Program Management Lead Analyst - Cigna Healthcare - Remote

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Remote, US
Base: $77,500 - $129,100 usd yearly; bonus: eligib...
Fully remote
3+ years medical claim processing experience
2+ years proclaim facets or pmhs platform knowledge
Developing edit rules for overpayment reduction
The Program Management Lead Analyst at Cigna Healthcare is a remote position focused on improving claim accuracy and reducing medical costs through collaboration and analytical skills. The role involves overseeing financial risks, managing edit rules, and enhancing quality strategies within the AAPS program

Job Summary

  • This role supports the AAPS program by ensuring accurate claim payments and reducing medical costs through policy and quality strategies.
  • The position requires leveraging analytical skills to identify overpayment cases, develop edit rules, and manage financial risks effectively.
  • Candidates will benefit from a comprehensive benefits package including health coverage, 401(k), and paid time off starting on day one.

Matching Summary

Match Score: 85

The Program Management Lead Analyst at Cigna Healthcare is a remote position focused on improving claim accuracy and reducing medical costs through collaboration and analytical skills. The role involves overseeing financial risks, managing edit rules, and enhancing quality strategies within the AAPS program.

Salary

Base: $77,500 - $129,100 USD yearly; Bonus: Eligible for annual bonus plan; Benefits: Medical, vision, dental, 401(k), life insurance, tuition reimbursement

Skills & Requirements

Must-have

  • 3+ years medical claim processing experience
  • 2+ years Proclaim Facets or PMHS platform knowledge
  • Developing edit rules for overpayment reduction
  • Root cause analysis and financial impact assessment
  • Data mining and query execution for corrections

Nice-to-have

  • Strong interpersonal skills for vendor collaboration
  • Experience with predictive modeling and QET systems
  • Ability to work independently with minimal supervision
  • Proficiency in pivot tables and VLOOKUP functions

Key Requirements

  • Bachelor's degree or equivalent work experience
  • 3+ years of medical claim processing required
  • 2+ years of strong claim systems knowledge (Proclaim, Facets, PMHS)

Work Rights

Not specified

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