Business Operations Lead Analyst

The job profile for this position is Business Operations Lead Analyst, which is a Band 3 Senior Contributor Career Track Role.

Excited to grow your career?

We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!

Our people make all the difference in our success.

Job Responsibilities

• Prepare and create test scenarios that match real life enrollment, fulfillment service, digital and migration processing.

• Create and execute the testing of business process scenarios for all aspects of Medicare business including provider matching, provider fallout, member validation, enrollment, disenrollment, MOOP/OOP, benefit terms, Rules and Rates, procedure codes, appeals.

• Create configuration testcases for product and benefit setup, COB, CMS mandates, EGWP, Service and procedure codes, Accumulators etc.

• Work with Test data and Test environment teams on deployment schedule for SERVICE READINESS VALIDATION (SRV) environment readiness for testing

• Coordinate necessary access on tools/platforms to enable SERVICE READINESS VALIDATION (SRV) testing.

• Gain a deep working knowledge of Medicare business, IT landscape, and coordinate collaboration across SERVICE READINESS VALIDATION (SRV) team.

• Identify and document defects, issues, risks and dependencies.

• Develop and execute test scripts, test conditions, input test data, and expected results for Service Readiness Validation (SRV)

• Ensure appropriate testing tasks are scheduled during release, iteration planning

• Participate proactively in daily standup meetings, story grooming sessions, team retrospectives and suggest improvements.

• Provide recommendations for Go/ No Go release decisions.

Minimum Qualifications

• Bachelor’s degree preferred or equivalent experience.

• 3+ Years of experience in Testing and Quality Engineering

• Two+ Year of experience of related business or healthcare experience.

• Candidate should have strong claim processing understanding, and advanced knowledge of health care coding, fee schedules and reimbursement methodologies.

• Knowledgeable with high complexity, high volume transaction healthcare claim environment

• Experience in Quality Engineering and/or Service Readiness Validation testing

• Knowledge of data model/database design concepts and working knowledge of SQL is a plus.

• Experience in QNXT & Facets is preferred.

• Ability to work with shifting priorities to meet project requirements; self-motivated.

• Attention to detail, with strong analytical and problem-solving skills.

• Excellent written and oral communication skills

• Experience working with multiple groups, both internally and externally – clients, engineering and product management teams

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 61,200 - 102,000 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.

We want you to be healthy, balanced, and feel secure. That’s why 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) with company match, 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, visit Life at Cigna Group.

About The Cigna Group

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