Senior Operations Analyst
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Job Description
Operations Sr. Analyst providing support in managing benefits for ESI Markets at Cigna Group. Responsible for operational tasks related to benefit set-ups and ensuring compliance standards are met.
Responsibilities:
- 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.
- 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.
Requirements:
- 3+ years of equivalent work experience
- 1+ years of relevant experience in PBM and benefit set-up knowledge
- Strong PC skills and knowledge of Microsoft Office Suite and SharePoint, email and Internet
- 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
- Detail-oriented with strong analytical and problem solving skills
- Ability to manage timelines and meet 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
Benefits:
- medical, vision, dental, and well-being and behavioral health programs
- 401(k)
- company paid life insurance
- tuition reimbursement
- a minimum of 18 days of paid time off per year
- paid holidays
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