Business Project Sr Specialist - Work from home (PA)

Remote, Work from home

Must reside near Philadelphia, PA

This role is responsible for supporting Cigna Medicare Advantage's Stars program for multiple operational markets. Responsibilities include assisting regional leadership in maintaining, or improving, overall Star Ratings to achieve 4+ Stars for all contracts. This role will support markets in leading and oversight of strategy execution for specific areas or state within region. The role will support Cigna's local market representatives with quality improvement activities within the region and/or market for HEDIS® measures and hybrid data collection, CAHPS and HOS improvement, Pharmacy / Part D, Administrative measures, general Stars program education and related activities, as well as other activities as assigned.

Major Duties

• Assist in the identification, development and implementation of Stars measure improvement activities within the region.
• Serve in a consultative role as the local market Stars Strategist to ensure overall Star strategy is being executed to meet market goals
• Support the process of improving HEDIS® through initiatives to drive rate improvements, data collection and process improvement, as well as innovative activities that target additional gap closure.
• Assist in the education of Cigna regional staff, providers and office staff through the dissemination of Stars materials and best practices.
• May attend priority and/or Quality JOCs market meetings within region as needed and to drive Stars strategy
• Project manage initiatives designed to impact Stars rates, which may include coordinating activities with matrixed partners, updating tracking tools and reporting updates.
• Analyze data to identify Stars improvement opportunities based off Projected rates, KPIs, and proxy measure performance
• Work on quality-related project teams, identifying improvements to workflows, and through the identification of operational efficiencies and best practices.
• Coordinate the development and dissemination of operational policies and procedures, workflows, and communications (both internal and external) in support of Cigna's Stars Program.
• Perform QA on Cigna's internal reporting suites to allow for feedback on ways to improve reports and the analysis of reports to enhance their value.
• Manage intake of and provide resolution or escalation for ad hoc requests or needs of market operations or health services staff.
• Assure compliance by delivering quality services and meeting all contractual, state & federal legal and regulatory requirements.
• Serve as liaison between markets and enterprise teams to ensure market's are informed and that the impact of enterprise strategy at the local market level is tracked and communicated

Qualifications

• 3+ years of CMS Stars, clinical quality, or healthcare quality improvement experience and/or experience within Cigna required
• Excellent written and verbal communication skills
• Managed care and/or other healthcare service delivery experience strongly preferred
• Strong time management, project management, organizational, research, analytical, negotiation, communication, and interpersonal skills
• Highly motivated, self-starter individual
• Strong proficiency in Microsoft Office applications (Outlook, Word, Excel, Power Point, etc.), including experience running web based meetings.
• Analytic background required and medical record collection background a plus
• Travel required (Approximately 25% - 50%)

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 Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, 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 us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives. What difference will you make?

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: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.

Cigna 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.