Cigna Healthcare

Develop and maintain data governance policies and standards while ensuring the integrity and quality of healthcare data. Collaborate with stakeholders to validate data accuracy and support compliance with regulations. | Candidates should have a Bachelor's degree in a related field and at least 3 years of experience in data governance or management roles, particularly with healthcare data. Proficiency in SQL and experience with tools like Databricks and Snowflake are essential. | Summary: Provides professional input to Business Analytics assignments/projects. Works in collaboration with business partners to provide analyses and reports to aide decision making based on data, facts, and analytical findings across different parts of the organization. Analyzes and interprets collected data, spots trends, writes reports and recommendations and completes data modeling. Exercises judgment in the evaluation, selection, and adaptation of both standard and complex techniques and procedures. Utilizes in-depth professional knowledge and acumen to develop models and procedures, and monitor trends, within Business Analytics. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position, you see is right for you, we encourage you to apply! Our people make all the difference in our success. About the Role We are seeking a detail-oriented and strategic Data Governance & Validation Analyst to join our team. In this critical role, you’ll help ensure the integrity, consistency, and quality of healthcare data across the organization. You’ll work cross-functionally to implement governance frameworks, validate data accuracy, and support compliance with internal standards and external regulations. Responsibilities: Develop and maintain data governance policies, standards, and procedures. Query and analyze large-scale healthcare datasets (e.g., claims, pharmacy, patient data) using SQL and other tools. Collaborate with business and technical stakeholders to define data definitions, ownership, and lineage. Design and build monitoring dashboards and reports using BI tools (e.g., Tableau, Databricks). Develop and maintain automated monitoring jobs to proactively track data quality, system performance, and analytic pipeline health. Work with big data platforms and tools to manage, process, and analyze high-volume, high-velocity healthcare data efficiently. Monitor data quality metrics and report anomalies or inconsistencies. Manage multiple projects simultaneously, ensuring timely delivery and alignment with stakeholder expectations. Assist in regulatory compliance efforts related to data management (e.g., HIPAA). Maintain clear, comprehensive documentation of data definitions, validation processes, analytic methodologies, and project deliverables. Qualifications: Bachelor’s degree in Data Science, Information Systems, Business Analytics, or a related field. 3+ years of experience in data governance, data quality, or data management roles. 3+ years of experience working with healthcare data, including claims, pharmacy, and drug data. Proficiency in SQL and data profiling tools. Hands-on experience with Databricks and Snowflake environments. Strong analytical, problem-solving, and communication skills. Adapt to a dynamic work environment, learn quickly, solve problems, and make decisions with minimal oversight. Proficiency in data management tools and platforms: SQL or Python and Databricks Ability to identify and prioritize opportunities for impact, develop analytic solutions and leverage technology Excellent verbal and written communication skills, including the ability to clearly and openly communicate status, issues/risks, and challenges presented to a project. Preferred Qualifications: Experience with data cataloging and metadata tagging tools. Familiarity with healthcare regulatory requirements (e.g., HIPAA). Basic proficiency in Python for data analysis. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 80,400 - 134,000 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and 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 paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Handle inbound calls from patients to learn about their medical history and challenges with fertility. Coordinate fertility plans and medications while ensuring a positive patient experience through effective issue resolution and follow-up. | A high school diploma or GED is required along with excellent customer service and organizational skills. Candidates should possess multitasking abilities and proficiency in Microsoft Office Suite. | Ready for a job that encourages you to use your communication and problem solving skills? If so, prepare to use those skills to help your patients’ dreams of having a family come true! As a Customer Service Associate Representative at Freedom Fertility, you’ll use your empathy and listening skills to handle inbound calls from patients and learn more about their medical history and challenges with fertility. This is not your average customer service job – you’ll work for a company that truly cares about people while helping our patients achieve happiness. Here’s a little more on how you’ll make a difference: Ensure process efficiency – Work with both patients and physicians to coordinate fertility plans and medications. Own the patient experience through resolving customer issues and ensuring 100% follow-up to customers. Pay attention to detail – Accurately obtain and enter patient information, including shipping, insurance and payment information. Be a team player – Escalate complex claims to the appropriate team for further action. Why join us? Health coverage effective day 1 (including medical, dental, vision) Holiday, PTO and OT pay 401K with company match Tuition reimbursement Fun, friendly and unique culture – bring your whole self to work every day! What you need to do the job: An empathetic and fun-loving personality with a few good jokes on the ready High School Diploma or GED required Excellent customer service, organization and time management skills Multitasking - Operating several systems at once PC skills including knowledge of Microsoft Office Suite (Outlook) and Internet If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an hourly rate of 17.75 - 19 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and 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 paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Handle high-volume inbound calls to support patients with medication orders, billing inquiries, and issue resolution while maintaining confidentiality and adhering to healthcare regulations. | High school diploma, 1+ years healthcare customer service experience preferred, strong communication and problem-solving skills, ability to work in a structured virtual call center environment, reliable internet, and residency in specified states. | Location: Remote Opportunity - Must live in Arizona, Ohio, Indiana, Georgia, Pennsylvania, Texas, Virginia, or Oregon. Summary: Are you passionate about assisting others and ready to thrive in a fast-paced, highly structured virtual environment? Join our team at Accredo Specialty Pharmacy, a leading specialty pharmacy serving patients with complex and critical health conditions. As a Customer Service Call Center Representative, you'll play a vital role in supporting patients, ensuring timely access to life-impacting medications while representing Accredo with professionalism and empathy. This is not a typical customer service role — our work directly impacts patients' health and well-being. We are looking for individuals who are dedicated, detail-oriented, and committed to making a difference. Key Responsibilities Answer 30-50+ inbound phone calls in a high-volume contact center setting with professionalism and efficiency. Support patients with medication orders, benefits explanations, billing inquiries, and complex issue resolution. Follow structured workflows and adhere to a scheduled, continuous call-taking environment until designated breaks. De-escalate concerns and provide empathetic solutions within standard operating procedures. Maintain patient confidentiality and comply with healthcare regulations. Meet monthly performance metrics and actively participate in ongoing training and feedback. Role Expectations Attend a paid 9-week virtual training program (on camera) with required participation in live call-taking and assessments. Maintain reliable internet and a distraction-free home workspace. This is a highly structured role requiring the ability to remain focused and engaged while taking back-to-back calls for the duration of each shift. The position involves handling sensitive health-related issues, not casual customer service requests. Ideal candidates will understand the serious nature of the work and the importance of accuracy, empathy, and responsibility. This is a desk-based role that requires the ability to sit for extended periods and work at a computer screen throughout the entire shift. Qualifications High School Diploma or equivalent required. No experience required, but 1+ years of healthcare customer service experience preferred. Must live in Arizona, Ohio, Indiana, Georgia, Pennsylvania, Texas, Virginia, or Oregon. Ability to excel in a high-volume call center environment. Flexibility with a changing environment of call types, processes, and procedures. Strong problem-solving skills with the ability to analyze situations, identify solutions, and take appropriate action in real-time. Strong communication skills, both written and verbal. Organized with excellent time-management abilities. Customer-oriented with the capacity to adapt to various patient perspectives. Proficient in Microsoft Office Suite and navigating multiple systems simultaneously. Must be available to work within Contact Center hours: Monday through Friday, 8:00 am to 11:00 pm EST, and Saturday, 8:00 am - 5:00 pm EST. Reliable internet connectivity and a dedicated workspace free of distractions required. Must attend 100% of training and work your schedule the first 90 days of employment. Join Our Team: Start a meaningful career with Accredo Specialty Pharmacy, part of Evernorth Health Services, where you’ll have the opportunity to impact lives every day. We offer robust training, ongoing development, and a supportive virtual team environment where excellence is the standard. If you're ready to bring your skills and dedication to a mission-driven role, apply today. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an hourly rate of 17.75 - 19 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and 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 paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Provide expert medical review of clinical service requests, conduct peer discussions, support discharge planning, maintain credentials, and assist with staff training and quality improvement. | MD or DO degree, active board certification in Physical Medicine and Rehabilitation, unrestricted medical license, minimum 3 years clinical practice post-training, knowledge of utilization review standards. | Summary: The Medical Director provides timely expert medical review of medical necessity requests for clinical services that do not meet utilization review criteria and renders a clinical opinion about the medical service under review while located in a state or territory of the United States. Responsibilities include: Provide timely expert medical review of medical necessity requests for clinical services related to post acute care and render a clinical opinion about the medical service under review, including post-decision reviews. Provide timely and collegial peer-to-peer discussions with treating physicians to clarify clinical information and to explain review outcome decisions. Participate in proactive peer to peers to assist with appropriate and timely discharge planning. Document all actions related to clinical review sessions and attest to review qualifications as required. Conduct weekly Case Conferences with nursing and social worker teams; discussing every assigned member receiving care in a post-acute care facility, focusing on discharge planning, complex medical care management, quality of care, appropriate level of care, and appropriate length of stay. Maintain necessary credentials and immediately inform eviCore of any adverse actions relating to medical licenses and/or board certifications. Support the review of eviCore clinical guidelines. Support and communicate eviCore policies and procedures to the provider community. Testify at ALJ Hearings when your cases are being appealed Assist with staff educational training and in-service programs and serve as a clinical resource for eviCore staff. Serve as a Subject Matter Expert when Medical Directors and/or Senior Medical Directors are unavailable. Available for scheduled weekend call from home based on business needs. Participate in Joint Operating Committee (JOC) meetings, including the collection and review of data relevant to the client, and other virtual events with the provider engagement team in your specified territory. Participate in all required educational and quality improvement activities and maintain passing scores in all assessments. Assist in reviewing case determinations from clients responding to a provider or member complaint Maintain necessary credentials and immediately inform eviCore of any adverse actions relating to medical licenses and/or board certifications Other duties as assigned Minimum Education, Licensure and Professional Certification requirement: M.D. or D.O. degree from accredited institution. Minimum of three (3) years of clinical practice experience after completion of all graduate medical education training, including residency and fellowship (when applicable) Active board certification in Physical Medicine and Rehabilitation required Active unrestricted license to practice medicine in a state or territory of the United States as a utilization review doctor of medicine or doctor of osteopathic medicine. Knowledge of applicable state and federal laws, URAC and NCQA standards, and utilization management Ability to commit to a set, weekly work schedule (Monday through Friday) Strong computer skills: ability to work autonomously with automated processes, computer applications, and systems Meet physical demands of the role including, but not limited to, typing, speaking, and listening 100% of time In accordance with our HITECH Security Accreditation, company provided encrypted-workstation is required to be hard-wire connected to a modem or router. Wireless connection is not permitted. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 203,200 - 338,600 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and 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 paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

The Presale Support Analyst is responsible for reviewing RFPs and preparing medical, dental, and vision quotes. This role involves coordinating aspects of new business sales and existing business renewals to drive membership and revenue growth. | Candidates should have a Bachelor's Degree or equivalent work experience, preferably with a health insurance background. Strong communication, problem-solving, and organizational skills are essential, along with the ability to work in a fast-paced environment. | The U500 Presale Analyst is responsible for reviewing Request for Proposals (RFPs) and preparing medical, dental and vision quotes. The Presale Consultant works closely with the New Business Manager (NBM), Client Mangers (CM), Brokers and internal matrix partners to ensure an accurate and competitive Cigna quote is generated. Role Summary The selected candidate will partner with Sales leads and business partners to coordinate aspects of new business sales and existing business renewals within the U500 Business Segment. The position is integral in driving membership and revenue growth by managing multiple aspects of the RFP (Request for Proposal) process and coordinating all deliverables to clients and/or producers. Role Components Prepare medical, dental and vision field quotes using Cigna rating systems Support new and existing sales managers Manage the RFP process, report results and meet submission turnaround times. Ensure accuracy of information and opportunities in Salesforce.com Timely submission of complete and accurate proposal data to Underwriting and other matrix partners Proactive communication with internal and external customers to facilitate the RFP workflow. Communicate effectively with Brokers to demonstrate the value that Cigna brings to the market Develop and build relationship with matrix partners Support New Business Managers with benefit optimization May work on various projects within the sales office Minimum Qualifications Bachelor's Degree or equivalent work experience may substitute in lieu of degree Health insurance background with general understanding of the overall sales process preferred Strong written & verbal communication skills Strong problem-solving and analytical skills Detail oriented with exceptional follow-up skills Basic math skills Ability to work in a production-like, fast paced environment and adapt quickly to change Strong organization skills with the ability to work both independently and in a team environment; manage, prioritize and work on numerous projects at one time. Ability to consistently meet tight deadlines and work under pressure while anticipating the needs of the customer and/or business partner and understanding the consequences of actions. Strong computer based technical skills including Outlook, Excel and Word and internet/web navigation If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an hourly rate of 26 - 39 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and 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 paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

The Lead Analyst will manage the accuracy and compliance of invoices from Global Service Partners and third-party suppliers. This includes auditing invoices, ensuring adherence to company policies, and collaborating with finance and procurement teams to resolve discrepancies. | A High School Diploma is required, with a preference for a Bachelor's degree. Candidates should have 2+ years of experience in invoice review or auditing, strong communication skills, and proficiency in Excel and financial software. | Job Description: The Lead Analyst - Invoice Review and Audit will be responsible for Coverage Review Operations (CRO) Global Service Partners (GSP) Invoice management by: Ensuring the accuracy and compliance of invoices received from various GSPs and third-party suppliers. Performing comprehensive review, auditing, and approval of invoices. Ensuring adherence to company policies and contract terms. The Lead Analyst will work closely with the finance, procurement, and accounts payable teams to streamline processes and resolve any discrepancies. Key Responsibilities: Review and verify the accuracy of invoices and supporting documents. Ensure invoice amounts align with monthly budget allocations and forecasted spend (volume/hours/FTE) Audit invoices to ensure compliance with contract terms, company policies, and regulatory requirements. Track and report on total invoice amounts, trends, variances to support budget visibility and decision making Approve invoices in Ariba for payment, ensuring timely and accurate processing. Provide regular updates to business leaders on invoice status, pending approvals, and payment timelines Identify and resolve discrepancies or issues with invoices by collaborating with GSPs (Global Service Provider) along with Business and Operational Stakeholders. Support governance reporting needs by providing invoice data insights as needed Maintain detailed records of invoice reviews and audits, ensuring proper documentation and traceability. Develop and implement best practices for invoice review and audit processes. Manage and maintain CRO Term Sheets: Establish cadence to review and ensure Term Sheets are accurately funded for the life of the GSP Contract. Validate the Term Sheet are active during the life of the contract. Collaborate with the finance and procurement teams to resolve invoice or Term Sheet issues. Support CRO Business and Operational stakeholders by scheduling ad hoc meetings with GSPs to resolve invoice discrepancies. Miscellaneous items to support and manage CRO GSP initiatives and projects Qualifications: High School Diploma Required ; Bachelor’s degree preferred Intermediate to Advanced Excel experience required 2+ experience in invoice review or auditing role required Excellent communication skills; both written and oral Strong interpersonal skills; must be able to collaborate with internal cross-functional teams to resolve issues timely. Excellent analytical and problem-solving skills. Attention to detail and accuracy in reviewing and auditing invoices; must be able to track issue progress and perform follow-ups timely. Proficiency in using financial software and Microsoft Office Suite (Excel, Word, PowerPoint) Ability to work independently and as part of a team. Preferred Qualifications: Experience in invoice processing or accounts payable, preferably in a BPO or vendor-managed environment valuable. Familiarity with ARIBA / Oracle. Experience working with vendors and third-party suppliers. Certification in auditing or accounting (e.g., CPA, CIA) is a plus. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 56,800 - 94,600 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and 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 paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About The Cigna Group Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Provide expert medical review of clinical service requests, conduct peer discussions, support discharge planning, maintain credentials, and assist with staff training and quality improvement. | MD or DO degree, active board certification in primary care specialties, unrestricted medical license, 3+ years clinical practice post-training, knowledge of utilization management standards, and ability to work remotely with secure internet. | Summary: The Medical Director provides timely expert medical review of medical necessity requests for clinical services that do not meet utilization review criteria and renders a clinical opinion about the medical service under review while located in a state or territory of the United States. Responsibilities include: Provide timely expert medical review of medical necessity requests for clinical services related to post acute care and render a clinical opinion about the medical service under review, including post-decision reviews. Provide timely and collegial peer-to-peer discussions with treating physicians to clarify clinical information and to explain review outcome decisions. Participate in proactive peer to peers to assist with appropriate and timely discharge planning. Document all actions related to clinical review sessions and attest to review qualifications as required. Conduct weekly Case Conferences with nursing and social worker teams; discussing every assigned member receiving care in a post-acute care facility, focusing on discharge planning, complex medical care management, quality of care, appropriate level of care, and appropriate length of stay. Maintain necessary credentials and immediately inform eviCore of any adverse actions relating to medical licenses and/or board certifications. Support the review of eviCore clinical guidelines. Support and communicate eviCore policies and procedures to the provider community. Testify at ALJ Hearings when your cases are being appealed Assist with staff educational training and in-service programs and serve as a clinical resource for eviCore staff. Serve as a Subject Matter Expert when Medical Directors and/or Senior Medical Directors are unavailable. Available for scheduled weekend call from home based on business needs. Participate in Joint Operating Committee (JOC) meetings, including the collection and review of data relevant to the client, and other virtual events with the provider engagement team in your specified territory. Participate in all required educational and quality improvement activities and maintain passing scores in all assessments. Assist in reviewing case determinations from clients responding to a provider or member complaint Maintain necessary credentials and immediately inform eviCore of any adverse actions relating to medical licenses and/or board certifications Other duties as assigned Minimum Education, Licensure and Professional Certification requirement: M.D. or D.O. degree from accredited institution. Minimum of three (3) years of clinical practice experience after completion of all graduate medical education training, including residency and fellowship (when applicable) Active board certification, primary care specialties (Family Medicine, Internal Medicine or Emergency Medicine) required. Active unrestricted license to practice medicine in a state or territory of the United States as a utilization review doctor of medicine or doctor of osteopathic medicine. Knowledge of applicable state and federal laws, URAC and NCQA standards, and utilization management Ability to commit to a set, weekly work schedule (Monday through Friday) Strong computer skills: ability to work autonomously with automated processes, computer applications, and systems Meet physical demands of the role including, but not limited to, typing, speaking, and listening 100% of time In accordance with our HITECH Security Accreditation, company provided encrypted-workstation is required to be hard-wire connected to a modem or router. Wireless connection is not permitted. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 203,200 - 338,600 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and 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 paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Handle insurance claims and policy inquiries via phone and email in a fast-paced call center environment, responding independently to routine and moderately complex customer issues. | Must have strong Japanese and English proficiency, 1+ years customer service experience, call center experience preferred, high school diploma or higher, and ability to multitask with Microsoft Office. | SUMMARY The Cigna Group is a global health Service Company dedicated to helping people improve their health, well-being, and sense of security. The Cigna Global Health Benefits team seeks dedicated, compassionate, and empathetic Japanese speaking Customer Service Senior Representatives to join our team who are genuinely interested in helping people worldwide at some critical points of their lives. In this pivotal role, Customer Service Senior Representatives effectively handle inquiries from customers, clients, or providers received domestically and internationally via phone and e-mail in a "real-time" contact center environment. The Call Center Japanese speaking Customer Service Senior Representative represents the company; our people make all the difference in our success. RESPONSIBILITIES Receive requests by email or telephone regarding insurance claims/policies while operating on multiple computer applications. Respond to inquiries from policy holders, providers and/or others for information and assistance Perform research to respond to inquiries and interpret policy provisions to determine most effective response. Mail or route claim forms and supporting documentation to various units for final processing Independently respond to inquiries, grievances, complaints or appeals ranging from routine to moderate complexity. May seek assistance with complex customer services issues Ability to understand and interpret policy provisions Performs research to respond to inquiries and interprets policy provisions to determine most effective response using established departmental procedures, HIPAA regulations, and corporate policies. QUALIFICATIONS Strong proficiency in both speaking and writing Japanese is a must. Strong proficiency in speaking English. High School Diploma or equivalent required, associate or bachelor’s degree preferred. 1+ years of customer service experience analyzing and solving customer problems required, call center experience a PLUS Intermediate proficiency in Microsoft Office Suite; high level capacity to multitask independently and on a computer. Knowledge of Medical Terminology a PLUS. Excellent written and oral communication skills. Ability to perform in a high volume, fast paced call center environment. Proven ability to work independently as well as a productive member of a team. Exceptional organizational and time-management focus. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an hourly rate of 17.98 - 26 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and 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 paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

The Events and Communications Lead Analyst develops and executes strategic event plans to enhance client engagement and brand consistency. This role also manages logistics for client-facing events and collaborates with cross-functional teams for seamless execution. | Candidates should have a Bachelor's degree and over 5 years of experience in business planning, communications, or corporate events. Strong strategic thinking, project management, and communication skills are essential, along with proficiency in Microsoft Office applications. | Position Overview: The Events and Communications Lead Analyst plays a key role in supporting the Health Plan Account Management, Growth, and Regulated Markets teams by delivering high-impact client experiences through strategic event planning and communications. This role ensures alignment between event strategy and business objectives, enhancing client engagement and brand consistency. Key Responsibilities: Develop and execute strategic event plans aligned with business goals and audience needs. Manage logistics for client-facing events (e.g., conferences, lab visits, onsite meetings), including travel, catering, room setup, briefing materials, and site visits. Collaborate with cross-functional teams (leadership, marketing, communications, events COE) to ensure seamless execution. Propose innovative event formats to enhance engagement and brand experience. Conduct pre - and post-event evaluations, including surveys and debriefs, to identify improvements. Lead special projects such as custom member satisfaction surveys and team meetings. Support internal communications and presentation development across the division. Monitor industry trends to inform event strategy and execution. Qualifications: Bachelor’s degree with 5+ years of experience in business planning, communications, or corporate events. Healthcare experience is a plus. Proven ability to link event outcomes to business growth, efficiency, and client loyalty. Strong strategic thinking, project management, and organizational skills. Excellent communication and interpersonal abilities across all organizational levels, including senior leadership Proficiency in Microsoft Excel, Word, and PowerPoint; basic graphic design skills a plus. Willingness to travel (15–20%) and work occasional off-hours. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 76,400 - 127,300 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and 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 paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Handle inquiries from customers, clients, or providers via phone and email in a real-time contact center environment. Resolve customer complaints and strive to meet call center metrics while providing excellent customer service. | A high school diploma or equivalent and at least 1 year of customer service experience are required. Candidates should have strong communication skills and the ability to remain calm in difficult situations. | SUMMARY The Cigna Group is a global health Service Company dedicated to helping people improve their health, well-being, and sense of security. The Cigna Global Health Benefits team seeks dedicated, compassionate, and empathetic Customer Service Senior Representatives to join our team who are genuinely interested in helping people worldwide at some critical points of their lives. In this pivotal role, Customer Service Representatives effectively handle inquiries from customers, clients, or providers received domestically and internationally via phone and e-mail in a "real-time" contact center environment. The Call Center Customer Service Senior Representative represents the company; our people make all the difference in our success. RESPONSIBILITIES •Handle requests received via inbound calls or emails concerning insurance claims and policies while using multiple computer applications. Respond to inquiries from policyholders, providers, and others seeking information and assistance. Address inquiries, grievances, complaints, or appeals that vary from routine to moderately complex on your own, but you may consult with colleagues for assistance with more complex customer service issues. •Performs research to respond to inquiries and interpret policy provisions to determine most effective response using established departmental procedures, HIPAA regulations, and corporate policies. •Available to attend 100% training and the first 90 days of employment. • Resolve customer complaints through independent problem-solving skills and one-call resolution. • Understand and strive to meet or exceed call center metrics while providing excellent consistent customer service • Enjoy a work-from-home lifestyle where you can virtually connect with coworkers and customers. QUALIFICATIONS • High School diploma or equivalent • 1+ years of customer service experience is required. Call center experience preferred. • A dedicated workspace with no distractions is required • Intermediate proficiency in Microsoft Outlook • Strong organization skills, written, and verbal communication skills • Ability to remain calm and helpful even when dealing with difficult situations • Foster teamwork and partnership with cross-functional departments to resolve issues and improve customer experience. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an hourly rate of 17.98 - 26 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and 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 paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

The Operations Senior Analyst is responsible for handling client access requests and ensuring satisfactory results for the Client Service Team. This role involves problem-solving, process improvement, and maintaining ownership of assigned requests. | A High School Diploma is required, with a Bachelor's Degree preferred. Candidates should have 2+ years of experience in customer service or healthcare administration and strong communication skills. | The Operations Senior Analyst for Client Access is responsible for handling requests related to clients gaining access to our suite of on-line system tools. This includes a multitude of requests for new user access, updates to current access, issue analysis, problem solving and other tasks to ensure satisfactory results for our Client Service Team (CST) and our Clients. The Operations Senior Analyst will have basic account service and operational knowledge in order to successfully complete assigned work. The ideal candidate will routinely communicate with internal cross-functional partners. A proactive approach to identifying opportunities for improvement and enhanced customer support is highly desired. The Operations Senior Analyst participate in process improvement activities and other projects as assigned by leadership. What you'll do to make a difference: Works closely with CST’s to ensure client satisfaction Maintains ownership of assigned requests with a focus on quality and timeliness to meet all defined service standards Work autonomously to ensure that production levels and targets are achieved Resolves routine or standard problems using existing procedures and escalates as needed Shows willingness to engage in process improvement initiatives and other team projects Supports special projects as assigned by leadership What you need to be successful: High School Diploma required; Bachelor's Degree preferred 2+ years of professional work experience in customer service or healthcare administration 2+ years of experience using Microsoft Office; Intermediate Excel skills is a plus Knowledge of the health care and PBM industry and its products and services preferred Strong verbal and written communication skills are a must Excellent attention to detail; problem solving and analytical skills preferred Ability to work cross functionally to resolve issues Strong focus on customer service Ability to manage timelines and meet tight deadline If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 52,900 - 88,100 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and 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 paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Lead strategy development and execution for Dental & Vision business, drive innovation and competitive intelligence, manage product growth and vendor relationships, and support executive leadership with operational management. | 10+ years in strategy or product strategy within a dental/vision health insurer environment, strong leadership and communication skills, ability to manage complex initiatives in a matrixed organization, and a bachelor's degree with advanced degree preferred. | Job Summary As a member of the Dental & Vision leadership team, the Strategy, Execution & Innovation Lead will drive efforts to identify and oversee the development, implementation, and sustainment of strategies to grow and differentiate Cigna Dental & Vision solutions. Reporting to the VP of Dental & Vision, the role is accountable to shape long-term business strategy by partnering closely with teams across the value chain to understand stakeholder needs and the broader external environmental forces impacting the marketplace. The role will drive focus and transparency into progress against priorities, bring capability needs through the Enterprise Portfolio process, and successfully deliver enhancements in pursuit of business goals. In addition, the role will be responsible for all innovation and competitive intelligence analysis for the business. Duties & Responsibilities Key activities include, but are not limited to, the following: Strategy development and communication Drives the annual strategy process, including communication of business strategy to all levels of the organization. Leads competitive Intelligence and other market-facing teams to understand market trends and developments, and the influence on strategic assumptions and direction. Works closely with technology and functional-area partners to drive strategic alignment between business and technology roadmaps. Ensures that Dental & Vision activities are aligned with Cross-Enterprise initiatives and strategies. Project delivery Drive Dental & Vision participation in the Enterprise Portfolio process: Advocate for annual Enterprise Portfolio investments in Dental & Vision, ensuring strong business cases and N-1 prioritization for capability needs. Analysis of new capabilities and enhancements, including feasibility review, business case creation, and related business and technical analysis in support of Agile project mobilization and delivery. Oversight of business project delivery in close partnership with Agile delivery teams, including but not limited to business readiness and change management activities. Ownership of business intake process, evaluating annual and ad-hoc requests for business value and relative priority. Insights & Innovation Lead Enable and guide the ongoing assessment of market conditions, early stage companies and new technologies across the oral care and vision ecosystems to unearth and consider opportunities aligned with the strategy, interest and of value to Cigna. Partner with Cigna and Evernorth personnel in similar capacity across other solution lines to understand broader Enterprise innovation strategies and tactics, seeking aligned and synergistic opportunities. Guide a disciplined approach to testing and evaluating potential B2B relationships. Responsible for creating, promoting and delivering a culture and mindset of innovation throughout the dental & vision organization. Provide oversight and manage deployment of innovation funds in the identification, assessment and deployment of high potential and impactful solutions. Develop market insight capabilities, and as part of Dental Senior Leadership, leverage those insights to inform the company’s strategy, growth objectives and plan execution. Provide market insights that inform matrix stakeholders of key competitor capabilities, supporting accelerated growth. Guide business intelligence best practices in a bi-directional basis with Enterprise resources tasked with similar business intelligence responsibilities. Vision Product Business Lead Lead growth strategy for our Vision product (currently $30M Earnings/3 Million customers) Manage the overall relationship with EyeMed (our primary vision vendor) Partner with Buyer group leadership (National and U3000) to grow size of Vision as a part of the broader USE portfolio of products. Identify, champion, and implement new capabilities required to support growth. Chief of Staff & Management process lead Supports the VP of Dental & Vision to manage and execute the operating model, connecting all functions/teams to the overall Dental & Vision priorities and strategies. Drives annual creation of goals and key priorities for Dental & Vision line of business. Leads a management process that drives transparency into progress towards goals and initiatives, highlighting leading + lagging indicators of business performance, and driving consistent messaging across all levels of the organization. Creates scorecards and exhibits to track and report business health and performance. Ensures content is developed and aggregated for effective meeting management. Coordinates weekly, monthly, and quarterly team meetings, town halls, executive business reviews, and other ad-hoc meetings as necessary. Drives decision-making & alignment, escalating risks and opportunities. Qualifications, Knowledge, and Skills Bachelor’s degree required and advance degree preferred. Prior experience with a Dental/Vision health insurer required. 10+ years in Strategy Development, Execution and/or Product Strategy. Successful experience managing complex initiatives to completion in a highly matrixed environment. Self-starting leader that exhibits high levels of emotional intelligence and strong interpersonal skills. Ability to work independently while being thoughtfully collaborative. Strong written and verbal communications skills. Ability to clearly articulate messages to all levels of the organization. Able to develop and articulate a clear strategic vision and see through fruition. Willing to challenge the status quo with new ideas, approaches and solutions. Effectively pivots between strategic development and tactical deployment. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

The RFP Project Manager manages the end-to-end RFP/RFI process for new and existing business across various lines of business. This role involves coordinating activities and communication among internal partners to align with client strategies and Cigna's value proposition. | Candidates should have experience with healthcare RFPs and a strong understanding of the healthcare industry. Excellent project management skills and the ability to build relationships with matrix partners are essential. | The National Sales Analyst (NSA) is an integral member of the National Accounts sales team and partners closely with the new and existing business sales team members to enable and support the growth of client and consultant relationships within the segment. The NSA owns the end-to-end RFP/RFI process and coordinates and drives activity and communication across all internal matrix partners to ensure alignment with client strategy and Cigna's value proposition. ROLE COMPONENTS: RFP Project Manager Manages new and existing business RFPs end-to-end for all Lines of Business (including but not limited to medical, clinical, dental, pharmacy, behavioral, vision, and stop loss). Responsible for RFP from initial review and down streaming to final review and submission, follow-up questions, Best and Final Offer, and other RFP-related requests Manages multiple complex RFPs concurrently with aggressive deadlines and diverse formats Facilitates How to Win (HTW) / Prospect Qualification process as a consultative partner; which includes initial strategy call with leadership and matrix partners with reliance on NSE (New Business Sales Executive) /NAE (National Account Executive – Existing Business) support Assists NSE/NAE to build client-specific strategy; applies and disseminates during RFP process Engages standard matrix partners as needed based on RFP specifications Edits/Manipulates matrix partner output, i.e., plan designs from PBAB, disruption results from RSU, etc. Reviews proposal components prior to submission to ensure best in class RFP responses (or client specific strategy) reflecting Cigna solutions and capabilities Provides RFP data to NST/NAE for finalist meeting Ensure salesforce.com entry and accuracy Strategic Partner – Internal & External Manages relationships with sales and account team members, Underwriting, other matrix partners Communicates externally with consultants, including related to missing data, logistical elements of RFPs Subject Matter Expert Maintains and enhances knowledge of Cigna products and capabilities to include in RFPs Identifies applicable solutions to quote in RFPs based on consultant/client issues and requests Demonstrates a foundational level of understanding of Cigna's processes, solutions, and strategy Understands and applies all established processes and Standard Operating Procedures (SOP) Proactively participates in segment-wide trainings and discussions as an active learner to establish and uphold baseline knowledge Team Contributor Supports off-season process improvement projects, segment initiatives Collaborates with new team members as needed Shares recommendations on updates to existing documentation of best practices Actively participates in team meetings QUALIFICATIONS Experience with healthcare RFPs for some or all of the following lines of business: medical, dental, pharmacy, clinical, behavioral, vision Knowledge of the healthcare industry, including trends, products, processes Strong presentation skills; ability to modify communication delivery based on audience Excellent project management skills Ability to prioritize projects and to handle multiple demands simultaneously Demonstrated ability to develop strong working relationships with matrix partners to drive deliverables Familiarity with Salesforce.com If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 73,000 - 121,600 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and 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 paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Perform evidence-based medical necessity reviews and peer consultations for pain medicine cases remotely using specialized software. | MD or DO with active US medical license, board certified in Pain Medicine, 3+ years clinical experience post-residency, strong computer skills, and ability to work a set schedule remotely. | Do you crave an intellectually stimulating job that allows you to leverage your clinical expertise while developing new skills and improving the lives of others? Then look no further! As a Pain Medicine Medical Director at EviCore, part of Evernorth Health Services, a division of The Cigna Group, you’ll use your clinical know-how to provide evidence-based medical reviews for patient care. Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases. This role offers you the opportunity to build new skills while enhancing the health and vitality of others. We're seeking a detail-oriented individual with good communication, technology, and typing skills, as well as strong clinical judgment. Drive growth in your career with our innovative team. How you’ll make a difference: You’ll start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success. Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on EviCore’s case management software. Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence–based medical necessity and appropriateness of the requested service or treatment. Leverage your clinical expertise to recommend alternative services or treatments as necessary. Work collaboratively with over 500 EviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making. What you’ll enjoy about working here: Benefits start on day one Predictable work schedules 100% work from home 8 Paid Holidays + 23 PTO Days 401(K) with company match Reimbursement for continuing medical education Career growth opportunities across the enterprise Networking with peers across multiple medical specialties Requirements: M.D. or D.O. with a current, active, U.S. state medical license and board certified in Pain Medicine, recognized by the American Board of Medical Specialties, or American Osteopathic Association Eligible to acquire additional state licensure as required 3 years of relevant clinical experience post residency/fellowship Knowledge of applicable state federal laws Utilization Review Accreditation Commission and National Committee for Quality Assurance standards is a plus Ability to commit to a set, weekly work schedule (Monday through Friday) Strong computer skills: ability to work autonomously with automated processes, computer applications, and systems Meet physical demands of the role including, but not limited to, typing, speaking, and listening 100% of time In accordance with our HITECH Security Accreditation, company provided encrypted-workstation is required to be hard-wire connected to a modem or router. Wireless connection is not permitted. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 203,200 - 338,600 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and 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 paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

The Clinical Policy Lead Analyst is responsible for creating and maintaining evidence-based clinical guidelines and technical assessments. This includes monitoring literature updates, maintaining evidence tables, and presenting revised guidelines to stakeholders. | Candidates must have a degree in Nursing or a related healthcare field and a minimum of 3 years of experience in medical writing or clinical policy research. Strong literature evaluation skills and experience with peer-reviewed publications are essential. | Clinical Policy Lead Analyst: Summary: Create and maintain technical assessments and evidence-based policy for clinical programs through evaluation of published literature. Serve as primary author of evidence-based for program-specific clinical guidelines Monitor peer-reviewed, published evidence-updates for relevant clinical programs Maintain evidence tables and apply evidence-grading to literature Apply evidence updates to clinical guidelines Maintain library of relevant literature Maintain policy library through regular assessments and updates and revise and maintain clinical guidelines in the content management system Present revised clinical guidelines to the Medical Advisory Committee (MAC) Present to external stakeholders as needed Work with internal stakeholders related to clinical guideline development, maintenance, and implementation Act as a subject matter expert for programs and guidelines assigned Partner with internal and external subject matter experts to assimilate current practice standards into clinical policy, reconciling with published literature Ensure downstream operational representation, such as branching logic, is consistent with the intent of the clinical policy as approved by MAC Provide thought leadership and subject matter expertise for complex projects, working across business units Engage in cross-enterprise projects through ICOG aimed at creating optimal health care experiences Minimum Qualifications: Degree in Nursing or Healthcare related field (e.g.: Public Health, Healthcare Administration) Minimum of 3 years of experience in medical writing, clinical or policy research, literature evaluation and peer-reviewed publications. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 74,400 - 124,000 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and 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 paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Conduct evidence-based medical case reviews and physician consultations remotely to ensure appropriate patient care. | MD or DO with active US medical license, board certified in Pulmonology, 3+ years clinical experience, strong computer skills, and ability to work remotely with secure internet. | Do you crave an intellectually stimulating job that allows you to leverage your clinical expertise while developing new skills and improving the lives of others? Then look no further! As a Pulmonology Medical Director at EviCore, part of Evernorth Health Services, a division of The Cigna Group, you’ll use your clinical know-how to provide evidence-based medical reviews for patient care. Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases. This role offers you the opportunity to build new skills while enhancing the health and vitality of others. We're seeking a detail-oriented individual with good communication, technology, and typing skills, as well as strong clinical judgment. Drive growth in your career with our innovative team. How you’ll make a difference: You’ll start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success. Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on EviCore’s case management software. Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence–based medical necessity and appropriateness of the requested service or treatment. Leverage your clinical expertise to recommend alternative services or treatments as necessary. Work collaboratively with over 500 EviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making. What you’ll enjoy about working here: Benefits start on day one Predictable work schedules 100% work from home 8 Paid Holidays + 23 PTO Days 401(K) with company match Reimbursement for continuing medical education Career growth opportunities across the enterprise Networking with peers across multiple medical specialties Requirements: M.D. or D.O. with a current, active, U.S. state medical license and board certified in Pulmonology, recognized by the American Board of Medical Specialties, or American Osteopathic Association Eligible to acquire additional state licensure as required 3 years of relevant clinical experience post residency/fellowship Knowledge of applicable state federal laws Utilization Review Accreditation Commission and National Committee for Quality Assurance standards is a plus Ability to commit to a set, weekly work schedule (Monday through Friday) Strong computer skills: ability to work autonomously with automated processes, computer applications, and systems Meet physical demands of the role including, but not limited to, typing, speaking, and listening 100% of time In accordance with our HITECH Security Accreditation, company provided encrypted-workstation is required to be hard-wire connected to a modem or router. Wireless connection is not permitted. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 203,200 - 338,600 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and 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 paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

The Risk Adjustment Quality & Review Analyst evaluates complex medical conditions and determines compliance of medical documentation. They conduct medical records reviews, perform audits, and collaborate with team members to improve data and processes for Continuous Quality Improvement. | Candidates must have a high school diploma and at least 2 years of experience in medical coding with relevant certifications. Familiarity with CMS regulations and proficiency in ICD-10-CM coding guidelines are also required. | Job Summary: 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, and any additional applicable rule set. • Utilize HHS’ 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’ 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’ 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): o Certified Professional Coder (CPC) o Certified Coding Specialist for Providers (CCS-P) o Certified Coding Specialist for Hospitals (CCS-H) o Registered Health Information Technician (RHIT) o Registered Health Information Administrator (RHIA) o Certified Risk Adjustment Coder (CRC) certification Individuals who have a certification other than the CRC must become CRC certified within 6 months of hire. 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 If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an hourly rate of 25 - 38 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and 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 paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Perform evidence-based medical case reviews and physician consultations for Sleep Medicine services remotely, ensuring appropriate patient care and compliance with healthcare standards. | M.D. or D.O. with active U.S. medical license, board certified in Sleep Medicine, 3+ years clinical experience post residency/fellowship, strong computer skills, and ability to work remotely with secure internet connection. | Do you crave an intellectually stimulating job that allows you to leverage your clinical expertise while developing new skills and improving the lives of others? Then look no further! As a Sleep Medicine Medical Director at EviCore, part of Evernorth Health Services, a division of The Cigna Group, you’ll use your clinical know-how to provide evidence-based medical reviews for patient care. Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases. This role offers you the opportunity to build new skills while enhancing the health and vitality of others. We're seeking a detail-oriented individual with good communication, technology, and typing skills, as well as strong clinical judgment. Drive growth in your career with our innovative team. How you’ll make a difference: You’ll start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success. Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on EviCore’s case management software. Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence–based medical necessity and appropriateness of the requested service or treatment. Leverage your clinical expertise to recommend alternative services or treatments as necessary. Work collaboratively with over 500 EviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making. What you’ll enjoy about working here: Benefits start on day one Predictable work schedules 100% work from home 8 Paid Holidays + 23 PTO Days 401(K) with company match Reimbursement for continuing medical education Career growth opportunities across the enterprise Networking with peers across multiple medical specialties Requirements: M.D. or D.O. with a current, active, U.S. state medical license and board certified in Sleep Medicine, recognized by the American Board of Medical Specialties, or American Osteopathic Association Eligible to acquire additional state licensure as required 3 years of relevant clinical experience post residency/fellowship Knowledge of applicable state federal laws Utilization Review Accreditation Commission and National Committee for Quality Assurance standards is a plus Ability to commit to a set, weekly work schedule (Monday through Friday) Strong computer skills: ability to work autonomously with automated processes, computer applications, and systems Meet physical demands of the role including, but not limited to, typing, speaking, and listening 100% of time In accordance with our HITECH Security Accreditation, company provided encrypted-workstation is required to be hard-wire connected to a modem or router. Wireless connection is not permitted. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 203,200 - 338,600 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and 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 paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Perform evidence-based medical case reviews and physician consultations remotely to ensure appropriate patient care in orthopedic spine surgery. | M.D. or D.O. with board certification in Orthopedic Spine Surgery, active U.S. medical license, 3+ years clinical experience post residency/fellowship, strong computer skills, and ability to work remotely with secure internet connection. | Do you crave an intellectually stimulating job that allows you to leverage your clinical expertise while developing new skills and improving the lives of others? Then look no further! As an Orthopedic Spine Surgery Medical Director at EviCore, part of Evernorth Health Services, a division of The Cigna Group, you’ll use your clinical know-how to provide evidence-based medical reviews for patient care. Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases. This role offers you the opportunity to build new skills while enhancing the health and vitality of others. We're seeking a detail-oriented individual with good communication, technology, and typing skills, as well as strong clinical judgment. Drive growth in your career with our innovative team. How you’ll make a difference: You’ll start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success. Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on EviCore’s case management software. Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence–based medical necessity and appropriateness of the requested service or treatment. Leverage your clinical expertise to recommend alternative services or treatments as necessary. Work collaboratively with over 500 EviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making. What you’ll enjoy about working here: Benefits start on day one Predictable work schedules 100% work from home 8 Paid Holidays + 23 PTO Days 401(K) with company match Reimbursement for continuing medical education Career growth opportunities across the enterprise Networking with peers across multiple medical specialties Requirements: M.D. or D.O. with a current, active, U.S. state medical license and board certified in Orthopedic Spine Surgery, recognized by the American Board of Medical Specialties, or American Osteopathic Association Eligible to acquire additional state licensure as required 3 years of relevant clinical experience post residency/fellowship Knowledge of applicable state federal laws Utilization Review Accreditation Commission and National Committee for Quality Assurance standards is a plus Ability to commit to a set, weekly work schedule (Monday through Friday) Strong computer skills: ability to work autonomously with automated processes, computer applications, and systems Meet physical demands of the role including, but not limited to, typing, speaking, and listening 100% of time In accordance with our HITECH Security Accreditation, company provided encrypted-workstation is required to be hard-wire connected to a modem or router. Wireless connection is not permitted. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 203,200 - 338,600 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and 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 paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Assist with clinical program management by performing clinical data analysis, financial modeling, trend evaluation, and supporting implementation of clinical products and services. | Bachelor’s degree or equivalent experience, 0-5 years relevant experience, proficiency in Microsoft applications, knowledge of pharmacy laws, strong communication and organizational skills, and ability to work in a hybrid environment. | 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. This position is a Hybrid role where the Cigna policy requires office alignment but is not restricted to locations that are identified in this posting. POSITION SUMMARY The Clinical Business Analyst assists and supports Clinical Program Management with the delivery of clinical products and services to clients. Under general supervision, performs the primary functions of clinical data analysis, financial modeling, trend evaluation, and participation in project management. This position develops skill sets necessary for clinical strategy planning, development, consultation, presentation, implementation, and ongoing management of clinical programs and services. ESSENTIAL FUNCTIONS Assist with assigned business division projects. (e.g., reviews and detects medication utilization and plan design trends, where findings are applied to client-specific clinical strategies and within the scope of utilization management initiatives) Supports formulary modeling and plan design analysis, in the context of building experience toward developing clinical strategies and business plans for existing and prospective clients. Works with clinical program management staff to successfully plan and implement clinical products and services on behalf of new and existing clients in support of business division work plan goals and objectives Works together with Sales/Marketing, Finance/Underwriting, Clinical and other organization departmental staffs in support of business division work plan goals and objectives Participates in formal and informal training programs and professional development activities Effectively participates in and contributes to staff meetings, committees and departmental work groups QUALIFICATIONS Bachelor’s degree in related field or 8 to 11 years of experience. 2-5 years relevant experience with Bachelor’s Degree or Master’s degree and 0-3 years of relevant experience Proficiency in Microsoft applications required Knowledge of pharmacy laws and regulations Proven leadership and ability to build strong team cohesion Ability to evaluate current state and analyze possible solutions in business workflow Detail oriented with strong organizational skills Excellent verbal and written communication skills Ability to adapt in a dynamic work environment learns quickly, solve problems and make decisions Able to work under pressure and meet tight deadlines ABOUT THE DEPARTMENT As a member of the Sales and Account Management team, you’re the face of Express Scripts for our clients. Your team is responsible for relationship building, winning new business and retaining clients. You’ll educate clients on how our benefit offerings can help them achieve their business goals and make recommendations on products and services to best serve their members. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 76,400 - 127,400 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and 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 paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.