Talent.com
Product Management Senior Advisor, Claims Transactions and Adjustments - Express Scripts - Hybrid

Product Management Senior Advisor, Claims Transactions and Adjustments - Express Scripts - Hybrid

The Cigna GroupSaint Louis, MO, US
job_description.job_card.variable_hours_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

Overview

The job profile for this position is Product Management Senior Advisor, which is a Band 4 Senior Contributor Career Track Role.

Excited to grow your career?

We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!

Our people make all the difference in our success.

Description of Position

The Product Management Senior Advisor is responsible for supporting Claim and Adjustment data that is provided to our clients. To help educate clients on methods of delivery, interpreting the data and best practices for using the data within their systems. The position will also support internal stakeholders and account teams as a subject matter expert on claim and adjustment data. This position will ensure responsibility in establishing a working partnership and process flow between the client, account management, finance and data analytics team(s). Support on client calls providing overview of the processes, expectations, education and answering client questions as needed.

Position Details

  • Serve as the Regulated Markets business owner for Claim and Adjustment data that is provided to our clients
  • Meet with account teams and clients, educating how data claim and adjustment data is provided and how to understand and use the data
  • Understanding project changes due to new or changing regulations and the impact to data and files provided internally and to clients
  • Establishing a working partnership and process flow between the client, account management and data analytics team(s)
  • Responsible for gathering business requirements and define alignment on functional requirements and rules.
  • Analyze trends and data to develop recommendations to ensure client needs, compliance metrics, and / or internal support is met
  • Ensure internal / external policies and procedures are documented, maintained, and followed
  • Understand and use system tools to research and resolve issues and concerns
  • Cross-train and support other team initiatives where appropriate
  • Exhibit problem solving capabilities in a complex environment
  • Participate in cross-functional projects or work teams
  • Ability to appropriately interact with clients / account teams including :

Communicate information about their area of expertise

  • Meet with clients to educate and also help troubleshoot concerns
  • Manage account team expectations and ensure appropriate follow-up
  • Qualifications

  • College degree or equivalent experience preferred.
  • 5 or more years work experience, preferably in business analysis.
  • Regulated Markets experience preferred
  • Familiarity with pharmacy adjudication and other PBM operations
  • Proficient in collecting and analyzing large data sets
  • Strong strategic, analytical, problem solving, and project management skills required
  • High attention to detail and proven ability to manage multiple, competing priorities simultaneously.
  • Internal and External Customer focused in all activities
  • Excels working cross functionally, at all levels of the organization to own, drive, manage and continuously improve the processes, perform root cause analysis, and develop reporting, and communication processes
  • Knowledge of PBM / healthcare industry or specialized business area
  • Ability to see business needs outside of one's own work area
  • Ability to execute tactics under a strategic vision
  • SQL skills are highly desirable
  • 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 110,700 - 184,500 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.

    Benefits and Additional Information

    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.

    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.

    Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this site.

    Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

    We look forward to reviewing your application.

    J-18808-Ljbffr

    serp_jobs.job_alerts.create_a_job

    Product Management • Saint Louis, MO, US

    Job_description.internal_linking.related_jobs
    • serp_jobs.job_card.promoted
    Senior Specialist, Global Product Management - Payment Reconciliation

    Senior Specialist, Global Product Management - Payment Reconciliation

    MasterCardO'Fallon, MO, United States
    serp_jobs.job_card.full_time +1
    Mastercard powers economies and empowers people in 200+ countries and territories worldwide.Together with our customers, were helping build a sustainable economy where everyone can prosper.We suppo...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    Energy Sales & Account Management Job

    Energy Sales & Account Management Job

    CLAE SOLUTIONSOld Jamestown, Missouri, United States
    serp_jobs.job_card.full_time
    Clae Goldman Team is seeking a proactive and enthusiastic Field Sales Associate to join our team.Our mission is to protect customers from rising energy costs, offer discounts, and promote green ene...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Outside Insurance Sales - Completed Training Required

    Outside Insurance Sales - Completed Training Required

    Platinum Supplemental InsuranceBelleville, Illinois
    serp_jobs.job_card.full_time
    Ready to jump-start your career and take charge of your earning potential?.At Platinum Supplemental Insurance, we’re looking for motivated individuals ready to learn, grow, and thrive in a fast-pac...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Insurance Sales Representative - Completed Training Required

    Insurance Sales Representative - Completed Training Required

    Platinum Supplemental InsuranceBelleville, Illinois
    serp_jobs.job_card.full_time
    Ready to jump-start your career and take charge of your earning potential?.At Platinum Supplemental Insurance, we’re looking for motivated individuals ready to learn, grow, and thrive in a fast-pac...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Business Senior Project Advisor - Express Scripts - Hybrid

