Program Management Lead Analyst - Encore Program - Remote

Cigna Healthcare is dedicated to improving health and vitality, and they are seeking a Program Management Lead Analyst to support their Client Growth & Innovations Clinicians. This role involves transforming complex clinical and claims data into actionable insights to enhance provider partnerships and client decision-making.

Responsibilities:

• Deliver timely, high-quality clinical and claims insights that enable CGI Clinicians to support client and broker engagements
• Analyze, investigate, and summarize HCC data, including TC131 and TC56 reports, to inform Total Health Insight deliverables and external clinician meetings
• Conduct comprehensive clinical summary reviews for high-cost claimants in alignment with established clinical and corporate guidelines
• Interpret medical records and claims data to identify trends, risks, and opportunities that support strategic recommendations
• Synthesize findings into clear, executive-ready summaries for Market Medical Executives and Nurse Executives
• Lead or contribute to small- to mid-sized projects focused on improving processes, quality, and efficiency
• Partner effectively across a matrixed organization, building trust and momentum in a fast-paced, evolving environment
• Apply a working knowledge of core clinical programs, products, and systems (e.g., ICMS, CCMS, HEV, OneView, TruCare) to support business outcomes

Requirements:

• 3+ years of clinical or clinical support experience
• Strong analytical and research skills with the ability to interpret complex clinical and claims information
• Experience reviewing medical records and summarizing clinical findings
• Effective written and verbal communication skills, with the ability to convey insights clearly to diverse stakeholders
• Strong organizational and time management skills, with comfort managing multiple priorities
• Bachelor's degree in a related field
• 5+ years of clinical or related healthcare experience
• Experience with CPT and ICD-10 coding
• Proficiency in Microsoft Office and healthcare technology platforms
• Demonstrated ability to influence, collaborate, and drive outcomes across cross-functional teams