The Cigna Group

Advisor

• Design standardized performance analytics aligned with DS&I priorities and enterprise goals
• Build measurement frameworks, data definitions, and methods to improve reporting consistency and trustworthiness
• Develop and automate Tableau dashboards with clear insights and recommended actions
• Partner with business leaders to define key questions and translate needs into analytical solutions
• Evaluate trends, risks, opportunities, and performance drivers through root-cause, variance, and operational analysis
• Use advanced SQL to validate results, investigate data issues, and analyze multiple data sources
• Apply SAS, Altair, or Python to prepare data, automate work, and solve complex analytical problems
• Resolve reporting, data quality, and measurement issues with IT and cross-functional teams
• Deliver executive-ready reporting covering results, risks, business impact, and next steps
• Create reusable templates and documentation to strengthen quality, accuracy, and team capabilities
• Manage priorities independently while meeting commitments and building stakeholder relationships

Data Measurement & Reporting Advisor

Operations

• Serve as Client Support/Support Shift Lead TSS and first-line contact for Essentials and Optimizer clients regarding PowerGridRx questions and issues
• Exhibit teaching leadership and oversee continuity of care and service to clients and staff
• Act as first-line contact for internal issues including IT and team coverage
• Triage client, pharmacist, and TSS connectivity or PowerGridRx problems
• Create and follow through on Zendesk tickets when required
• Direct clients to the correct point of contact
• Provide TSS staffing services
• Assist with TSS training and intervention documentation understanding
• Train TSS and pharmacist staff on Intervention notes and Parked orders notes
• Assist with managing the PipelineRx queue by posting orders to the appropriate pharmacist
• Monitor queues to help pharmacists decrease turnaround time
• Contact clients on behalf of the on-duty pharmacist to optimize workflow and minimize time away from orders
• Monitor and triage high-volume client phone calls and answer calls during peak hours
• Use Phone Tree guidelines to ensure pharmacist visibility of assigned clients
• Contact client IT or PipelineRx IT for advanced technology support
• Ensure pharmacist coverage for all clients during contractual PipelineRx shift hours
• Coordinate emergency pharmacist coverage for no-shows, call-offs, illness, and power or internet outages
• Facilitate pharmacist communication with clients when client-system access is interrupted
• Maintain accurate interaction and issue records
• Provide a nightly shift-activity report to the TSS manager
• Serve as a resource to the pharmacist on duty during shifts

Pharmacy Operations Lead Representative

• Lead complex, cross-functional business projects from planning through execution, implementation, and operational stabilization
• Translate business objectives into project scope, deliverables, milestones, responsibilities, dependencies, and success measures
• Develop and maintain integrated project plans and implementation-readiness plans
• Coordinate execution across Operations, Technology, Product, Compliance, Finance, Vendor Management, Customer Experience, and other enterprise partners
• Establish project governance and facilitate meetings, working sessions, decision forums, status reviews, and readiness discussions
• Maintain project documentation, status reports, action items, decisions, risks, issues, dependencies, and business artifacts
• Monitor milestones and identify impacts to timing, scope, quality, cost, and operational readiness
• Coordinate business requirements, operational readiness, testing, training, communications, procedures, controls, reporting, and support models
• Lead or support vendor onboarding, transitions, new capabilities, service changes, and operational improvements
• Manage project risks, issues, dependencies, decisions, escalations, and resolution paths
• Prepare executive-ready communications, leadership summaries, decision materials, and project health reporting
• Incorporate change-management principles and coordinate adoption of new processes or capabilities
• Support post-implementation reviews, stabilization, lessons learned, and continuous improvement

Senior Business Project Advisor, Individual Dental Operations

Analyst

• Lead cross-functional commercial growth and optimization programs from planning through phased execution
• Establish governance, decision tracking, risk management, and follow-through for programs
• Translate reporting needs into insights by managing intake, prioritizing requests, validating outputs, and improving data quality
• Standardize intake, tracking, reporting, and data-validation processes across regions and functions
• Conduct opportunity sizing, segmentation, pipeline, market share, and related analyses
• Maintain reliable client and prospect datasets and partner with Data and Analytics teams on dashboards, reporting accuracy, and system integration
• Prepare executive-ready updates, recommendations, and presentations for leadership meetings, business planning, steering committees, and sales forums
• Own the structure and cadence of the NPS program, including communications, insight consolidation, strategic alignment, tracking, monitoring, and pulse survey planning
• Identify responsible digital and AI use cases and support adoption through governance-aligned implementation plans
• Coordinate vendor-supported wellbeing and employee assistance programs across virtual, hybrid, and onsite settings
• Support proposals and requests for proposal by assessing operational feasibility and advising Sales and Client Management

