Job Description

Product Management Lead Analyst – Centene Operations Management The job profile for this position is Product Management Lead Analyst, which is a Band 3 Senior Contributor Career Track Role. The Regulated Markets Centene Operations Management team is responsible for ensuring the execution of key operations accountabilities associated with all regulated lines of business including Medicare, Medicaid, and Marketplace (Exchange / Health Care Reform). The team supports Pharmacy Benefit Management (PBM) delegated responsibilities associated with regulatory audit support, issue management, adjustment processing, Prescription Drug Event (PDE)/encounters reporting and regulatory communications. The Lead Analyst will support analytics of operational data, specific to claims processing, adjustments, and PDE/Encounters for the client. The role will also support initiatives to ensure member/client satisfaction, alignment with client contractual support and client retention. When necessary the analyst will also provide functional SME support to client facing discussions. Key Responsibilities: Provides advanced professional input to complex assignments/projects. Works autonomously, only requiring “expert” level technical support from others. Develop and support analytics of claims, adjustments data to support client initiatives Oversee the timely completion of all adjustments aligned with client specific request processes and accurate delivery, response management and correction of client PDE (Medicare) and Encounter (Medicaid) reporting Process completion of all adjustment requests aligned with client specific request processes Ensure accurate delivery, response management and correction of client PDE (Medicare) and Encounter (Medicaid) reporting Promotes the tracking and documentation of all team activities in associated systems Supports the client Project Management Office (PMO) and Account Teams with function specific communications needs via account team/client inquiry requests, Field Alert development, deliverable reports and presentations Compiles and evaluates data on the functional performance. Utilizes in-depth professional knowledge and acumen to develop models and procedures and monitor trends. Exercises judgment in the evaluation, selection, and adaptation of both standard and complex techniques and procedures. May assist, coordinate or lead portions of mid-size projects. Supports and provides direction to more junior professionals. Exhibits proven ability to work cross-functionally in development and execution of operational plans aligned to enterprise goals and in support of the needs of our clients. Exercises considerable creativity, foresight, and judgment in conceiving, planning, and delivering initiatives. Ideal Candidates will offer: Bachelor’s Degree with a preferred focus of Health Care Administration or Business At least one year experience in a health plan or PBM setting. Medicare, Medicaid and Marketplace experience a plus. Technical knowledge of relational database concepts, querying, data warehouses and decision support tools, including but not limited to: SQL, Excel, Power BI, and Tableau. Alteryx experience is a plus. Able to balance high priority, long-term projects with short-term, immediate deadlines Creative thinker and exceptional problem solving skills Ability to follow processes and document information consistently and timely to meet obligations Able to translate technical data concepts to business partners for understanding and alignmentProven ability to function in a heavily matrixed environment. Extensive knowledge of Microsoft Office products (particularly Excel, Word, Power Point, etc.). Experience leading projects and working with cross functional teams, especially Business and Marketing communications teams Other Essential Skills: Excellent process mapping and analysis skills Open communicator; excellent oral and written communication skills Ability to work effectively in dynamic, rapidly changing, team-based environment across multiple functions and in support of diverse regulatory obligations. Critical thinker and creative problem solver, who exercises good judgment in resolving difficult situations, prioritizes and can balance needs with enterprise objectives Ability to work in a fast-paced deadline-driven environment, and juggle multiple, sometimes competing, priorities and requirements Ability to motivate, influence and connect others Ability to influence direction and action; build and leverage internal relationships Goal oriented and personally accountable; resourceful and self-directed Adaptable and flexible; open minded, innovative and creative – seeks ‘out of box’ solutions 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. The Cigna Group

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