The Cigna Group · 18 hours ago
Plan Implementation Sr. Analyst - Evernorth - Remote
United States
Full-time
Remote
Mid, Senior Level
$55K/yr - $92K/yr
2+ years expThe Cigna Group is dedicated to improving health and vitality, and they are seeking a Plan Implementation Sr. Analyst to manage contract reviews and ensure compliance with policies and procedures. This role involves collaboration across business systems and teams, addressing claims issues, and supporting team training to enhance operational efficiency.
CommercialHealth CareHospitalInsuranceMedical
Responsibilities
Perform contract reads and work on any fall-out issues from the contracts
Understand and follow all loading instruction, policy and procedure documentation. Continually identify and escalate process gaps and opportunities for process efficiencies across documentation to avoid negative customer impacts
Loads in HCPM, Facets, Proclaim & PWB
Work on our National Ancillary pended claim issues that come from the pended claim team
Follow up with the manager on infractions
Able to understand the interdependencies between business systems, teams and matrix partners; recognizes when changes or additional analysis needs to be conducted and provide appropriate feedback and suggestions
Participate in peer training and coaching support to obtain required processing knowledge
Participate in workload balancing daily as needs arise to support work streams and functions
Understands needs of the team and supports the team
Initiate accurate problem identification and present root cause analysis findings utilizing appropriate data trending tools and resources. Collaborate to implement corrective actions
Meet deadlines and accept additional tasks and assignments while maintaining established quality, production, and team timeliness standards
Able to work successfully in a team environment
Able to work and collaborate with matrix partners to provide regular data performance feedback, close data integrity gaps and proactively seek resolutions
Qualification
Required
Bachelor's degree or higher strongly preferred or equivalent work experience required
2 + years of prior work experience with loading provider data required
Understand how contracts are set up and how current business policies and technology will affect claim payment
Working knowledge of HCPM, Facets, Proclaim and PWB/CPF required
Excel experience is required
Proven ability to maintain positive working relationships, receiving and providing feedback, coaching and guidance to/from other staff members is required
Self-starter with proven technical, analytical, negotiating, problem-solving, organizational and time management skills. Self-motivated, detail oriented, decisive, and adaptable to change
Aptitude in demonstrating the ability to maintain a high level of focus and attention to detail while working with complex data and systems
Ability to function well in a fast-paced, demanding environment
Must be able to effectively communicate across a wide variety of topics to various audiences
Ability to work independently while managing multiple tasks and meeting deadlines while also being a strong team player, partnering with others to collaboratively resolve issues and deliver solutions
Preferred
Proficiency with Microsoft Word and Access preferred
Prior claim exposure/experience highly preferred
Benefits
Medical
Vision
Dental
Well-being and behavioral health programs
401(k)
Company paid life insurance
Tuition reimbursement
A minimum of 18 days of paid time off per year
Paid holidays
Company
The Cigna Group
The Cigna Group is a healthcare firm that focuses on providing hospital services and innovative solutions for better health.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
David Cordani
Chairman and Chief Executive Officer
Michele Berg
CEO Communications
Recent News
2026-01-25
2026-01-06
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