Senior Analyst, Commercial Effectiveness

• Manage customer issue intake queues by tracking, prioritizing, researching, documenting, resolving, and closing cases
• Research and resolve complex or sensitive customer issues, complaints, Senior Leadership inquiries, and Department of Insurance matters
• Support inquiries received through federal exchange and state-based marketplace channels
• Evaluate customer needs and develop effective resolutions using technical knowledge and established processes
• Communicate findings, decisions, and resolutions to customers, business partners, and leadership
• Maintain complete and accurate case documentation
• Monitor case activity and turnaround times for regulatory and internal compliance
• Identify and escalate compliance risks, missed dependencies, and resolution barriers
• Protect customer information and follow privacy, security, documentation, and records-management requirements
• Support audits, compliance reviews, and operational inquiries
• Analyze issues and case activity to identify recurring themes, trends, process gaps, and risks
• Recommend improvements to customer service processes, workflows, controls, communications, and documentation
• Participate in operational projects, business testing, and process-improvement initiatives
• Provide technical guidance and subject matter expertise to team members and cross-functional partners
• Coordinate timely resolutions with Operations, Compliance, Customer Service, and business support teams
• Share trends, risks, and lessons learned
• Independently manage workload, competing priorities, and time-sensitive requests

Issue Resolution Lead Analyst, Individual Dental Operations

• Conduct and coordinate quality reviews and audits of internal operations and vendor-supported processes
• Support review planning, case selection, evidence collection, documentation, analysis, and reporting
• Evaluate complex audit findings and engage business owners or subject matter experts when needed
• Maintain accurate audit documentation supporting findings, conclusions, and recommended actions
• Monitor audit activities and deliverables against regulatory turnaround requirements and internal expectations
• Collect and organize evidence for enterprise, regulatory, internal, or external audits
• Identify compliance concerns and escalate material findings or risks
• Support calibration activities among audit professionals, operational teams, and vendor partners
• Collect, validate, analyze, and summarize audit and quality data
• Develop and maintain reports, dashboards, and analyses covering quality performance, findings, trends, and improvement opportunities
• Identify patterns, recurring findings, emerging risks, and reporting gaps
• Communicate analytical findings to Quality Assurance, Operations, vendor, and business partners
• Define data-collection requirements and develop tracking and reporting capabilities
• Analyze findings for root causes, business impacts, customer impacts, and compliance risks
• Support corrective and preventive actions, remediation tracking, and unresolved-risk reporting
• Present audit results and supporting analysis to stakeholders and vendor partners
• Support regulatory changes by updating audit tracking, workflows, job aids, procedures, and policies
• Identify process-improvement opportunities and lead or support improvement project components
• Partner with Operations, Compliance, vendors, and other teams to develop sustainable solutions
• Evaluate whether implemented changes address findings and improve quality
• Recommend updates to controls, documentation, training, reporting, and monitoring
• Develop, maintain, and update audit procedures, SOPs, job aids, workflows, and supporting documentation
• Provide technical direction and quality-related guidance to audit professionals and team members
• Serve as a resource for audit methodology, data interpretation, documentation, and complex findings
• Manage multiple assignments and priorities independently while adapting to changing business needs

Quality Review and Audit Lead Analyst, Individual Dental Operations

• Conduct quality reviews through call monitoring, transaction review, claim review, or examination of operational systems and records
• Evaluate work against procedures, audit guidelines, quality standards, business requirements, and regulatory expectations
• Apply scoring criteria and quality controls consistently
• Complete routine and moderately complex audits within productivity, accuracy, and timeliness expectations
• Record audit results and maintain supporting documentation
• Identify and document errors, procedural gaps, recurring observations, and potential trends
• Escalate unusual circumstances, compliance concerns, customer-impacting issues, and technical barriers
• Enter, validate, organize, and summarize audit data using designated systems, trackers, reporting tools, Microsoft Excel, and other approved tools
• Assist with standard audit reports, summaries, report distribution, questionnaires, case validation, error responses, and evidence collection
• Participate in calibration sessions, training, coaching, job shadowing, and knowledge-sharing activities
• Maintain current knowledge of procedures, audit guidance, products, systems, and business requirements
• Identify process, procedure, audit-guidance, and documentation gaps
• Assist with quality and process-improvement initiatives, testing, and validation activities
• Build relationships with Quality Assurance colleagues and matrix partners
• Support onboarding through job shadowing or process demonstration when assigned

