Clinical Consultant / Client Account Support Senior Specialist
Location: New York New York
Description: Cigna is at the momment seeking for Clinical Consultant / Client Account Support Senior Specialist right now, this career will be placed in New York. For detail informations about this career 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.
Support may include:
Functioning as external representat! ion for Clinical Operations and Programs at selected meetings.
Consulting with and providing recommendations to the client team regarding strategy to evolve the client’s health offerings.
Participation in/providing consultation for external sales/network meetings such as Cigna forums, health care professional meetings, support of 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 process requests 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.
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Conducting periodic reviews of OLAM (On Line Account Mana! gement System) to ensure clear communication of client specific needs on assigned accounts.
Collaborating with Informatics and the Medical Director to review trend analysis (both client and network) including:
Service utilization patterns
High dollar claim trend patterns and reports provided by client reporting
Quality outcomes
Financial results
Conducting analysis and monitoring of key indicator measures that affect performance guarantees and medical cost.
Supporting Cigna enterprise network initiatives related to Accountable Care or other Value-Based initiatives including:
Promote and maintain both prospective and current collaborative partnerships
Serve as clinical resource and liaison to ensure successful collaboration
Support report analysis and presentation of performance results
Qualifications:
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 recent health insurance industry experience including working knowledge of clinical operations, quality, claim, customer service, sales, provider relations, or contracting.
Excellent presentation and collaboration skills, experience preferred.
Requires intermittent travel (may vary by assignment) approximately 30-40% of time.
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If you were eligible to this career, please email us your resume, with salary requirements and a resume to Cigna.
If you interested on this career just click on the Apply button, you will be redirected to the official website
This career starts available on: Wed, 26 Feb 2014 18:26:17 GMT
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