Medicare Operations Program Management Senior Advisor - Remote - Cigna Healthcare

Reporting to the Risk Adjustment Strategy and Operations Leader, this role serves as leading and managing all activities related to Cigna’s Corporate Integrity Agreement (CIA).  Serves as the main point of contact for internal teams to drive performance and deadlines related to deliverables related to Corporate Integrity Agreement as well as key compliance related deliverables.  Identify gaps in operational infrastructure to ensure the delivery within expected timeframes, establish critical measures to track performance to goals, identify additional critical operational metrics to support improved execution and performance, collaborate with vendors and legal and compliance teams to drive execution. 

Role Components

• Collaborating with matrix partners to ensure execution of key deliverables
• Engaging and influencing the organization to prioritize around the established CIA deliverables.
• Influencing operational performance and the impact to CIA deliverables, including socializing and communicating the overall requirements, strategy and direction
• Identifying and championing additional opportunities/efficiencies around CIA requirements and other key compliance initiatives, including exploring operational solutions that drive efficiency in process. 
• Facilitating and actively participating in monitoring vendor performance related to these initiatives and identifying roadblocks to success
• Monitoring operational proxy metrics, tracking and trending metric performance, and identifying gaps/opportunities to improve

Primary Responsibilities

Lead projects from end to end using best practices and disciplines. Partner with cross-organizational areas in implementing project initiatives. Provide leadership and guidance to the project team and across multiple areas.

• Responsible for delivering small to large scale project initiatives.
• Collaborate with leadership teams on all aspects of the day-to-day operations to build and manage a detailed project plan, with key milestones, priorities, dependencies/sequencing, from inception to closure. Plan will incorporate tasks that represent all work needed for a successful implementation.
• Identify, track, mitigate and escalate (when appropriate) project risks, issues, and decisions. Develop contingency plans and triggers to invoke.
• Drive to delivery timelines, while also adapting to a dynamic work environment; set priorities to best support organization performance and impact.
• Provide transparent and accurate project status reporting at all times, in alignment with stakeholder and sponsor input.
• Identify and develop relationships with cross-enterprise teams and key stakeholders to establish and monitor progress against goals and objectives, and a clear vision to achieve goals.
• Understand communication dynamics and build/execute a plan to meet stakeholder needs.
• Ensure funding and resources are prioritized and secured to facilitate the successful attainment of project goals.
• Utilize and contribute to best practices and governance within the project team. Provide oversight and guidance to less experienced project managers on the team.
• Performs self and team reflection continuously and implements changes to improve team’s effectiveness.

Qualifications and Competencies

• 5+ years’ experience working with the Medicare market and operations environments
• 5+ years’ experience in Medicare risk adjustment rating related role, identifying opportunities, and implementing initiatives to drive improved rating performance
• Medicare Compliance experience preferred  
• Project Planning experience preferred.
• Knowledge and use of Microsoft Office tools.

• Strong problem-solving skills; solution identification & development.
• Ability to perform contingency planning.
• Ability to interact effectively with all levels of the organization.

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 annual salary of 92,800 - 154,600 USD / yearly, 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