Lead Analyst, Enterprise Print & Distribution

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee and direct the resolution of intricate issues involving multiple clients and customers reported to the Pharmacy Reliability team.

• Triage, investigate, and resolve individual member issues that require escalation support from business partners.

• Evaluate complex client issues utilizing knowledge of Pharmacy benefit design, including cost, contractual, and legal ramifications.

• Summarize issues and their impacts, identify stakeholders, and communicate the outcomes effectively.

• Collaborate with Customer Service, Claims, Client Implementation & Service, and PBM vendors to ensure prompt and precise reimbursement.

• Recognize obstacles and escalate issues to engage the relevant business units and stakeholders.

• Enhance processes, products, and services by applying best practices.

• Identify root causes and establish preventive measures for Client Service Issues.

• Foster partnerships across Pharmacy Operations and coordinate efforts to meet objectives.

• Calculate impacts to clients, customers, and pharmacies utilizing internal and external claims reports.

• Submit impact documentation to matrix partners for financial remediation.

• Maintain and update issue-tracking tickets in SharePoint.

• Manage and coordinate remediation funding, including DMRs, P&L, and E&O.

• Provide executive-level communications for escalated issues.

• Analyze complex inquiries and determine the suitable technical area or vendor for resolution.

⛳️ Requirements

• High School Diploma or GED is required.

• Bachelor’s degree is preferred.

• A minimum of 3 years of relevant experience in a Pharmacy Benefit Management (PBM) related role is required.

• Working knowledge of internal Cigna systems, including ePro, BPL, and CIT is preferred.

• Expert-level understanding of Pharmacy operations.

• Financial acumen and claim processing knowledge are required.

• Strong analytical skills to assess and comprehend financial impacts.

• Excellent decision-making skills.

• Ability to facilitate issue and impact analysis discussions and simplify complex topics.

• Proficient technical skills with MS Excel, including the use of formulas and pivot tables.

• Strong critical thinking, problem-solving, and negotiation skills.

• Experience with logical problem-solving methodologies such as Six Sigma or Total Quality.

• Ability to navigate ambiguous scenarios that involve multiple organizational areas.

• Proven issue management and organizational skills.

• Capacity to plan for both long-term and short-term priorities.

• Detail-oriented with the ability to prioritize multiple tasks and adjust work to meet service standards.

• Ability to work independently with minimal supervision.

• For remote work, a cable broadband or fiber optic internet service with at least 10 Mbps download and 5 Mbps upload is required.

🏝️ Benefits

• Eligibility for an annual bonus plan.

• Medical insurance coverage.

• Vision insurance coverage.

• Dental insurance coverage.

• Programs for well-being and behavioral health.

• 401(k) retirement plan.

• Company-paid life insurance.

• Tuition reimbursement opportunities.

• A minimum of 18 days of paid time off annually.

• Paid holidays.

• Leaves of absence available.

• Remote work arrangement offered.