Payment Integrity Project Effectiveness Manager
Cigna
- Glasgow
- Permanent
- Full-time
- Support the Payment Integrity business strategy and responsible for executing departmental plans and priorities.
- Responsible for oversighting various US Cost Containment initiatives being delivered through third parties including Enterprise and ensuring a pipeline of new activities to continue to enhance cost containment opportunities across all international books of business.
- Accountable for maintaining an overview to inform through governance on the status and progress of PI affordability incremental initiatives. Support PI business owners with engagement with PMO to ensure timely delivery, the documentation of perceived risk and collation of mitigation actions.
- Accountable for overseeing the continued development of the HealthCloud solution bespoke for PI.
- Responsible for owning the front-door change process for PI, ensuing business requests are reviewed, resourced and allocated.
- For initiative impacting PI, ensuring all business acceptance testing is performed and approved to enable business improvement, adoption, implementation, and execution of processes.
- Examines performance results for problem determination and takes appropriate corrective actions, reporting through appropriate governance.
- Works cross-functionally within PI to improve the operational effectiveness of project and incremental initiative opportunities.
- Proven track record of leading global and remote operational teams.
- Ability to work in an Agile framework.
- Knowledge of US healthcare delivery systems and provider business models, including competitor offerings on product, network, and payment integrity propositions would be a benefit.
- Knowledge of US standard claims medical coding (CPT, ICD10, HCPC) and regulatory billing rules.
- Demonstrated experience in seeking out, building and nurturing strong relations with third parties.
- Exceptional stakeholder management and proven ability to develop strong working relationships within a fast-paced, matrix organization.
- Superior problem solving, decision-making, project management skills.
- Minimum of 5 years of health insurance or health care provider experience, and/or customer service or related experience.
- Commercial experience operating effectively under pressure and delivering results.
- Excellent communication skills, both written and verbal and high level of financial acumen.
- Strong reporting and analytical skills with ability to create and improve reporting packs and methodologies.
- Strong organization skills with the ability to balance multiple priorities at once and deliver on tight timelines.
- Experience of operational risk management, including internal and external risk and compliance reporting.
- Dedicated to meeting the expectations and requirements of internal and external customers, excellent at building effective relationships and gaining trust and respect.
- Flexibility to meet with global teams across varying time zones effectively.
- Confidence to deal with internal stakeholders and ability to work across cross-functional teams.