Cigna Senior Manager, Prior Authorization - Express Scripts in Whitestown, Indiana
The Senior Manager is primarily responsible for providing leadership to a team accountable for ensuring department compliance with all Federal and State regulations concerning Prior Authorizations. Work with cross functional departments and stakeholders to guarantee compliance. Participate in client and regulatory audits of Prior Authorizations. Areas of responsibility include overall medical prior authorization process, CMS Medicare and Medicaid compliance, process compliance with state regulations and industry accreditations, and medical claim re-pricing.
Responsible for successful maintenance, reporting, analyzing, and communication of performance surrounding medical prior authorizations for both commercial and regulated (Medicare & Medicaid) programs.
Proactively improve processes and procedures, streamline work flow, automate manual processes, drive new IT projects which improve the product, increases its value, and ensure success in TAT and PG compliance
Build relationship and maintain working communication with Product Management, Account Management, Finance, and other cross-functional business partners in aligning with all requirements, current and future.
Build relationship and maintain working communication with Key Clients in aligning with all requirements.
Manage team of direct reports, responsible for performance evaluations, providing feedback, planning career path
Additional projects as assigned
Bachelor’s degree preferred; MBA preferred
8 years experience in relevant operations environment
Demonstrated leadership skills; experience supervising staff
Demonstrated ability to coordinate people and teams to project completion
Knowledge of Coverage Review/prior authorization processes preferred
Advanced communication (oral and written), presentation and analytical skills
Demonstrated project management capabilities
Ability to work cross-functionally to solve complex problems and improve quality and service
Ability to manage toward budget, service and quality goals
Willingness to work a flexible schedule to accommodate business requirements
Proficient with MS Office software
Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. We offer an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products. Together, with our 74,000 employees worldwide, 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 Cigna, you’ll enjoy meaningful career experiences that enrich people’s lives while working together to make the world a healthier place. What difference will you make? To see our culture in action, search #TeamCigna on Instagram.
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.
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