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- The position is responsible for responding to complex service inquiries requiring Sales involvement, solving non-routine problems using independent judgment and discretion, and ensuring client satisfaction with products and the overall service experience. Coordinates with Sales to ensure service needs are met and potential problems are averted. This position will require consultative thinking when decisions are needed in real time and for brokers or clients. These decisions or explanations may include how benefits are administered across platforms, the intricacies of specific products and how our networks work. The person in this role must be able to balance capability with client desire and set expectations appropriately with new and existing clients.
- Handles escalation of service issues internally, using appropriate escalation guidelines.
- Provides out of office service support for SM, DCM, NBM’s, and CM’s on complex or escalated service issues requiring Sales involvement.
- Provides support for resolution of complex service issues requiring Sales involvement.
- Proactively educates and provides recommendations to sales to avoid future service issues (for example, identifies a trend with certain Rx formulary issues due to product change that is not being communicated by Sales.)
- Training is on eligibility and billing system for Facets clients to ensure proper procedures are followed
- Serves as a subject matter expert on benefits for NBM’s and CM’s
- Leads “Service project work” required in the local market to proactively identify service issue trends and internal procedures that adversely affect customer satisfaction.
- Maintains knowledge and expertise in all products (benefits and general funding knowledge), programs, services and enrollment activity.
- Partners with Service Operations or other matrix partners to drive resolution of issues and to proactively identify process improvements and increased efficiency
- Training done onsite/in person or by phone
- May conduct training on Client Resource Portal for high-touch clients or clients with complex structure set-up
- Proficient knowledge (min 3-5 years) in health care / managed care business; to include many or all of the following: product knowledge, sales practices, account management and knowledge of administrative operations
- Knowledge of Cigna Select funding options, benefits structure, and platforms are preferred.
- Ability to manage through systems and influence both external clients/brokers and internal matrix partners
- Ability to make quality decisions
- Strong verbal and written communication skills
- Displays empathy & compassion
- Strong negotiation skills
- Demonstrated planning/organizational skills; ability to plan for both the long and short term; ability to work on many issues at once and to prioritize work
- Demonstrated ability to develop strong working relationships with both external clients/brokers and matrix partners in the organization; ability to leverage matrix resources to drive deliverables
Qualification & Experience:
- Bachelor’s degree highly preferred
Vacancy Type: Full Time
Job Location: Atlanta, GA, US
Application Deadline: N/A