Senior Manager Regulated Markets Issue Management - Express Scripts - Remote

Overview

The Senior Manager of Regulated Markets Issue Management is responsible for leading a team responsible for the timely resolution of issues impacting regulatory compliance, client/regulator CAPs and audit finding remediation for the Regulated Markets book of business. This individual assists in setting the strategic direction, establishing goals and driving performance of their team. Serves as a SME and point of contact for leadership, other Regulated Market capability owners, and the broader organization. This position collaborates with enterprise Issue Management, Product Management SMEs, Compliance and other stakeholders to ensure compliance with the various State and Center for Medicare and Medicaid Services (CMS) guidance/regulations and Client contract requirements. Maintains and enhances process and documentation to identify, align support and track issue resolution. Analyzes Issue data and integrates findings into ongoing quality improvement initiatives.

Accountabilities include (but not limited to):

- Provides day-to-day oversight and management of team

- Assesses team performance per company policy and processes

- Acts as point of escalation and resolution of team and function related issues

- Ensures the efficiency and integrity of issue support activities

- Provides direct issue resolution support as IRL as needed

- Promotes collaboration between departments and stakeholders to support issue management

- Develops metrics and delivers scorecards and other reports to track issue performance

- Serves as point of contact and SME to internal and external stakeholders

Skills and experiences:

The ideal candidate will have a broad-based knowledge of Regulated Markets, experience leading people, a strategic mindset, the ability to influence and drive change. Preferred experience:

- 3 -5 years in managed care or PBM environment, preferably participating in or leading quality and/or performance improvement capacity

- 3-5 years as a people leader

- understanding of data modeling, reporting and scorecards

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 122,300 - 203,800 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.

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 Group.

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. 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.