Cigna

Position Summary As a Product Management Senior Advisor, you will manage and support the suite of medical network products available to Cigna Healthcare clients and customers. The Product Management Senior Advisor will be responsible for the management of existing medical network products and will serve as the expert supporting sales and operational readiness. This person will work closely with matrix partners across the enterprise-including Sales, Contracting, Marketing, Pricing/Finance, Operations, Analytics, Go-to-Market, Compliance and Legal, and external partners when appropriate. You will provide high-level support to clients, internal teams, and other partners by resolving product issues, analyzing trends, and contributing to continuous improvement initiatives. This role requires a deep understanding of health insurance operations, sales support, performance analytics and customer service excellence. Key Responsibilities Govern holistic network solution suite...

Position Summary As a Product Management Senior Advisor, you will manage and support the suite of medical network products available to Cigna Healthcare clients and customers. The Product Management Senior Advisor will be responsible for the management of existing medical network products and will serve as the expert supporting sales and operational readiness. This person will work closely with matrix partners across the enterprise-including Sales, Contracting, Marketing, Pricing/Finance, Operations, Analytics, Go-to-Market, Compliance and Legal, and external partners when appropriate. You will provide high-level support to clients, internal teams, and other partners by resolving product issues, analyzing trends, and contributing to continuous improvement initiatives. This role requires a deep understanding of health insurance operations, sales support, performance analytics and customer service excellence. Key Responsibilities Govern holistic network solution suite...

Role Summary This position is responsible for driving B2B solutions (product) marketing including new product launches, product enhancements and product upsells within Express Scripts pharmacy benefits, Evicore medical benefit management and care solutions within Evernorth, Cigna’s health services unit. Scope is subject to change as the Evernorth business evolves. This is a business-to-business (B2B) marketing role that requires understanding of B2B, healthcare and/or product marketing best practices in planning marketing strategies and overseeing tactical execution and measurement. Success is highly dependent upon successful collaboration with product leaders across the organization, with marketing partners and across the COE’s when applicable. Focus Is On The Following Key Areas Establish strong relationships with product teams to develop a strong understanding of business and product priorities and foster partnership in launch planning. Direct marketing strategy and...

Position Summary As a Product Management Senior Advisor, you will manage and support the suite of medical network products available to Cigna Healthcare clients and customers. The Product Management Senior Advisor will be responsible for the management of existing medical network products and will serve as the expert supporting sales and operational readiness. This person will work closely with matrix partners across the enterprise-including Sales, Contracting, Marketing, Pricing/Finance, Operations, Analytics, Go-to-Market, Compliance and Legal, and external partners when appropriate. You will provide high-level support to clients, internal teams, and other partners by resolving product issues, analyzing trends, and contributing to continuous improvement initiatives. This role requires a deep understanding of health insurance operations, sales support, performance analytics and customer service excellence. Key Responsibilities Govern holistic network solution suite...

As a Lead Analyst, Invoice Review & Audit, you will play a critical role in ensuring financial accuracy, transparency, and trust across our Coverage Review Operations (CRO). You will partner with Global Service Partners (GSPs), Finance, and Procurement teams to strengthen invoice governance, support informed decision-making, and continuously improve how we manage vendor spend. This role is ideal for someone who enjoys detail-driven work while thinking strategically about process improvement and business impact. Responsibilities Ensure invoices from Global Service Partners and third-party suppliers are accurate, compliant, and aligned to contract terms, budgets, and forecasts. Perform thorough invoice reviews and audits, identifying trends, variances, and risks that impact financial performance. Approve invoices in Ariba to support timely and accurate payment processing. Partner with Finance, Procurement, and Accounts Payable teams to resolve...

We are seeking a detail-oriented Lead Analyst to support the Voluntary Out-of-Network Protection Team. This role focuses on driving accurate, fair, and cost-effective pricing for voluntary out-of-network claims, with expertise in Maximum Reimbursable Charge (MRC), Fair Health pricing, and Medicare-based methodologies . The Lead Analyst resolves pricing disputes, analyzes claims data, and develops tools and insights that support manual pricing teams and external pricing operations. This role directly impacts affordability for members, consistency for providers, and cost efficiency for clients. Key Responsibilities Resolve voluntary out-of-network pricing disputes using MRC, Fair Health, and Medicare methodologies. Analyze pricing data to identify trends, variances, and improvement opportunities. Develop tools, reporting, and insights to support manual and external pricing operations. Collaborate with Claims, Call Center, and matrixed teams to...

