The Cigna GroupRemote
Program Management Lead Analyst - Encore Program - Remote
United States
Full-time
1 week ago
No H1B
Key skills
Clinical data analysisMedical records reviewCPTICD-10 codingMicrosoft Office proficiencyAnalytical skillsEffective communicationOrganizational skillsTime managementCollaborationCommunicationTime Management
About this role
The Cigna Group 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 support 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