The Cigna Group

Billing Specialist

• Ensure timely and accurate submission of medical and NCPDP claims to maximize reimbursement
• Research and resolve claim rejections by finding root causes and taking action
• Review billing trends to reduce errors and improve performance
• Keep patient and insurance information current to support clean claims
• Work with payors, patients, and internal teams to resolve billing issues
• Support home infusion and nursing billing with strong quality and accuracy
• Meet productivity and quality goals set by leadership

Manager

• Drive new business growth by acquiring large employer accounts through direct and broker channels
• Deliver results aligned to annual business plan targets for revenue, membership, and profitability
• Lead end-to-end sales strategies across Medical, Dental, Pharmacy, and Behavioral Health solutions
• Manage and respond to RFPs by coordinating internal strategy, pricing, and presentations
• Build and maintain strong relationships with producers, consultants, and internal partners
• Maintain accurate prospect and activity data to inform pipeline and forecasting decisions

New Business Manager, U500

Operations

• Provides advanced professional input to complex Operations Management assignments/projects
• Supports and provides direction to more junior professionals
• Works autonomously, only requiring “expert” level technical support from others
• 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 Operations
• May lead projects or project steps within a broader project or have accountability for ongoing activities or objectives
• Manage and track department and cross-functional projects and periodically report out to management

Operations Lead Analyst, Issue Management

Social Media Manager

• Supporting the Social Media Center of Excellence
• Creating compelling social media content
• Managing and engaging on social platforms
• Conducting social advertising campaigns
• Monitoring feeds and social media analytics reports
• Helping to create research and content assets and supporting materials to execute social media campaigns
• Monitoring day-to-day content on social media platforms
• Performing social media metrics analysis and reporting
• Developing paid social advertising plans and social strategies with advertising execution

Social Media and Marketing Co-op

Claims Specialist

• Independently research and navigate various documents and databases to accurately process claims, ensuring compliance and adherence to established guidelines
• Confirm the presence of necessary documents within submitted claims
• Validate the accuracy of medical codes provided in claim submissions
• Assess the eligibility status of claims based on established criteria
• Review and verify other insurance coverage information in submitted claim
• Evaluate authorizations provided in claim submissions for accuracy
• Analyze account benefit plans to ensure claims align with coverage and policies
• Identify discrepancies, errors, or missing information
• Utilize multiple computer applications simultaneously
• Maintain self-discipline, consistently uphold a strong work ethic, and complete work tasks/responsibilities while working without close supervision
• Meet or exceed quality and productivity goals
• Identify claim processing learning opportunities by working directly with supervisors, coaches, and trainers to learn efficient and effective processing techniques and workflows
• Utilize a variety of virtual tools, including Outlook email, Cisco Webex, and similar applications, to effectively collaborate, communicate, and stay connected with colleagues and supervisors

Claims Representative

• Lead the design and delivery of enterprise reporting that enables data-driven decisions across Provider Data Management Operations.
• Establish and standardize key performance indicators (KPIs) that align executive priorities with frontline execution.
• Build scalable dashboards and reporting tools that provide clear, actionable operational insights.
• Integrate and reconcile data across multiple systems to ensure accuracy, consistency, and trust in reporting outputs.
• Drive reporting governance by defining metrics, implementing data quality controls, and maintaining documentation.
• Manage and develop a team of reporting analysts by setting priorities, coaching talent, and ensuring high-quality delivery.
• Own reporting intake and prioritization, balancing demand, capacity, and timelines while communicating tradeoffs effectively.
• Serve as the business lead for reporting system enhancements, partnering with technology teams to define requirements and implement improvements.
• Operationalize analytics by embedding insights into workflows and continuously improving reporting processes and automation.

Data Measurement & Reporting Manager

Pharmacist

• Utilization management pharmacists are responsible for reviewing each plans policy to determine if coverage can be granted for a medication
• Provide clinical support and oversight for all utilization management (UM) activities
• Responsible for finalizing all denials of clinical prior authorization requests
• Supports the Coverage Review Department (CRD) as a clinical resource for drug therapy questions
• Applies critical thinking to achieve proper clinical decisions when performing clinical reviews
• Utilizes multiple systems and other clinical resources to achieve proper decisions in Utilization Management reviews
• Works and maneuvers within a queue system that prioritizes clinical reviews
• Makes clinical decisions quickly and at times decides and acts with limited information
• Works and collaborates with a multi-disciplinary clinical team to provide a customer centric experience

