Remote, Work from home

PURPOSE

The Payment Integrity program manager lead analyst will partner with EOB/MOOP and EOP/IDN advisors who are responsible for the end to end processes of these deliverables. In this role, you will interface with a variety of business partners, senior leadership, and external vendors. A successful candidate in this role will have experience in driving process improvement and achieving results.

Deliverables:
• Weekly, or as-needed project status reports
• Maintain project plan/test plan
• Test cases for new and regression testing of EOB, MOOP, EOP and IDN
• 98% of deliverables are generated timely
• 98% of deliverables have accurate content and format
• All policies and procedures are reviewed and updated annually

Responsibilities:
• Works closely with manager and advisors to successfully meet the deliverables
• Works closely with internal/external partners to answer questions related to process and compliance issues
• Manage internal scorecard and disseminate key metrics to internal / external partners
• Identify and track key issue trends - perform root-cause analysis and drive process improvement initiatives
• Identify test cases, create test case scenarios and perform user acceptance testing
• Support Audit functions/findings
• Build and maintain effective stakeholder relationships
• Support team processes
• Other duties as required

Qualifications:
• At least 3 years' of Medicare experience preferably in a Medicare Advantage plan
• At least 1 year of audit experience
• Basic SQL experience required
• Prior UAT experience preferred
• Prior claims processing experience preferred
• Preferred to have EOB, EOP, IDN and MOOP experience
• CMS requirements are understood and able to quickly locate
• Detail oriented and ability to produce high quality work
• Demonstrate strong problem solving, organizational, time management, and interpersonal skills
• Ability to multitask and operate in a fast paced environment
• Proficient in computer skills (Excel, Word, and Outlook)
• Team player
• Act with a sense of urgency to research inquiries. Identify the right parties or resources to resolve these issues. Follow up with these parties to drive resolution and provide on-going feedback to individual(s) who raised the question or issue
• Excellent written and oral communication skills
• Ability to work independently with minimal guidance
• Strong commitment to customer service and providers
• Quick to learn new systems and workflows
• Comfortable with raising questions, issues, ideas or suggestions to co-workers of all levels across all organizations

For this position, we anticipate offering an annual salary of $56,200 - $93,600, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

Helping our customers achieve healthier, more secure lives is at the heart of what we do. While you take care of our customers, we'll take care of you through a comprehensive benefits program that helps you be at your best. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and best in class well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and dozens of corporate discounts on essentials you use every day. For more details on our employee benefits programs, please visit the "Life at Cigna" tab on our careersite: www.cigna.com/careers

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives. What difference will you make?

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: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.