Business Project Lead Analyst – Payment Integrity – Evernorth - Remote

The Cigna Group is dedicated to improving health and vitality, and they are seeking a Business Project Lead Analyst to enhance payment integrity outcomes. This role involves collaborating with providers, vendors, and internal teams to drive accurate recovery of provider overpayments while fostering trusted relationships across the enterprise.

Responsibilities:

• Lead strategic collaboration between recovery vendors, providers, and internal network partners to improve provider overpayment refund outcomes
• Drive monthly provider and vendor discussions to review overpayment inventory, resolve barriers, and accelerate recoveries
• Partner with Network and Contracting teams to address uncooperative providers and implement effective remediation strategies
• Monitor vendor performance and accuracy, translating findings into corrective action plans that improve results and compliance
• Serve as a subject matter expert on claim identification and recovery processes, providing guidance to cross-functional partners
• Support client-driven and third-party audit initiatives by reviewing, analyzing, and reporting on recovery accuracy and financial impact
• Evaluate provider contract audit language and recommend enhancements to strengthen recovery rights and outcomes
• Analyze trends, exclusions, and provider behaviors to quantify financial impact and present opportunities to optimize recoveries
• Develop and deliver clear, actionable reporting for leadership, providers, vendors, and external stakeholders
• Enable vendor success through education on systems, procedures, and evolving recovery requirements

Requirements:

• High School Diploma or G.E.D. required
• 3+ years of experience in payment integrity, provider relations, claims operations, or related healthcare analytics roles
• 2+ years of experience hands-on experience with healthcare claim systems such as PROCLAIM and FACETS
• Working knowledge of healthcare claim processing and recovery workflows
• Experience partnering across matrixed teams including Network, Legal, Contracting, Sales, and Operations
• Strong analytical, organizational, and communication skills with the ability to work independently
• Demonstrated ability to manage complex issues with appropriate urgency and sound judgment
• Proficiency in Microsoft Word and Excel
• Experience working directly with providers and interpreting provider contract language
• Familiarity with Cigna applications including iView, CED, and OneView
• Bachelor's degree in a related field