MIRS is the Medicare Issue Remediation System, where the organization logs and tracks issues that are systemic and have a compliance implication. The MIRS Issue Management Project Management Operations Risk Advisor is responsible for working with Compliance partners, functional leaders and SMEs across Medicare Advantage to ensure MIRS issues are worked timely and with high quality. The MIRS Issue Project Manager is expected to drive the completion of issues utilizing standard project management tools and techniques that are appropriately matched to the specific issue.
The ideal candidate is generally knowledgeable about Medicare operations and regulations, can quickly develop deeper knowledge related to specific issues, possesses a broad network, can quickly establish good working relationships with individuals across the organization, and is able to influence people who do not report to them. Highly successful candidates will be able to navigate the organization, conduct effective root cause analysis, form teams quickly to address issues and effectively facilitate those teams. They will also possess strong skills in problem solving, project management, change management, and process & data analysis.
The MIRS Issue Management Project Management Operations Risk Advisor has considerable autonomy in their day and is expected to effectively manage competing priorities.
ESSENTIAL DUTIES AND RESPONSIBILITIES
The MIRS Issue Management Project Management Operations Risk Advisor will:
- Manage a portfolio of MIRS issues, ensuring clear and effective status updates.
- Ensure issues are solved timely with high quality.
- Escalate barriers appropriately, as needed.
- Develop collaborative partnerships with Compliance MBS, functional leaders and SMEs.
- Be a trusted ally and expert on best practices for working within the MIRS system and in solving MIRS issues.
- Utilize effective and standard project management tools and techniques.
- Maintain an appropriate balance of flexibility and consistency to accommodate changes while avoiding counter-productive distractions and scope creep.
- Maintain essential documentation, data and reporting for each MIRS issue.
- Create effective communication and reporting mechanisms that meet the needs of the target audience (in terms of content, format and level of detail).
QUALIFICATIONS, EDUCATION & EXPERIENCE, and TOOLS & TECHNOLOGIES
The ideal MIRS Issue Management Project Management Operations Risk Advisor candidate will have at least 5 years of demonstrated experience in or certification in:
- Medicare operations & regulations.
- Project Management.
- Change Management.
- Process Engineering/ Process Improvement /Lean Six Sigma.
- Conducting Root Cause Analysis and Impact Analysis.
- Building Remediation Plans and driving teams to complete such plans.
- Effective verbal and written communications. (E.g., email, PowerPoint).
- Facilitating meetings, as well as in engaging 1:1 with individuals at all levels of the organization.
- Microsoft Office (Word, Excel, PowerPoint, Outlook, and SharePoint)
- Possessing a working knowledge of other tools and platforms used within MA Ops (e.g., Claims Platforms, MHK, ServiceNow, SharePoint) is a plus.
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 91,300 - 152,100 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 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 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.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