Quality Review and Audit Analyst, Individual Dental Operations

• Conduct quality reviews and audits of customer interactions, operational transactions, and supporting system activity
• Evaluate work against procedures, quality standards, scoring guidelines, business requirements, and regulatory expectations
• Manage routine and complex audits from case selection and evidence review through scoring, documentation, and completion
• Maintain audit records supporting scores, findings, and conclusions
• Support internal, vendor, regulatory, or third-party audit activities
• Analyze audit results to identify recurring errors, quality trends, process gaps, and operational risks
• Prepare audit summaries and initial analyses for Quality Assurance leadership
• Assist with recurring quality and audit reporting
• Participate in internal and vendor calibration sessions
• Serve as a technical resource for team members and support onboarding and job-shadowing
• Identify gaps in procedures, workflows, systems, training, and audit guidance
• Assist with quality-improvement projects, process changes, testing, and validation
• Work with Operations, Compliance, vendor partners, and matrix teams to research findings and address quality concerns
• Present audit results and supporting information to business and vendor partners
• Support technical troubleshooting and incident escalation when system issues affect audit completion or accuracy

Senior Quality Review and Audit Analyst, Individual Dental Operations

Physician

• Provide telehealth consultations exclusively for Medical Group patients
• Consult and treat patients virtually through clinical, diagnostic, and therapeutic telehealth medical services
• Provide virtual urgent care and virtual primary care services
• Perform related administrative services, including meeting attendance, in-basket management, and provider cross-coverage
• Participate or lead within a designated Primary Care team structure
• Supplement primary care work with urgent care as the provider panel is established
• Participate in Medical Staff activities, clinical chart reviews, compliance training, continuing medical education, committees, quality improvement, and patient safety review
• Prepare timely and accurate medical records
• Meet or exceed quality and clinical competency goals
• Collaborate on workflows, policies, and procedures for the virtual primary care hybrid care model
• Mentor colleagues and supervise APRNs in compliance with state requirements
• Take on additional tasks as reasonably requested

Virtual Primary Care Physician

• Review and validate new business, renewal, and maintenance documentation for accuracy, completeness, and implementation readiness
• Partner with Sales and cross-functional teams to resolve documentation issues and drive cases to In Good Order status
• Manage case activity within VISTA, including documentation, status updates, and readiness reviews
• Validate benefit configurations, legislative requirements, and installation readiness across Facets and Non-Facets platforms
• Transition implementation-ready cases to the Implementation Manager for downstream execution
• Participate in training, team meetings, and continuous improvement initiatives
• Contribute to special projects and achieve departmental quality, productivity, and service performance goals

Operations Fulfillment Analyst

Account Executive

• Lead territory strategy and execution to achieve referral, patient admit, and growth objectives
• Serve as primary sales representative for physicians, hospital clinics, infusion centers, and other referral sources
• Build and maintain relationships with healthcare providers, office staff, and pulmonary specialty stakeholders
• Collaborate with clinical, reimbursement, operational, and manufacturer partners to improve patient access and strengthen Accredo’s value proposition
• Support payer agreement implementation and collaborate with National Account Managers on market opportunities and local pull-through activity
• Develop territory business plans, forecasts, and referral strategies using market intelligence and account insights
• Monitor referral activity, market trends, and competitive dynamics to identify growth and retention opportunities
• Represent Accredo at conferences, educational programs, advocacy events, and industry meetings
• Partner compliantly with pharmaceutical manufacturers on provider education and referral process excellence
• Participate in strategic launch planning, case conferences, and sales meetings

Senior Account Executive, Advanced Pulmonary Conditions

Medical Director

• Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity using EviCore’s case management software
• Conduct physician consultation (peer-to-peer) calls with referring providers
• Discuss evidence-based medical necessity and appropriateness of requested services or treatments
• Recommend alternative services or treatments as necessary
• Collaborate with over 500 EviCore physician colleagues to support evidence-based decision-making and proper patient care
• Participate in structured remote training with trainers, mentors, and leadership
• Stay current on healthcare regulations and industry developments

Medical Director – Medical Oncology

• Lead territory strategy and execution to achieve and exceed referral, patient admit, and growth objectives across assigned markets
• Serve as the primary sales representative for physicians, hospital clinics, infusion centers, and other referral sources
• Build and maintain trusted relationships with healthcare providers, office staff, and key stakeholders within the pulmonary specialty community
• Collaborate with clinical, reimbursement, operational, and manufacturer partners to improve patient access and strengthen Accredo’s value proposition
• Support implementation of payer agreements and collaborate with National Account Managers to maximize market opportunities and local pull-through activity
• Develop territory business plans, forecasts, and referral strategies using market intelligence and account insights
• Monitor referral activity, market trends, and competitive dynamics to identify opportunities for growth and retention
• Represent Accredo at conferences, educational programs, advocacy events, and industry meetings
• Partner compliantly with pharmaceutical manufacturers to support provider education and referral process excellence
• Participate in strategic launch planning, case conferences, and sales meetings that support organizational goals

