Payment Integrity Manager Post Payment Cigna Healthcare
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Job Location:
Chattanooga, TN - USA
Monthly Salary:
Not Disclosed
Posted on:
3 days ago
Vacancies:
1 Vacancy
Job Summary
Candidates who reside within 50 miles of the following locations may be asked to work in person three days per week: Bloomfield CT Chattanooga TN Denver CO St Louis MO or Scottsdale AZ.
The Operations Manager will lead Cignas internal postpayment overpayment identification and recovery strategy while driving significant financial impact through effective program execution and team leadership. This role manages a team of overpayment analysts accountable for annual recoveries and partners closely across Payment Integrity including prepay analytics vendor operations and external recovery vendors. The Manager uses analytics and trend insights to identify savings opportunities while ensuring compliance operational excellence and strong crossfunctional collaboration.
Responsibilities
- Lead and develop a highperforming team focused on maximizing internal overpayment identification and recoveries.
- Partner with prepay analytics to shift postpayment overpayment opportunities upstream where possible.
- Expand and integrate internal overpayment programs across products and lines of business to increase financial impact.
- Collaborate with internal partners (e.g. Client Services Contracting Legal Compliance) to identify and prioritize overpayment initiatives and audits.
- Serve as the subject matter expert for internal overpayment activities providing education analysis reporting and expectation management to stakeholders.
- Manage partnerships with recovery vendors ensuring timely and accurate responses and monitoring project performance.
- Ensure program compliance with organizational policies and regulatory requirements.
- Lead and execute projects within tight timeframes to meet financial and operational goals.
- Partner with Technology to enhance systems and tools supporting recovery strategies and business processes.
- Build and execute a people strategy that attracts develops and retains talent through coaching performance management and succession planning.
Qualifications
- Bachelors degree or higher strongly preferred or equivalent work experience required.
- 5 years of experience leading and developing highperforming diverse operations teams with direct bottom-line impact preferred.
- 5 years of experience managing large data sets including claims data; experience with Payment Integrity vendors strongly preferred.
- Claim auditing experience required and advanced knowledge of provider contracts reimbursement policies and claim operations required.
- Proven ability to meet or exceed financial and operational goals and to lead change initiatives.
- Strong analytical problemsolving and stakeholder partnership skills; comfortable challenging the status quo to drive improvement.
- Proficiency with Microsoft tools and databases.
If you will be working at home occasionally or permanently the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position we anticipate offering an annual salary of 87100 - 145100 USD / yearly depending on relevant factors including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
At The Cigna Group youll enjoy a comprehensive range of benefits with a focus on supporting your whole health. Starting on day one of your employment youll be offered several health-related benefits including medical vision dental and well-being and behavioral health programs. We also offer 401(k) company paid life insurance tuition reimbursement a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs click here.
About The Cigna Group
Doing something meaningful starts with a simple decision a commitment to changing lives. At The Cigna Group were dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services we are committed to enhancing the lives of our clients customers and patients. Join us in driving growth and improving lives.Qualified applicants will be considered without regard to race color age disability sex childbirth (including pregnancy) or related medical conditions including but not limited to lactation sexual orientation gender identity or expression veteran or military status religion national origin ancestry marital or familial status genetic information status with regard to public assistance citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you need a reasonable accommodation to complete the online application process please email for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama Alaska Arizona Arkansas Delaware Florida Georgia Hawaii Idaho Iowa Kansas Maryland Massachusetts Michigan Nebraska Ohio Pennsylvania Texas Utah Vermont and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal state and local ordinances.
Required Experience:
Manager
Key Skills
About Company
Cigna Healthcare offers health insurance plans such as medical and dental to individuals and employers, international health insurance, and Medicare coverage.
