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Provides consultation at the highest technical level to project teams and client areas assisting with the successful development and implementation of effective computer systems applications across multiple computing environments (e.g., host based, distributed systems, client server). Consults with client and IT management and staff throughout the project life cycle, to assist and support the design, development, and implementation of effective systems. Drafts, revises, and approves test plans and scripts to ensure alignment with standards and IT strategy. Creates test data files with valid and invalid records to thoroughly test program logic and verify system flow. Collaborates with users to plan user acceptance testing, alpha and beta testing. Ensures that system tests are successfully completed and documented, and all problems are resolved. Analyzes, designs new or modified Quality Assurance (QA) procedures and standards, and assists in the development and implementation of QA metrics for assessing the quality of delivered application software. Participates in the review of new QA software and consults with IT staff and client areas in resolving questions during the testing process. Works with client and IT management and staff to establish and maintain a consistent test methodology. Focuses on providing thought leadership and technical expertise across multiple disciplines. Recognized internally as \u201cthe go-to person\u201d for the most complex Quality Assurance & Testing assignments. Ability to design the strategy for all end-to-end test efforts, including the testing roadmap, data plan, execution approach, communication cadence, and identification of risks/dependencies. Ability to work with the assigned testing points of contacts and TPO's, facilitate successful cross-functional coordination across all teams. 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Support advanced analytical and data mining efforts which could include but not limited to clustering, segmentation, logistic and multivariate regression. Visualize, interpret, report, and communicate data findings creatively in a variety of formats and audiences using Excel, ggplot, Tableau, etc. Proven experience in developing and deploying production ML models using analytical methods such as regression, decision trees, support vector machines, supervised and unsupervised learning. 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POSITION SUMMARY: The Quality Review and Audit Lead Analyst is responsible for facilitating the analysis, research, and risk assessment of claims/system processing issues. The lead analyst will use an in depth understanding of technical principles, theories, and concepts in the field of quality to perform a thorough root cause and corrective action analysis. In addition to supporting tickets for root cause analysis, the lead analyst will be engaged in strategic initiatives to drive continuous improvement in the process to support our enterprise business. Required Qualifications: 3-5 years\u2019 experience in Root Cause and Corrective/Preventive Action Excellent verbal and written business communication skills Knowledge including Microsoft Office; Outlook, Word, Excel, PowerPoint and SharePoint Knowledge of ESI platforms preferred: Service Now, RSAM, Polaris Adapt to a dynamic work environment, learn quickly, solve problems and make decisions with minimal oversight Demonstrate initiative, commitment, and ability to work under pressure and meet tight deadlines Demonstrated ability to work collaboratively with other departments to resolve complex issues with strategic & innovative solutions Preferred Qualifications: BA/BS degree Healthcare acumen Corrective Action/Preventive Action Management Responsibilities:\u00a0\u00a0\u00a0\u00a0\u00a0 Review, analyze, and appropriately disposition tickets for RC/CA Analysis Collaborate with Business Partners to ensure correct root cause is established and a solid corrective action/preventive action is in place Utilize system platform to manage tickets and accurately capture/categorize all necessary trend information Review submitted data for quality and accuracy Support projects and initiatives which drive department strategy Assist in training, documentation, and other duties required to sustain and improve process performance Partner with Service Operations & PBM Customer Services to execute on action plan deliverables Share and communicate pertinent information with internal partners Hourly Pay Rate Range (dependent on location, experience, expectation) The pay range that Magnit reasonably expects to pay for this position is: $25- $33.57/hour Benefits: Medical, Dental, Vision, 401K (provided minimum eligibility hours are met)", "stars": 0.0, "medallionProgram": null, "location_flexibility": null, "work_location_option": null, "canonicalPositionUrl": "https://magnitdirectsourcing-cgn.magnitglobal.com/careers/job/137458244058", "isPrivate": false}, {"id": 137458024222, "name": "Quality Review and Audit Analyst", "location": "Nashville, Tennessee, US ", "locations": ["Nashville, Tennessee, US ", "Remote"], "hot": 0, "department": "Business Operations", "business_unit": "Cigna Group Contingent Labor", "t_update": 1700241673, "t_create": 1700065158, "ats_job_id": "27798843", "display_job_id": "27798843", "type": "ATS", "id_locale": "27798843-en", "job_description": "This is a temporary role through Magnit Global with one of the world\u2019s leading health insurance companies. Position notes: Monday - Friday - start time flexible between 7am-9am - 40 hours Training Schedule - Mon, Tues, Wed -9am EST - 5:30pm, Thurs & Fri - shadow co-worker 100% Remote Responsibilities: The Risk Adjustment Quality & Review Analyst in IFP brings medical coding and Hierarchical Condition Category expertise to the role, evaluates complex medical conditions, determines compliance of medical documentation, identifies trends, and suggests improvements in data and processes for Continuous Quality Improvement (CQI). Key Job Functions: Conduct medical records reviews with accurate diagnosis code abstraction in accordance with Official Coding Guidelines and Conventions, Cigna IFP Coding Guidelines and Best Practices, HHS Protocols and any additional applicable rule set. Utilize HHS\u2019 Risk Adjustment Model to confirm accuracy of Hierarchical Condition Categories (HCC) identified from abstracted ICD-10-CM diagnosis codes for the correct Benefit Year. Apply longitudinal thinking to identify all valid and appropriate data elements and opportunities for data capture, through the lens of HHS\u2019 Risk Adjustment. Perform various documentation and data audits with identification of gaps and/or inaccuracies in risk adjustment data and identification of compliance risks in support of IFP Risk Adjustment (RA) programs, including the Risk Adjustment Data Validation (RADV) audit and the Supplement Diagnosis submission program. Inclusive of Quality Audits for vendor coding partners. Collaborate and coordinate with team members and matrix partners to facilitate various aspects of coding and Risk Adjustment education with internal and external partners. Coordinate with stake holders to execute efficient and compliant RA programs, raising any identified risks or program gaps to management in a timely manner. Communicate effectively across all audiences (verbal & written). Develop and implement internal program processes ensuring CMS/HHS compliant programs, including contributing to Cigna IFP Coding Guideline updates and policy determinations, as needed. Education & Experience: The Quality Review & Audit Analyst will have a high school diploma and at least 2 years\u2019 experience in one of the following Coding Certifications by either the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC): Certified Professional Coder (CPC) Certified Coding Specialist for Providers (CCS-P) Certified Coding Specialist for Hospitals (CCS-H) Registered Health Information Technician (RHIT) Registered Health Information Administrator (RHIA) Certified Risk Adjustment Coder (CRC) certification Minimum Qualifications Experience with medical documentation audits and medical chart reviews and proficiency with ICD-10-CM coding guidelines and conventions Familiarity with CMS regulations for Risk Adjustment programs and policies related to documentation and coding compliance, with both Inpatient and Outpatient documentation HCC coding experience preferred Computer competency with excel, MS Word, Adobe Acrobat Must be detail oriented, self-motivated, and have excellent organization skills Understanding of medical claims submissions is preferred Ability to meet timeline, productivity, and accuracy standards Required Qualifications: AAPC and/or AHIMA Certification Needed Risk Adjustment Experience Able to work independently\u00a0 Hourly Pay Rate Range (dependent on location, experience, expectation) The pay range that Magnit reasonably expects to pay for this position is: $25.00/hour-$27.77/hour Benefits: Medical, Dental, Vision, 401K\u00a0", "stars": 0.0, "medallionProgram": null, "location_flexibility": null, "work_location_option": null, "canonicalPositionUrl": "https://magnitdirectsourcing-cgn.magnitglobal.com/careers/job/137458024222", "isPrivate": false}, {"id": 137456987973, "name": "QA & Testing Advisor", "location": "Franklin, Tennessee, US ", "locations": ["Franklin, Tennessee, US ", "remote"], "hot": 0, "department": "IT", "business_unit": "Cigna Group Contingent Labor", "t_update": 1699576132, "t_create": 1694786044, "ats_job_id": "25896507", "display_job_id": "25896507", "type": "ATS", "id_locale": "25896507-en", "job_description": "Be a part of an ongoing effort to bring new testing knowledge and methodologies to the team Works with business partners and IT staff to establish and maintain a consistent testing methodology Identify and prepare complex test data to support the test cases defined by the team Design, develop and code SQL programs to execute backend code tests Design a comprehensive testing strategy & build test suites Design, develop and maintain regression test beds and schedule test cycles Leverage the testing process and test tool kit to create re-usable test sets Ensure regression scripts are in appropriate format for automation Test execution-manual and automated Perform UAT of functional requirements Utilize appropriate testing tools Assist in the coordination of User Acceptance testing (UAT) and End to End (E2E) testing Validate and report progress, risks, issues and defects to agile team Communicates with business partners and agile team members throughout the project life cycle, to assist and support the design, development and implementation of effective systems and deliverables Be an active participant during PI Planning, retrospective and daily stand-up meetings and business demonstrations Participates in the review of QA procedures and processes and the development of QA metrics for assessing the quality delivered application software or systems. Support all post implementation activities, such as post implementation testing and lessons learned analysis Testing/working experience with Healthcare IT, familiarity with Healthcare IT terminology and Healthcare claims processing, business