Sr Supervisor, Infusion Nursing

SUMMARY:The primary function/purpose of this job.The Supervisor - RN Clinical is responsible for managing the daily operations of the clinical team in the area of medical management operations, inclusive, but not limited to maintaining production metrics, delivering on current service level agreements, fulfilling contractual requirements and supporting future state initiatives while meeting strategic, operational and budgetary targets. Additionally, this position will partner with leadership to continue the development of clinical quality programs. In collaboration with key business partners, the Supervisor – RN Clinical will identify operational opportunities and areas for process development, improvement and administration applicable to clinical product offerings and present recommendations to leadership.Provide quantitative data reflecting the scope and impact of the job – such as budget managed, sales/revenues, profit, clients served, adjusted scripts, etc.Supervises and coordinates daily activities of business support, technical support or production team at entry level and/or at nonexempt levels using established policies and procedures. Sets priorities for the team; Coordinates work activities with other supervisors and managers. Work is reviewed for soundness of decision-making and overall quality and efficiency.

Monitor operational performance relating to Operational metrics, Quality measures, Contractual requirements, Execution of MBM policies and procedures and Clinical appropriateness.

Monitor the daily administration of clinical programs, including application of medical policy, utilization management processes and practices while remaining compliant with contractual and regulatory requirements.

Serve as a point of escalation for issues requiring a higher degree of expertise or discretion to resolve.

Provides department leadership in the area of staff performance including mentoring, auditing, productivity monitoring and coaching for success. Corresponds with management on employee/HR issues, state of the department and any service issues involving key clients or legal risk issues to the company.

Analyze reporting data trends within team relative to quality to ensure efficiency and productivity requirements are maximized. Provide feedback to team related to productivity and efficiency.

Continual identification of operational opportunities to gain efficiencies, improve processes and workflow and develop best practices.

MINIMUM QUALIFICATIONS:Formal Education and/or Training: Registered NurseBachelor’s degree in relevant discipline or equivalent experienceYears of Experience:2-5 years relevant experience or Master’s degreeLicensures/Certifications:Registered Nurse- with an active state licenseComputer or Other Skills:Solid PC navigation skill set; Working knowledge of Microsoft Office; Excellent verbal and written communication and presentation skillsKnowledge and Abilities: PreferredSolid understanding of the health insurance industry; Ability to navigate and support both public and private insurance/plan requirements; Managed care exposure; Understanding or ability to implement utilization management principles; Proven leader in a clinical ops environment.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.