SUMMARY The Cigna Group is a global Health Service company dedicated to helping people improve their health and vitality. We seek dedicated, compassionate, and empathetic Customer Service Representatives to join our team who are genuinely interested in helping people at some critical points of their lives. The Call Center Customer Service Representative represents the company, and our people make all the difference in our success. RESPONSIBILITIES Answer inbound calls from members, providers, and pharmacies with questions about Pharmacy Benefit Management (PBM) benefits, mail-order pharmacies, or Medicare. Take calls back-to-back while toggling through several applications on multiple screens. Attend 100% of trainings and the first 90 days of employment. Update conversion requests and provide shipment status to members Facilitate transition of requested medications to home delivery Advocate for the member patient by placing phone calls,...

We are seeking a highly skilled, customer-focused Senior Analyst to support our Voluntary Out-of-Network team. This role plays a critical part in resolving complex pricing disputes, supporting cost containment efforts, and strengthening provider relationships. While not a people-management role, the Senior Analyst serves as a key contributor and subject-matter expert, guiding execution and supporting strategic initiatives. This position is ideal for someone with strong analytical capabilities, a passion for customer service, and the ability to work independently while collaborating effectively across teams. Key Responsibilities Lead the execution of pricing dispute resolution activities within Voluntary Out-of-Network cost containment programs. Conduct thorough investigations of pricing disputes to determine appropriate next steps, involved vendors, and resolution pathways. Ensure timely follow-up and resolution in alignment with established turnaround...

The Qualitative and Quantitative Insight Partners team is looking for a data savvy lead analyst to help us in our mission to provide personalized, actionable data driven insights for customers, working with cross-functional partners to streamline accessible and affordable care. The Business Lead Analyst will play an active part of a dynamic team that is designing, developing/building and deploying novel and complex decision models to support several key products. This role blends technical expertise, analytical rigor, and cross‑functional collaboration to enable data‑driven decision making. The Lead Analyst uses ADS (Automated Decisioning Service) to deliver scalable, transparent, and actionable decision logic for business partners. Responsibilities Implement and Deploy Decision Modeling by translating business requirements into structured decision frameworks, rule sets and model logic Use business requirements to design, develop, and maintain decision models...

This role will report to the Senior Director, Pharma Strategy & Contracting and will focus on Pharma industry/Managed Markets/Specialty. Knowledge of PBM/Health plans consistent with Contract negotiations with Pharma manufacturers. The Principal will be responsible for management of Pharma Manufacturing drug portfolios and pipelines, and strategic thinking around rebate contracting deal structures. In this role, you will have the opportunity to consult with Health Plans, develop strategic initiatives, cross functionality with products; own day to day responsibility for manufacturer relationship from negotiating, invoicing issues, payment, contract setup, confirmation and strategic development for health plan clients. ESSENTIAL FUNCTIONS: Assisting the Sr. Director of Pharma Strategy and Contracting in determining manufacturer, product class, and drug tactics and executing on these tactics. Collaborate with Ascent Health Services on product class strategies and...

The Cigna Group is a global Health Service company dedicated to helping people improve their health and vitality. Our Pharmacy Benefit Management (PBM) team seek dedicated, compassionate, and empathetic Customer Service Representatives to join our team who are genuinely interested in helping people at some critical points of their lives. The Call Center Customer Service Representative represents the company, and our people make all the difference in our success. RESPONSIBILITIES Answer inbound calls from members, providers, and pharmacies with questions about Pharmacy Benefit Management (PBM) benefits and mail-order pharmacies. An average of 70-80 calls are expected daily. Take calls back-to-back while toggling through several applications on multiple screens. Attend 100% of trainings, and the first 90 days of employment. Regular and predictable attendance. Resolve customer complaints through independent problem-solving skills and one-call...

Position Summary The Claims Manager leads the day-to-day operations of the claims organization, managing Claim Supervisors and/or Project Lead Analysts. This role partners closely with internal stakeholders and Global Service Partners (GSPs) to ensure appropriate staffing, inventory control, quality outcomes, and achievement of performance metrics across assigned claim platforms. Key Responsibilities Lead and develop Claim Supervisors, ensuring performance aligns with established KPIs, quality standards, and processing timelines. Drive efficient inventory management to meet time-to-process, quality, and LPI goals. Partner with Global Service Partners to achieve SLA commitments and operational objectives. Collaborate with workforce management to balance staffing levels and operating expenses. Analyze eMOS and operational data to identify trends, remove barriers, and improve efficiency. Coach, mentor, and develop high-performing teams...

