Business Project Lead Analyst – Payment Integrity – Evernorth - Remote

This role plays a critical part in strengthening payment integrity outcomes by partnering with providers, vendors, and internal teams to drive accurate and timely recovery of provider overpayments. The Business Project Lead Analyst brings expertise, collaboration, and a continuous improvement mindset to help maximize recoveries while building 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.

Qualifications

Required

• 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.

Preferred Qualifications

• 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.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an annual salary of 75,700 - 126,100 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here.

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

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