Operations Lead Analyst - Express Scripts - Remote

The Operations Lead Analyst is responsible for handling a multitude of requests for their appointed workstream including issue analysis, problem solving and other tasks to ensure satisfactory results for cross functional partners and our Clients. Position requires intermediate account service and operational knowledge to successfully complete assigned work. Position requires frequent and detailed communication with internal cross-functional partners with potential to be client facing. Position requires proactive approach to identify opportunities for improvement and projects, ensuring workload remains at full capacity based on accomplished cross-training. Position will actively participate and/or lead process improvement activities and other projects as assigned by leadership.

Position is accountable for assigned work with a focus on client satisfaction, quality, timeliness, performance guarantees and the effective use of cross-functional partnerships.

Responsibilities

· Reviews client intent submission requests and validates appropriate approvals provided to meet SOC2 audit compliance requirements.

· Partners with teams across the organization during audit failure scenarios to obtain correct approvals.

· Completes assigned operational tasks and provides support to client benefit requests.

· Executes assignments within committed targeted completion dates and/or performance guarantees.

· Adheres to all organizational SOPs and Compliance standards; provides subject matter input as it relates to checklists and SOPs.

· Requires minimal guidance from peers and management

· Provides support to internal and external clients by researching and assisting with resolution of benefit related issues.

· Management of client issues and escalations including RC/PM (IMTs)

· Reports immediately risks/issues and mitigation to management

· Works independently to resolve standard and complex problems using existing procedures; engages cross-functional support and escalates as needed

· Shows ability to engage in and lead process improvement initiatives and other team projects

· Demonstrates leadership abilities by assisting with peer training, mentoring and support

· Supports special projects as assigned by leadership

Qualifications

· High School Diploma or GED required

· Strong PC skills including Microsoft Office products, e-mail and the Internet preferred

· Excellent verbal and written communication and presentation skills highly desirable preferred

· Strong attention to detail; problem solving and analytical skills preferred

· Knowledge of the health care and PBM industry and its products and services desired

· Ability to work cross functionally to resolve issues preferred

· Strong focus on customer service required

· Ability to manage timelines and meet tight deadline required

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 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.

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