Operations Advisor – Delivery Support, Insights

The Cigna Group

Operations Advisor managing strategic claim pricing and reimbursement for Evernorth. Analyzing data trends and ensuring accurate claim payment outcomes in various operational environments.

Posted 6/6/2026full-timeArizona, Colorado, Connecticut, Montana, Tennessee • 🇺🇸 United StatesMid-LevelSenior💰 $82,400 - $137,300 per yearWebsite

ATS Keywords

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Hard Skills

data analysisclaim pricingclaims managementprocess improvementrisk analysisroot cause analysispricing rules validationAgile methodologycontinuous improvement

Soft Skills

analytical skillsproblem-solvingleadershipcollaborationcommunicationinfluencingstakeholder engagement

Tools & Technologies

Microsoft ExcelFacetsProclaimEnterprise Pricing ServiceNetworXreporting tools

Certifications & Qualifications

High School DiplomaG.E.D.

Industry Keywords

healthcare operationsclaim paymentoperational effectivenessperformance monitoringdata trends

About the role

Key responsibilities & impact

Support strategic claim pricing and reimbursement operations by monitoring performance, analyzing trends, and driving continuous improvement.
Partner across business, operations, and technology teams to ensure accurate, timely, and efficient claim payment outcomes.
Analyze system performance, data trends, and outputs to identify risks, anomalies, and root causes, and drive corrective and preventive actions.
Monitor claim pricing systems and workbaskets to proactively detect and address operational issues impacting claim payment accuracy.
Validate and optimize pricing rules to ensure alignment with business requirements, regulatory expectations, and operational effectiveness.
Serve as a subject matter expert, aligning cross-functional stakeholders on priorities, ownership, and resolution strategies.
Lead and support cross-functional initiatives, ensuring effective planning, coordination, and execution across teams.
Identify and implement process improvements to enhance system performance, efficiency, and quality outcomes.
Manage dependencies, risks, and issues across initiatives, ensuring timely delivery and operational readiness.

Requirements

What you’ll need

High School Diploma or G.E.D.
3+ years of experience in claims, claim pricing, or related healthcare operational environments.
Strong analytical and problem-solving skills with the ability to interpret complex data and drive actionable insights.
Demonstrated ability to lead initiatives and collaborate effectively in a matrixed environment.
Strong communication and influencing skills, with the ability to engage stakeholders at all levels.
Experience with claim payment or pricing systems and business rules (e.g., Facets, Proclaim, Enterprise Pricing Service, NetworX).
Proficiency in data analysis tools such as Microsoft Excel and other reporting tools.
Experience working in Agile or continuous improvement environments.

Benefits

Comp & perks

health-related benefits including medical, vision, dental, and well-being and behavioral health programs
401(k)
company paid life insurance
tuition reimbursement
a minimum of 18 days of paid time off per year
paid holidays
eligibility to participate in an annual bonus plan