    Business Senior Project Advisor - Express Scripts - Hybrid

    CignaSaint Louis, MO, US
    serp_jobs.job_card.full_time
    Business Senior Project Advisor.The Business Senior Project Advisor is responsible for providing program and project management over multiple projects. These projects are in support of key initiativ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Product Management Senior Advisor - Express Scripts - Hybrid

    Product Management Senior Advisor - Express Scripts - Hybrid

    CignaSaint Louis, MO, US
    serp_jobs.job_card.full_time
    Product Management Senior Advisor Medicare Solutions, Express Scripts.The Product Management Senior Advisor provides leadership and strategic direction for capabilities and new product development...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Senior Specialist, Global Product Management - Payment Reconciliation

    Senior Specialist, Global Product Management - Payment Reconciliation

    MastercardO Fallon, MO, US
    serp_jobs.job_card.full_time
    Senior Specialist, Global Product Management - Payment Reconciliation.The Services Business represents over a third of Mastercard revenues and is a key differentiator for Mastercard.Services use ou...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Senior Tax Professional - 2+ Yrs Paid Tax Experience Required

    Senior Tax Professional - 2+ Yrs Paid Tax Experience Required

    IntuitCOLUMBIA, Illinois, United States
    serp_jobs.job_card.full_time
    Intuit is seeking highly motivated individuals to join our dynamic team as dedicated TurboTax Live Seasonal Local Service Experts in one of our new TurboTax locations across the United States on a ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Remote Finance Advisor - AI Trainer

    Remote Finance Advisor - AI Trainer

    Data AnnotationBelleville, Illinois
    serp_jobs.filters.remote
    serp_jobs.job_card.full_time +1
    We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the q...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Insurance Sales Agent - Completed Training Required

    Insurance Sales Agent - Completed Training Required

    Platinum Supplemental InsuranceBelleville, Illinois
    serp_jobs.job_card.full_time
    Ready to jump-start your career and take charge of your earning potential?.At Platinum Supplemental Insurance, we’re looking for motivated individuals ready to learn, grow, and thrive in a fast-pac...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Make money your way. Deliver with Uber!

    Make money your way. Deliver with Uber!

    Uber eatsWinfield, MO, United States
    serp_jobs.job_card.full_time +1
    Delivering with Uber is an alternative to a part-time or full-time job and can get you earning cash quickly.Delivering with Uber allows you to earn quick cash while maintaining the flexibility your...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Product Management Senior Advisor, Claims Transactions and Adjustments - Express Scripts - Hybrid

    Product Management Senior Advisor, Claims Transactions and Adjustments - Express Scripts - Hybrid

    CignaSaint Louis, MO, US
    serp_jobs.job_card.full_time
    Product Management Senior Advisor.The Product Management Senior Advisor is responsible for supporting Claim and Adjustment data that is provided to our clients. To help educate clients on methods of...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Expert Claims Review Product Owner

    Expert Claims Review Product Owner

    Zelis Healthcare, LLCSt. Louis, MO, United States
    serp_jobs.job_card.full_time
    Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers.We serve more than 750 payers, including the top five national health plans, regional hea...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Drive with DoorDash - Sign Up in Minutes

    Drive with DoorDash - Sign Up in Minutes

    DoorDashRoxana, IL, United States
    serp_jobs.job_card.full_time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a var...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Drive with DoorDash - Flexible Onboarding

    Drive with DoorDash - Flexible Onboarding

    DoorDashMillstadt, IL, United States
    serp_jobs.job_card.full_time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a var...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Drive with DoorDash - Flexible Schedule

    Drive with DoorDash - Flexible Schedule

    DoorDashOld Monroe, MO, United States
    serp_jobs.job_card.full_time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a var...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Advanced Modality Technologist

    Advanced Modality Technologist

    BJCAlton, IL, United States
    serp_jobs.job_card.full_time
    Additional Information About the Role.Newly Approved Increased Compensation Package Now Available!.BJC HealthCare is now hiring a. Full-Time Advanced Modality Technologist.Alton Memorial Hospital lo...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Medicaid Product Management Advisor - Express Scripts - Hybrid

    Medicaid Product Management Advisor - Express Scripts - Hybrid

    CignaSaint Louis, MO, US
    serp_jobs.job_card.full_time
    Join our dynamic Regulated Markets team as a Product Management Advisor, primarily supporting Medicaid and HealthCare Reform. This position sits within the Regulated Markets Benefits, Claims, and CO...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours