The Cigna Group

Compensation

Full Description

Job Description: • Serve as the primary liaison for medical management leadership, triaging requests and providing timely updates • Partner in the design and refresh of the medical management oversight model for delegated programs • Facilitate governance structures for utilization management and clinical strategy committees • Develop, refine, and deliver reporting packages for utilization management performance and key metrics • Oversee delegated programs, including performance tracking, reviews, and accountability measures; lead remediation efforts as needed • Monitor appeals processes to ensure compliance with regulatory requirements and mitigate risk • Collaborate with cross-functional teams to align medical management strategies with organizational objectives • Prepare and present senior-level communications, including periodic status reports and monthly updates Requirements: • Bachelor's degree in healthcare administration, nursing, or related field (Master’s preferred) • Minimum 5 years in medical management, utilization management, or clinical operations • Strong knowledge of utilization management and appeals processes • Proven ability to lead cross-functional teams and manage complex projects • Excellent communication, facilitation, and stakeholder engagement skills • Experience with performance metrics, KPIs, and reporting tools • Familiarity with regulatory requirements and risk management in healthcare • Proficiency in data analysis and healthcare reporting systems Benefits: • Health insurance • Vision • Dental • Well-being programs • Behavioral health programs • 401(k) • Company paid life insurance • Tuition reimbursement • Minimum of 18 days of paid time off per year • Paid holidays