Individual & Family Plans (IFP) Operations Research Specialist - Remote - Cigna Healthcare

Job Summary:

We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. Main responsibility of the Operations Research Specialist is to assist in resolving other customer issue types through accessing various intake queues and ensuring requests are processed, triaged, and prioritized timely as well as adhering to all regulatory requirements. 

Core Responsibilities:

• Support intake queue for customer issues; ensuring all intake requests are tracked, prioritized, documented, resolved and loop closed with customer
• Manage assigned work load tasks
• Provide support on complex/sensitive customer issues, concerns and complaints
• Monitor and adhere to highly regulated turnaround and processing requirements
• Timely and accurate compliance with all disclosure requirements and root cause reporting/analysis/actions
• Participate in projects for customer process improvement initiatives
• Meet regulatory turnaround requirements for response on customer issues
• Identify customer needs and solutions and follow up with outreach to customers
• Assist in promoting customer satisfaction
• Identify gaps in processes
• Participate in projects for customer process improvement initiatives
• Assist other team members with questions and potentially act as a SME for IFP Operations
• Creates strong working relationships with matrix partners.

Minimum Qualifications:

• At least 3 years of Healthcare insurance business experience (such as Benefits, Eligibility, Claims, Call or Sales)
• Experience with Cigna IFP and/or solid understanding of the Affordable Care Act and the Federal Exchange highly desired
• Ability to function in a fast-paced environment and prioritize multiple tasks under tight deadlines
• Demonstrates agility to change course based on business needs
• Excellent oral and written communication skills
• Demonstrates strong analytical abilities in decision making and problem solving
• Exhibits ability to utilize technical skills and resources to ensure accuracy
• Strong computer skills required and proficiency in MS Office products
• Proficiency in Medical Facets and Oneview highly desired
• Flexibility with overtime and PTO hours during peak periods

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.

For this position, we anticipate offering an hourly rate of 23 - 35 USD / hourly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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 b