functions and processes Extensive QA/Software testing experience in large cross platform testing programs in both WEB (.NET/SQL environement), IBMi platform programs (RPG) and backend (database SQL Server/DB2) testing Knowledge of MC400 claims application highly desired Advanced database experience in SQL server databases required and proficiency in Transact SQL Ability to insert data in a table Ability to modify data within a table Ability to delete/truncate tables Ability to save off copies of tables Experience with deciphering complex SQL stored procedures is required Exposure to working in Agile/Scrum environment is required Working knowledge of automated testing tools and techniques, broad knowledge of business modeling, process engineering, change management and test case generation techniques across the testing lifecycle Solid experience in business requirements analysis, test design, defect logging and tracking Demonstrated experience in tools such as Selenium WebDriver, Jenkins, GIT, JavaScript Experience working with business analysts, system analysts and developers for test requirement gathering, acceptance criteria etc. Skilled utilizing test formulation tools for test management and operations, to include performance and load testing tools as well as test reporting tools (Zephyr) Must be able to manage multiple assignments with staggered deadlines Excellent interpersonal, communication, presentation and documentation skills Strong problem-solving and analytical skills Strong team and task management skills Self-directed and highly adaptive to changing priorities Innovative thinking and possess a keen eye for detail Comfortable working independently or as part of a team Bachelor's degree in business or Computer Science preferred but not required", "stars": 0.0, "medallionProgram": null, "location_flexibility": null, "work_location_option": null, "canonicalPositionUrl": "https://magnitdirectsourcing-cgn.magnitglobal.com/careers/job/137456987973", "isPrivate": false}, {"id": 137457274022, "name": "Application Development Advisor", "location": "Franklin, Tennessee, US ", "locations": ["Franklin, Tennessee, US ", "remote"], "hot": 0, "department": "IT", "business_unit": "Cigna Group Contingent Labor", "t_update": 1697956625, "t_create": 1695915548, "ats_job_id": "26415208", "display_job_id": "26415208", "type": "ATS", "id_locale": "26415208-en", "job_description": "Participate in medium to large scale projects by reviewing project requirements. Translating requirements into solutions, write code, unit tests, ensure code coverage, communicate status and issues across team while collaborating with product, project and cross-functional teams. Ensuring on-time delivery. Troubleshooting complex problems, identifying code defects and collaborating with other developers on defect fixes. Provide support to business by responding to and raising user story questions, concerns and issues. Identifying strategies to implement features and functionality in regular cadence with short and long term plan. Write technical documentation. Work on multiple projects with varying deadlines. Coordinate work with business, QA and other teams including offshore Development. Communicate with technical management and other departments, reporting statuses and risks. Work under minimal supervision. Hands-on experience in Microsoft .Net technologies such as MVC, EF ,vb.net, C#, ASP.NET, LINQ, REST, Terraform , Azure , Kafka , WCF and OO designs. Experience using Angular or React or similar modern UI libraries. Experience with Unit testing, Test Driven Development or use of mocking frameworks. Experience in MS SQL Excellent verbal and written communication skills Good understanding of SDLC and Agile methodologies. Ability to collaborate with multiple teams across geographies to deliver quality technology Experience in Microservice architecture and development using C Experience building in Event Driven Architecture a plus. Experience with Azure DevOps, NoSQL Solutions a plus. 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Participate in Client Installation meetings Responsible for the successful implementation of new client clinical programs, complete understanding of Express Script's clinical product portfolio Participate in weekly client review forums Coordinate Clinical Installation Activity with internal functional areas Manage Clinical Post Installation Issues Good verbal and written communication skills Very detailed oriented Great time management skills Focus on problem solving abilities Licensed Pharmacist required. 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Understand the relationship and differentiation between virtual servers, virtual server types, virtual addresses, pools, pool members, nodes, profiles, iRules, and address translation (NAT/SNAT). Be familiar with HTTP, ClientSSL, ServerSSL, TCP, UDP, and persistence profiles. Open a support case and utilize online resources such as AskF5, F5 iHealth, and DevCentral. Capable of performing F5 upgrades and licensing. Experience with ServiceNow ITSM application. Experience with large scale enterprise projects. Knowledge of security protocols and implementations. Experience in the use of multiple network tools, such as, SyslogNG, SevOne, Spectrum, Splunk, tcpdump and Qradar, for network troubleshooting and monitoring. Well versed in crisis management and root cause analysis techniques. Experience working in a team-oriented, collaborative environment. Proven analytical and problem-solving abilities. Strong interpersonal, written, and oral communication skills. 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