The Individual and Family Plans (IFP) Enrollment & Reconciliation Operations Manager leads a small team that executes and oversees enrollment processing and reconciliation efforts for Individual and Family Plan segment. This includes overseeing integration and reconciliation with Federal and State Healthcare Marketplaces, private exchanges, and third party administrators. Ensure that Medical and Dental customers that we have the privilege to serve have access to the care they have purchased on their coverage effective date. Implement and execute strategies to ensure that customer enrollment information is accurate and consistent across all systems in the care delivery and support value chains, so Cigna can deliver the optimal customer experience and achieve our growth and profitability targets. Drive continuous improvement and support the future of Cigna's Individual and Family Plans with leadership, business acumen, technical, and process subject matter expertise. Core Responsibilities: Ensure that new and renewing Medical and Dental customers have access to the care they have purchased on their coverage effective date, and that the organization is protected from unnecessary risk. Maintain a current knowledge of the Affordable Care Act, all federal or state specific regulations and sub-regulatory guidance as it relates to Federally Facilitated or State Based individual insurance exchanges, reconciliation, assistance, and risk programs. Ensure team, department and functional compliance with Federal and State regulations as well as all Cigna internal and external policies. This includes the creation and maintenance of critical documents such as policies, standard operating procedures, business rules, and technical specifications. Coach and develop employees. Evaluate performance, provide feedback and conduct regular "check ins" with a virtual team. Implement and execute strategies within the team, department, and enrollment function to ensure geographic expansions and new sales distribution partners are integrated successfully. Develop and prepare operational analysis, including operational effectiveness and capacity utilization to make recommendation for future growth needs and future improvements. Partners with matrixed operational and information technology teams to influence, develop, and implement strategies within the enrollment/reconciliation functions, team, and department that increase efficiency, reduce operational costs, support compliance, including internal and regulatory audits, optimizes customer experience, and supports growth and financial targets. Ensure that internal and external matrix partners' execution of our enrollment process meets or exceeds key performance indicators and service level agreements, and develop new metrics to meet the evolving business environment. Identify future program needs, including building business cases for change, acquiring executive sponsorship, and serve as business owner on projects. Work with vendor and key matrix partners to create and implement end to end data analysis, reconciliation, and discrepancy resolution processes for enrollment and financial data within the Individual Healthcare Segment for on and off marketplace business. Prepare and deliver operational results metric reporting on a regular basis. Act as subject matter expert in support of segment and enterprise initiatives. Minimum Qualifications: Minimum of 3 years of relevant experience required, ideally in Affordable Care Act enrollment and reconciliation Bachelor's degree in relevant field preferred Advanced problem solving skills and the ability to work collaboratively with internal and external teams to resolve issues. Excellent written and verbal communication skills Ability to adapt in a dynamic work environment and make independent decisions Demonstrated leadership capabilities; experience supervising teams preferred Strong analytical capabilities and organizational skills Comfortable with raising questions, issues, ideas or suggestions to co-workers of all levels across all organizations. Act with a sense of urgency to research questions or issues brought by the team. Proficiency with Microsoft Excel, Microsoft Word, and Power Point. Experience with Microsoft Access and relational databases 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.
For this position, we anticipate offering an annual salary of 83,000 - 138,300 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: for support. Do not email 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.
