Senior Network Operations Analyst, Provider Compliance

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The Cigna Group

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1982

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Healthcare • Healthcare Insurance • Pharmaceuticals

The Cigna Group is a global health company committed to improving the health and vitality of its clients, customers, and patients. With its two divisions, Cigna Healthcare and Evernorth Health Services, the company focuses on enhancing quality of life through healthcare services and pharmacy benefits management. The Cigna Group is dedicated to ethical practices in healthcare and artificial intelligence, and strives to create positive change in the healthcare system. It also emphasizes its Environmental, Social, and Governance (ESG) responsibilities, aiming to impact health equity and foster innovation in healthcare delivery.

📋 Description

• Assist with daily support and preparation of the provider termination process • Collect and report termination information across multiple groups • Support investigations of pharmacy noncompliance • Provide collaborative support for Client Account Team requests intersecting with pharmacy operations and compliance • Ensure network providers maintain compliance with state and federal regulations, the ESI Provider Manual, and Provider Agreement • Serve as liaison for internal compliance-related inquiries and projects • Identify and align business process efficiencies across teams and cross-functional partners • Drive process improvement, automation, technology adoption, and cross-functional partnerships • Deliver operational excellence while managing multiple competing priorities

🎯 Requirements

• Bachelor’s degree in related field preferred • High school diploma required • At least 2 years of relevant work experience • Proficient with Microsoft Office suite, including Word, Excel, PowerPoint, and Outlook • Strong written and verbal communication skills • Exceptional follow-through, attention to detail, and ability to handle multiple tasks and meet daily deadlines • Ability to demonstrate initiative and independent thinking • Ability to think strategically while solving tactical challenges • Demonstrated ability to work with cross-functional departments to resolve issues • Strong analytical and problem-solving skills • Ability to adapt in a dynamic, fast-paced work environment and make independent decisions • Cable broadband or fiber optic internet connection with at least 10 Mbps download and 5 Mbps upload for home working

🏖️ Benefits

• Annual bonus plan eligibility • Medical benefits starting day one • Vision benefits starting day one • Dental benefits starting day one • Well-being and behavioral health programs starting day one • 401(k) • Company-paid life insurance • Tuition reimbursement • Minimum of 18 days of paid time off per year • Paid holidays • Leaves of absence • Work-from-home arrangement