* Clinical focused Enterprise Architect * Learn technology capabilities * Survey and assess Cigna's current systems and capabilities, forming conclusions on gaps and opportunities * Collaborate with business partners and IT leads on forming conclusions from the findings and prioritizing the architecture components * Help create and share architecture materials that move from strategy to delivery * Translate complex functional, technical, and business requirements into architectural designs * Focused on SOA design, integrating internal systems with SaaS solutions * EHR Interoperability standards, FHIR, clinical data exchange, and delegation of services *
Project Manager and member of the Delivery Assurance Team within CIGNA's Group Insurance IT Department. Responsible for collaboration with numerous teams including development, testing and production support to deliver projects for the business on time and on budget. Managed the Group Insurance portfolio for client driven requests as well as the Enhancement portfolio.
Works with Clients and Brokers on a daily basis addressing issues including: Benefit Administration, Group Insurance, Enrollment Strategy, Employer/Employee Consumerism and proactive service. Provide proactive and high-level account development and support. Respond to customer calls by channeling questions and issues appropriately within CIGNA Group Insurance. Demonstrate the ability to handle, refer, or delegate complex questions, issues, and problems to appropriate CIGNA Group Insurance resources on a wide range of products as they relate to the assigned book of business. Collaborate with the Client Management team (i.e. - Client Manager, Implementation Manager, etc.) in the development of client specific strategies and in the pursuit of growth opportunities, and retail strategies. Develop strong working relationships with key customer contacts, Client Management team members, and internal matrix partners.
OPL Advisors provides dependent eligibility auditing and subrogation services to corporations and large group health plans. Activities involve conducting benefits comparison analyses, developing analytics, and writing RFP proposals including eligibility/medical claims auditing and pharmacy benefits (PBM) analysis. Provide sales / technical consults in cost-effective benefit solutions for clients. Select Accomplishments Recruited specifically for this start-up company to develop RFP and auditing process including financial modeling. Earned solid reputation as technical leading health and benefits for other company consultants. Selected to lead/troubleshooting of complex quantitative analyses for top clients.
Cambridge provides advice and assistance in program / plan strategy, design and auditing; organizational health and Wellness, compliance, and administration tailoring compensation and benefit solutions that reinforce business objectives. Centered on RFP & RFI analyses, assessment of benefit plans including some actuarial analyses, in addition to, pharmacy, benefits and financial modeling. Select Accomplishments Built financial budget for major client resulting in cost savings of $450,000. Solely created an RFP tool, approved by actuarial department, for Pharmacy Benefits (PBM) Division increasing $25 million in savings for client. Recommended plan designs for clients with 75% acceptance / approval rate. Successfully negotiated aggressive discounts for variety of agencies and organizations. Trained and mentored new hires.