Clinical Staff Pharmacist

Collections

• Drive timely and accurate reimbursement through billing and collections
• Investigate denials, identify root causes, and resolve issues
• Submit payer appeals within deadlines and improve approval rates
• Analyze accounts receivable and reduce payment delays
• Partner with payers, patients, and teams to resolve balances
• Document all activities, adjustments, and updates clearly
• Review claims to confirm correct reimbursement
• Correct and reprocess claims to optimize payment
• Interpret EOBs to guide next steps
• Improve processes to reduce denials
• Meet quality and productivity goals

Collections Specialist, Home Infusion

Clinical Operations

• Lead clinical operations and case management programs across Premium Solutions client segments
• Drive performance across quality, engagement, operational efficiency, and client experience metrics
• Support the implementation and optimization of enhanced client service models
• Oversee audit readiness, accreditation activities, and quality governance programs
• Partner across Product, Clinical, Operations, Sales, and Account Management to align strategy with service delivery
• Support client retention, growth initiatives, and operational readiness efforts
• Contribute to workforce planning, staffing strategy, financial stewardship, and operational efficiency initiatives
• Monitor performance guarantees and support measurement and achievement activities
• Lead and develop leaders across clinical and operational functions

Clinical Operations Director

• Contact doctors and/or patients regarding need for complete and accurate information for prescription processing.
• Complete data entry of prescriptions after reviewing for completeness and accuracy.
• Work with pharmacists per work instructions, policy and procedures, management direction or any national or state regulations.
• Complete training on Risk Evaluation and Mitigations Strategies (REMS) program requirements.
• Serve as a subject matter expert (SME) and assist with questions/issues for team members in coordination with supervisor.
• May assist with training of newly hired pharmacy technicians.
• Additional duties as assigned, may be cross trained to support other functional areas.

Senior Pharmacy Technician

Sales

• Provides analytical and administrative support to Sales representative in preparing and submission of new sale quotes
• Interact with underwriting on such matters as package quotations, and regular group benefit quotations
• Assists in the creation and development of sales proposals and client specific sales presentation materials
• Coordinate implementation process with matrix partners (internals / external) to improve client net promoter score
• Responsible to coordinate with Sales representative on prospect/broker inquiries, problem solving, and ensuring client intent is captured
• Preparing and sending application and supporting documents to clients
• Coordinating with operational departments on new business installations
• Maintain CRM system, salesforce.com, for new business and growth on existing business
• Preparing standard and customized reporting using salesforce.com
• Provides ad hoc analyses and operational tasks to understand data: utilizing enterprise tools, best practices and quality standards related to sales
• Acts as liaison to other teams to gain information, problem solve and execute various tasks
• Participates in project work for market as directed by Sales Administration Manager

Senior Sales Effectiveness Analyst

Accounting Manager

• Serve as the primary accounting lead for CarePathRx, with end‑to‑end accountability for general ledger accuracy, close execution, and financial reporting deliverables
• Lead and coordinate all monthly, quarterly, and annual close activities for CarePathRx in alignment with Health Systems Services timelines and standards
• Own key accounting judgments and estimates, escalating complex or sensitive matters to Health Systems Services accounting leadership as appropriate
• Directly manage a subset of CarePathRx accountants, providing coaching, performance management, and development
• Support the ongoing integration of CarePathRx accounting processes into the Health Systems Services and enterprise accounting model
• Ensure a strong internal control environment, including execution of key controls and support for SOX and SOC 1 requirements

Senior Accounting Manager

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Nurse Case Manager

Customer Support

• Answer inbound calls from health care providers with inquiries regarding medical claims, benefits, appeals, prior authorizations, and medical codes.
• Take inbound calls while toggling through several applications on multiple screens.
• Attend 100% of trainings, 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.

Customer Service Representative

Infrastructure Engineer

• Support systems engineering lifecycle activities for large hybrid Splunk and Cribl deployments, including requirements gathering, design, testing, implementation, operations, and documentation.
• Lead troubleshooting efforts and identify root cause of problems across the enterprise logging environment.
• Work on and lead projects that drive continuous improvement, enhancements of products, services offerings, and governance.
• Coach and mentor customers and staff that may need technical assistance or guidance.
• Partner with Agile Program and Product Management leads to develop, plan, and execute large initiatives.
• Hybrid work schedule.