Program Management Advisor, Medical Utilization Management
The Cigna Group
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $95,400 - $159,000 per year
About the role
- 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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
data analysishealthcare reporting systemsutilization managementappeals processesperformance metricsKPIsreporting toolsproject management
Soft Skills
communicationfacilitationstakeholder engagementleadershipcollaboration
Certifications
Bachelor's degree in healthcare administrationBachelor's degree in nursingMaster’s degree in healthcare administration (preferred)