MA Risk Adjustment Prospective Program Strategy, Senior Manager

Job Summary:

This position is responsible for development and oversight of Cigna's Medicare Advantage's risk adjustment program strategy for multiple states . Additional duties include presenting to senior leadership on status of market-based activities, researching and understanding market solutions available for risk adjustment, identifying improvement opportunities, and supporting specific activities for risk adjustment accuracy improvement.

Core Responsibilities:

• Develop vendor strategy for In Office and In Home Assessment programs.
• Strategize about segmentation of members and providers by program type to enhance performance.
• Develop model to coordinate movement of members from In Office to In Home programs.
• Design and implement market and provider level customized interventions to improve provider engagement and program participation.
• Design and implement member level outreach for yearly health checkups and coordinate with Customer Incentive Program team.
• Improve provider education process and materials.
• Drive integration of Risk Adjustment and Quality prospective programs and teams
• Identify trends in key operational metrics and inform financial projections specific to prospective risk adjustment programs.
• Prepare and present executive level reviews of prospective program performance.
• Assist in the redesign of In Office and In Home Assessment programs.
• Understand and implement business controls and reporting across markets and enterprise functional units to ensure that there is clear continuous improvement towards risk adjustment goals over time.

Minimum Qualifications:

• Bachelor's degree or equivalent amount of experience
• Minimum of 2 years of leadership experience
• 8+ years of experience needed in healthcare
• Deep understanding of Medicare Advantage Risk Adjustment, Provider Engagement and Compliance
• Track record of managing and leading teams focused on improvement, insights, strategy and execution
• Demonstrated ability to execute complex projects and operational processes in a matrixed environment

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 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: [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.

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.