Nurse

• Lead, coach, and develop direct reports, including case managers, health coaches, and other clinical team members
• Manage day-to-day team activities and provide guidance, feedback, conflict resolution, and support for escalated issues
• Monitor and evaluate performance against KPIs, quality standards, financial targets, and URAC and NCQA accreditation requirements
• Conduct performance discussions and support compensation decisions through performance evaluations
• Promote career development through coaching, mentoring, continuing education, and succession planning
• Improve service delivery, outcomes, and team effectiveness using available tools and resources
• Collaborate with matrix partners to develop work plans, remove barriers, and implement corrective actions
• Align team priorities with strategic, corporate, customer, product, and business initiatives
• Lead or participate in projects, work groups, national teams, and committees; communicate progress, risks, and barriers to leadership
• Serve as a liaison and escalation point between frontline staff, customers, and internal matrix partners
• Resolve service delivery concerns and respond to customer requests
• Support customer meetings, presentations, visits, and audits
• Build and maintain relationships with internal teams and external stakeholders
• Maintain clinical knowledge and provide coaching informed by clinical expertise
• Partner with quality teams to identify improvement opportunities and implement actions
• Support corporate and national quality and certification initiatives, including URAC and NCQA
• Communicate changes in customer requirements, protocols, and business processes to staff
• Recruit and hire qualified team members
• Demonstrate inclusive leadership and cultural sensitivity across diverse teams and customer populations

Nurse Case Management Supervisor

• Develop analyses, insights, and recommendations supporting strategic planning, operational decision-making, and performance improvement across Individual Dental Operations
• Monitor and analyze operational, customer, financial, and KPI data to identify trends, risks, performance gaps, and improvement opportunities
• Conduct root cause analyses of operational issues and performance variances
• Translate complex analytical findings into actionable recommendations for leaders and stakeholders
• Lead development, maintenance, and optimization of operational reports, dashboards, scorecards, and analytical tools
• Define reporting requirements, performance measures, data needs, and audience expectations with stakeholders
• Identify duplication, manual effort, reporting gaps, inconsistencies, and automation opportunities
• Design, develop, and implement automated reporting, analytical, and workflow solutions using approved enterprise tools
• Apply Microsoft applications, Excel, Power Platform, Alteryx, Tableau, and other analytics or automation platforms
• Incorporate documentation, testing, validation, exception handling, and controls into automated solutions
• Identify and evaluate responsible artificial intelligence and generative AI use cases
• Establish human review and validation expectations for AI-generated outputs
• Support development, documentation, measurement, and monitoring of KPIs
• Develop vendor performance reporting and analyze contractual, service-level, operational, and customer experience measures
• Establish controls for reporting accuracy, completeness, consistency, and traceability
• Validate reporting outputs and analytical results before distribution
• Identify data-quality concerns, discrepancies, and control gaps and coordinate remediation
• Lead or support continuous improvement initiatives involving workflow redesign, standardization, scalability, and modernization
• Provide analytical support for strategic initiatives, business transitions, operational planning, and enterprise projects
• Partner with Operations, Reporting, Technology, Finance, Vendor Management, Product, Compliance, and other teams
• Serve as a trusted advisor and subject matter expert for operational analytics, reporting, performance measurement, automation, and workflow improvement
• Communicate technical and analytical concepts to operational leaders, process owners, and nontechnical stakeholders
• Support knowledge transfer and sustainable ownership of analytical and automated solutions

Data Measurement & Reporting Advisor

Pharmacy Operations Lead Representative

Senior Business Project Advisor, Individual Dental Operations

Senior Analyst, Commercial Effectiveness

Issue Resolution Lead Analyst, Individual Dental Operations

Quality Review and Audit Lead Analyst, Individual Dental Operations

Quality Review and Audit Analyst, Individual Dental Operations

Senior Quality Review and Audit Analyst, Individual Dental Operations

Virtual Primary Care Physician

Operations Fulfillment Analyst

Senior Account Executive, Advanced Pulmonary Conditions

Medical Director – Medical Oncology

Senior Account Executive, Advanced Pulmonary Conditions

Nurse Case Management Supervisor

Operations Analytics & Automation Advisor