The Qualitative and Quantitative Insight Partners team is looking for a data savvy lead analyst to help us in our mission to provide personalized, actionable data driven insights for customers, working with cross-functional partners to streamline accessible and affordable care. The Business Lead Analyst will play an active part of a dynamic team that is designing, developing/building and deploying novel and complex decision models to support several key products. This role blends technical expertise, analytical rigor, and cross‑functional collaboration to enable data‑driven decision making. The Lead Analyst uses ADS (Automated Decisioning Service) to deliver scalable, transparent, and actionable decision logic for business partners. Responsibilities Implement and Deploy Decision Modeling by translating business requirements into structured decision frameworks, rule sets and model logic Use business requirements to design, develop, and maintain decision models...

Summary Responsible for design and buildout of trend prediction capabilities across key clinical and affordability metrics, this individual will build expert-level clinical metrics into the broader CHC Risk Ecosystem. Candidates should be very familiar with the intersection of clinical data with predictive techniques including authorization data, service category, and diagnosis drivers. Key stakeholder groups include clinical and affordability teams, analytics, and finance. Responsibilities Buildout key clinical risk indicators and projection insights into the CHC Risk Ecosystem Partner with clinical & financial stakeholders to design and implement effective clinical analysis capabilities and key performance indicators into trend analysis & claim insights Unpack relationships between key clinical drivers, including authorizations, claims, diagnostic categories, and episodes of care in the CHC Risk Ecosystem Own end-to-end development of...

Make a measurable impact on healthcare affordability and accuracy by leading initiatives that improve claim payment precision and reduce unnecessary medical spend. In this role, you will combine analytical expertise, collaboration, and strategic thinking to strengthen pre- and post-pay solutions that protect customers and the business alike. Responsibilities Lead policy and quality improvement initiatives that enhance medical claim accuracy and reduce overpayments across pre- and post-pay programs. Partner with internal teams and external vendors to identify overpayment opportunities and design effective edit rules with balanced accuracy and financial outcomes. Own assigned edits throughout their lifecycle, monitoring performance, implementing corrective actions, and driving continuous improvement. Analyze weekly and monthly performance reports to assess effectiveness, identify trends, and recommend enhancements. Build clear, data-driven business...

As part of Evernorth Health Services, this role supports CarepathRx within our Pharmacy and Care Delivery organization, focusing on specialty pharmacy and infusion services in partnership with hospitals and health systems. We are seeking a forward-thinking Business Analytics Lead Analyst who brings curiosity, analytical strength, and a growth mindset to help drive meaningful insights and strategic decision-making. Responsibilities Lead the development and preparation of quarterly business reviews, budget-to-actual performance analyses, gross margin analytics, and profitability models for 28+ partners. Deliver monthly financial and non-financial performance metrics, providing clear commentary and actionable insights. Partner with cross-functional teams to track and analyze KPIs across key business units and functions. Build pricing models, proformas, and business cases to support new investments and strategic initiatives. Utilize BI tools to surface...

This is a Hybrid position (3 days per week in-office + 2 days work at home). The incumbent candidate can be based out of any US Cigna Healthcare office and is not restricted to locations that are listed in this posting. JOB SUMMARY The Clinical Program Advisor/Program Management Advisor provides insight and guidance on complex clinical rebate modeling assignments/projects and provide financial rebate modeling support to assigned clients. Exercises considerable creativity, foresight, and judgment in conceiving, planning, and delivering initiatives. Uses clinical professional knowledge and acumen to advise functional leaders and educate other team members. Delivers formulary consulting clinical modeling support, but also works on broader projects, which require understanding on a more global perspective. Recognized internally as a clinical subject matter expert. Represents supply chain department internally and externally serving as conduit to educate downstream formulary...

The Cigna Group is a global Health Service company dedicated to helping people improve their health and vitality. Our Pharmacy Benefit Management (PBM) team seek dedicated, compassionate, and empathetic Customer Service Representatives to join our team who are genuinely interested in helping people at some critical points of their lives. The Call Center Customer Service Representative represents the company, and our people make all the difference in our success. RESPONSIBILITIES Answer inbound calls from members, providers, and pharmacies with questions about Pharmacy Benefit Management (PBM) benefits and mail-order pharmacies. An average of 70-80 calls are expected daily. Take calls back-to-back while toggling through several applications on multiple screens. Attend 100% of trainings, and the first 90 days of employment. Regular and predictable attendance. Resolve customer complaints through independent problem-solving skills and one-call...

