Operations Senior Analyst

Role Description

The Operations Senior Analyst completes assigned operational tasks using standard appropriate tools and provides support to client requests under the direction of the Client Benefit Managers and other team members. Responsibilities include:

• Handling daily request tracking
• Researching operational issues
• Running reports for internal and external clients upon request
• Providing documentation related to completion of assigned tasks
• Identifying operational or productivity enhancements
• Providing project and administrative support to the team
• Escalating issues, risks, and concerns as needed

ESSENTIAL FUNCTIONS:

• Provide operational support for assigned ESI Markets (Commercial, Medicare, Health Plan, etc.) for going plan changes, new implementations, and renewal activity.
• Review, analyze and verify intent of assigned benefit set-ups as they relate to products and programs.
• Identify and communicate need for customization to support client benefit requirements.
• Attend client calls/meetings as needed.
• Attend internal validation meetings.
• Run customized and scheduled reports.
• Manage performance guarantee tracking and report distribution for internal/external clients as requested.
• Adhere to all organizational SOPs and Compliance standards.
• Provide subject matter input as it relates to checklists and SOPs.
• Assist with operation input related to new product development.
• Identification, research and resolution of operational issues.
• Provide training and mentoring for new team members, off-shore and contingent employee resources.
• Comply with ESI document and retention requirements.

SCOPE OF JOB:

• Develops competence by performing structured work assignments.
• Uses existing procedures to solve routine or standard problems.
• Receives instruction, guidance and directions from others.

Qualifications

• High School Diploma required
• Bachelor’s degree preferred
• 5+ years of professional work experience
• Experience in Pharmacy Benefit Management and benefit set-up knowledge preferred
• Strong PC skills and knowledge of Microsoft Office Suite and SharePoint, email and Internet required
• Excellent verbal and written communication and presentation skills highly desirable required
• Strong analytical problem solving skills preferred
• Knowledge of the health care and PBM industry and its products and services required
• Detail-oriented with strong analytical and problem solving skills preferred
• Ability to manage timelines and meeting tight deadlines preferred
• Ability to adapt in a dynamic work environment and make independent decisions preferred
• Good organizational, prioritizing skills and ability to multi-task preferred
• Strong customer service focus preferred
• Demonstrated ability to work with other departments/teams to resolve issues preferred

Requirements

• Independently develop standardized new group benefit design requests in the ESI system required
• Assist with more complex setups or projects as needed preferred
• Track and report progress to team to ensure deadlines are met required
• Perform verification/QA and system testing before implementation and within contractual timeframe agreements required
• Provide consultative support to internal & external clients by researching & assisting with resolution of benefit design and claims issues preferred
• Must be a current contractor with Cigna Healthcare, Evernorth Health Services, or one of their subsidiaries
• 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

Company Description

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.