Program Management Senior Advisor - Cigna Healthcare - Remote
Core
Senior operational leader ensuring accurate, compliant execution of regulatory-driven alignment across reimbursement rules, prior authorization, and medical policy implementation.
Role type
Senior IC Program Management Advisor (Business Implementation Lead)
Builds
Compliance implementation action plans, quarterly compliance reports, and coordinated delivery across cross-functional teams for Payment Policy and Coding.
Domain
Health Insurance / Regulatory Compliance / Payment Integrity
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
Program management, regulatory mandate implementation, compliance facilitation, cross-functional coordination, risk identification, action plan development, list management, process improvement, executive-level communication
Preferred skills
Health plan operations knowledge, audit support, training development, autonomous critical thinking, strategic objectives alignment
Technologies
iComply, OpenPages, Q&A Fast Map, Law Exchange, Microsoft Office, Tableau, Wrike, ClaimsXten, Prepay, Precertification, Pricing, claim engine logic
Responsibilities
Review weekly Regulatory Instructions and assess impact across Payment Integrity and Payment Policy and Coding; Lead coordination of cross-functional implementation activities by identifying SMEs and aligning impacted teams; Develop, manage, and track implementation action plans, deliverables, timelines, controls, and evidence of compliance; Identify barriers to implementation, evaluate alternative solutions, and escalate risks; Coordinate compliance-related requirements across ClaimsXten, Prepay, Precertification, Pricing, and benefit classing; Maintain information and list management functions for biomarker-related activities.
Seniority
Senior, hands-on IC