The Qualitative and Quantitative Insight Partners team is looking for a data savvy lead analyst to help us in our mission to provide personalized, actionable data driven insights for customers, working with cross-functional partners to streamline accessible and affordable care. The Business Lead Analyst will play an active part of a dynamic team that is designing, developing/building and deploying novel and complex decision models to support several key products. This role blends technical expertise, analytical rigor, and cross‑functional collaboration to enable data‑driven decision making. The Lead Analyst uses ADS (Automated Decisioning Service) to deliver scalable, transparent, and actionable decision logic for business partners. Responsibilities Implement and Deploy Decision Modeling by translating business requirements into structured decision frameworks, rule sets and model logic Use business requirements to design, develop, and maintain decision models using ADS...

Evening Schedule - Shifts begin at 12pm and 3pm CST. Our mission is to provide immediate, personalized clinical support-whether it's a moment of crisis, clinical consultation, or a step towards lasting change. Our mission is to be responsive, collaborative, and impactful with each connection. As a Behavioral Licensed Clinician on our 24/7 Clinical Support Team, you will deliver expert, compassionate care across a wide spectrum of behavioral health needs. This team is designed to ensure continuity-each Behavioral Licensed Clinician remains with the customer throughout their journey, becoming a trusted clinical partner. While every team member supports various clinical populations and needs, we value and will leverage subject matter expertise in the development of training, curriculum, and clinical consultation. You'll be called on to bring depth into your areas of specialization while remaining flexible and responsive across all cases. The successful candidate will have...

The role of an Operations Analyst - Client Audit Coordinator responsible for managing external client audits, collaborating with cross-functional teams, analyzing audit results, and supporting overpayment recovery, requiring at least three years of claims processing experience and proficiency with the Proclaim system, with preferred qualifications including experience with additional processing platforms and virtual project leadership. Responsibilities Manage external client audits from initiation through post-audit follow-up, ensuring timely, accurate completion and clear communication of audit status. Research and respond to audit inquiries by leveraging KnowledgeXchange, internal partners, and deep claims processing expertise to provide clear, well-supported responses. Collaborate with cross-functional partners including Enterprise Operations, Eligibility, Auto Adjudication, Quality, Client Audit Managers, and Client Service teams to resolve audit...

Evening Schedule - Shifts begin at 12pm and 3pm CST Our mission is to provide immediate, personalized clinical support-whether it's a moment of crisis, clinical consultation, or a step towards lasting change. Our mission is to be responsive, collaborative, and impactful with each connection. As a Behavioral Licensed Clinician on our 24/7 Clinical Support Team, you will deliver expert, compassionate care across a wide spectrum of behavioral health needs. This team is designed to ensure continuity-each Behavioral Licensed Clinician remains with the customer throughout their journey, becoming a trusted clinical partner. While every team member supports various clinical populations and needs, we value and will leverage subject matter expertise in the development of training, curriculum, and clinical consultation. You'll be called on to bring depth into your areas of specialization while remaining flexible and responsive across all cases. The successful candidate will have...

Position Summary: We are seeking a highly skilled Lead Applied AI Analyst to support a strategic initiative aimed at transforming financial workflow across the enterprise. This role will be responsible for designing, developing, and operationalizing AI-driven solutions that automate workflows, modernize legacy processes, and unlock new analytical and decision-support capabilities. The Lead Applied AI Analyst will partner closely with the Director of Program Delivery, business teams across Finance and related functions, and technical delivery teams to embed AI into daily operations and deliver measurable business outcomes. Key Responsibilities: AI Solution Design & Development Lead the design and development of AI capabilities, including NLP, GenAI, predictive modeling, and agent-based automation. Build AI-driven workflows that simplify multi-step business processes and reduce manual effort. Business Problem Solving & Use Case Development...

This role plays a critical part in strengthening payment integrity outcomes by partnering with providers, vendors, and internal teams to drive accurate and timely recovery of provider overpayments. The Business Project Lead Analyst brings expertise, collaboration, and a continuous improvement mindset to help maximize recoveries while building trusted relationships across the enterprise. Responsibilities Lead strategic collaboration between recovery vendors, providers, and internal network partners to improve provider overpayment refund outcomes. Drive monthly provider and vendor discussions to review overpayment inventory, resolve barriers, and accelerate recoveries. Partner with Network and Contracting teams to address uncooperative providers and implement effective remediation strategies. Monitor vendor performance and accuracy, translating findings into corrective action plans that improve results and compliance. Serve as a subject matter...