent candidate must be able to work a hybrid schedule and report to one of the following office locations as needed:
Core Responsibilities:
Requirements:
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 72,400 - 120,600 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.
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