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Cigna Group

Sells health coverage and pharmacy benefits

Especialista en Autorizaciones Médicas

Claims AdjudicationConfirmed live in the last 24 hours
Full-timeMadrid, SpainNo salary listedHybrid

About the Job

Requirements

  • At least 5 years of experience managing medical authorizations in the insurance, hospital, or healthcare sector.
  • Advanced proficiency with computer tools.
  • Analytical ability and problem-solving orientation.
  • Ability to work in a team and collaborate with different areas of the organization.
  • Experience in healthcare management and operations.
  • Knowledge of risk underwriting in health insurance companies.
  • Experience controlling medical expenditure.
  • Ability to write protocols, procedures, and technical documentation.

Responsibilities

  • Parameterize the conditions declared by insured individuals in health questionnaires.
  • Identify and parameterize the coding of medical procedures associated with declared conditions and health conditions.
  • Manage parametrization and information-automation projects for the Directorate of Healthcare Management.
  • Manage medical authorizations and reimbursements and control healthcare expenditure, ensuring that prescribed medical procedures comply with contracted coverage and current clinical protocols.

About the Company

Cigna Group

Sells health coverage and pharmacy benefits

The Cigna Group sells health coverage and pharmacy services to employers, health plans and individuals, and most of its business runs through Evernorth, its health services arm. Evernorth owns Express Scripts, one of the largest pharmacy benefit managers in the U.S., which negotiates drug prices and processes prescriptions for plan sponsors, plus the specialty pharmacy Accredo. Its Cigna Healthcare unit sells medical, dental and behavioral coverage, mostly to employers that fund their own plans, and earns premiums and administrative fees, while Evernorth earns service fees and drug margins. The company was formed in 1982 through the merger of Connecticut General and INA and is based in Bloomfield, Connecticut.

Company size
10,001+
Company stage
Not listed
Total funding
Not listed
Headquarters
Bloomfield, CT
Founded
1982

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