(RN) Client Account Support Sr Spec - Work at Home -New York, N
Location: Albany New York
Description: Cigna is in need of (RN) Client Account Support Sr Spec - Work at Home -New York, N right now, this position will be placed in New York. More details about this position opportunity please read the description below. Job Description
The Clinical Consultant represents Cigna externally to assigned clients, brokers, and health care professionals as the subject matter expert on Cigna's clinical programs and processes.
Sales and network support may include:
Functioning as external representation for Clinical Operations and Product at selected client meetings.
Consulting with and providing recommendations to the client team regarding strategy to evolve the client’s health offerings.
Part! icipation in/providing consultation for external sales/network! meetings such as Cigna forums, health care professional meetings, new customer implementation strategies and meetings, consultant/broker meetings and/or guarantees.
Supporting vendor integration through clinical program education, and process and workflow development.
Providing consultative support to sales for identified non-standard processes including recommendation for Exception Review Committee (ERC) review.
Serving as a conduit to communicate industry and market specific trends both internally and externally.
Supporting clinical operations for cultural training, readiness assessments, clinical audits and communication of account specific needs.
Conducting periodic reviews of OLAM (On Line Account Management System) to ensure clear communication of client specific needs on assigned accounts.
Collaborating with Client Informatics and the medical director to review trend analysis including:
Service utilizati! on patterns
High dollar claim trend patterns and reports provided by client reporting
Quality outcomes
Financial results
Providing analysis/delivery of high cost claimant clinical review per assigned clients according to enterprise guidelines.
Conducting analysis and monitoring of key indicator measures that affect performance guarantees and medical cost.
Supporting Cigna enterprise initiatives related to Value Based Collaboration and Reward (VBCR).
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Requirements
Registered Nurse with a current licensure.
Preferred one (1) year of management experience.
Minimum of five (5) years of clinical practice experience.
Excellent time management, organizational, research, analytical, communication and interpersonal skills.
Minimum of three (3) years of health insurance industry experience including working knowledge of underwriting, claim, customer service, sales, provide! r relations, contracting and quality.
Excellent presentation s! kills, experience preferred.
Requires intermittent travel (may vary by assignment) approximately 30% of time.
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If you were eligible to this position, please email us your resume, with salary requirements and a resume to Cigna.
If you interested on this position just click on the Apply button, you will be redirected to the official website
This position starts available on: Mon, 09 Dec 2013 18:25:28 GMT
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