Network Operations Advisor - Express Scripts - Hybrid

Position SummaryThe Network Operations Advisor is a newly created position within the pharmacy credentialing team that will be responsible for translating credentialing processes into evolving business requirements that will further progress technology solutions, assisting with application feature prioritization, and understanding any analytical needs across the group. This role will also consult with members of the team to identify opportunities to leverage existing data sources and develop reporting that will allow the team to more efficiently and accurately perform standard tasks, as well as bring new insights to assist with decision-making and process improvement. This role will have responsibility to develop network products and strategy designed to drive margin initiatives as well as anticipate and meet client customization needs. Finally, the role will also focus on improved service to providers through innovative communication and technology functions.Essential FunctionsResponsible for partnering with the Network Compliance leadership team to transform business operations and process improvements into technology requirements to gain efficiencies within system applications and advance automation effortsCoordinate or participate in cross functional/departmental collaboration with other internal teams, including but not limited to, Network Compliance, Retail Network Operations, Retail Strategy and Contracting, the Pharmacy Special Investigations Unit, and Sales and Account Management in order to develop solutions for strategic business needs Generate credentialing and re-credentialing reports as needed for specific clients to support contractual commitments and compliance auditsIdentify and act upon opportunities to enhance the provider onboarding and re-credentialing experience by creating solutions to improve team timeliness, efficiency, accuracy, and service.Recognize opportunities to improve on existing communication pathways to support providers through the credentialing and network compliance processesPerform ad hoc analyses and special projects, when neededResearch best practices and improvements involving analytics, tools, and process improvementProvide support for questions and issues raised by teammates and internal network partners. Provide answers as quickly as possible, supporting the timeliness of the review or outreach.Ideal Candidates Will Have a Combination Of The FollowingBachelor’s degree and 2+ years of experience working with relational databases requiredKnowledge of pharmacy provider networks, contracting and credentialing requirements, network systems, and terminologyPharmacy benefit management experience preferred, including familiarity with the regulatory environment and compliance issues (i.e., URAC accreditation maintenance, credentialing, delegation and oversight standards, etc.)Strong analytical, planning, problem identification and resolution skills requiredAbility to work in a fast-paced environment and multi-task across multiple deadlines and deliverables, often under uncertain or ambiguous circumstancesExcellent communication, organizational, and time management skills essentialComfortable communicating concerns, questions, and risk at all levels of the organizationConsistently maintain a positive, helpful, engaged attitudeSelf-starter that can independently support and resolve issues and conflicts with minimal management oversightMicrosoft Office – Advanced Excel skills, including experience with formulas, data analysis, and/or pivot tables; fluent with PowerPoint, Word, etc.Interest in learning SQL and other data related systems preferred.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 ServicesEvernorth 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com 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.