Cigna Healthcare logo
Cigna Healthcare

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.

Proclaim Management Senior Advisor

ManagerManagerFull TimeRemoteSeniorTeam 10,001

Location

United States

Posted

7 days ago

Salary

$116.1K - $193.5K / year

Seniority

Senior

No structured requirement data.

Job Description

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

The Proclaim Management Senior Advisor, Global Service Partner (GSP) Operations is responsible for overseeing performance, financial management, and strategic partnerships across Global Service Partner sites within Service Operations. This role partners closely with internal stakeholders and external vendors to drive operational excellence, ensure contract and financial discipline, and identify opportunities to optimize and expand outsourced services. The ideal candidate brings deep claims operations experience, strong vendor leadership, and a proven ability to manage complex, matrixed initiatives.

Key Responsibilities

  • Operational & Vendor Leadership
    • Lead sourcing initiatives to evaluate onshore and offshore vendors, launch new GSP sites, and ensure performance standards are met across existing operations.
    • Provide ongoing oversight and consultation to Claims GSP sites to improve quality, efficiency, and service outcomes.
    • Partner with cross‑functional teams (Service Operations, Legal, Compliance, IT, Finance, Workforce Management, Strategic Sourcing) to align vendor operations with business priorities.
    • Identify and evaluate opportunities to outsource new or evolving business processes.
    • Build and maintain strong, collaborative relationships with GSP partners to drive performance and strategic alignment.
  • Financial & Contract Management
    • Manage annual operating budgets of $45M–$50M, maintaining results within a ±2% monthly variance.
    • Review, reconcile, and approve monthly vendor invoices.
    • Interpret contract terms, support renewals, and ensure vendor compliance with contractual and operational requirements.
  • Project & Performance Management
    • Lead transition planning and execution for work migrated to GSP partners.
    • Develop and implement action plans to improve performance and support continuous improvement initiatives.
    • Remove operational barriers and ensure teams have the resources needed to deliver quality and efficiency.
    • Support innovation and process transformation across GSP operations.
    • International travel required (approximately 5%).

Qualifications

  • High School Diploma or GED required. Bachelor’s degree preferred.
  • 5+ years of experience in Cigna Claims Operations required.
  • Experience in Proclaim, Facets, and Dentacom highly preferred.
  • Proven experience serving as a primary liaison with Global Service Partner is required.
  • Strong track record of managing vendor performance, driving quality, efficiency, and operational results is required.
  • Experience with eMOS or similar operational management tools.
  • Background in Claims Quality programs.
  • Solid understanding of capacity planning, financial modeling, and invoice reconciliation.
  • Ability to interpret contract language and contribute to contract negotiations or renewals.
  • Excellent written and verbal communication skills.
  • Strong organizational skills with the ability to manage multiple priorities in a fast‑paced environment.
  • 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.

Requirements

  • For this position, we anticipate offering an annual salary of 116,100 - 193,500 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.

Benefits

  • Comprehensive range of benefits, with a focus on supporting your whole health.
  • Health-related benefits including medical, vision, dental, and well-being and behavioral health programs starting on day one of employment.
  • 401(k), company paid life insurance, tuition reimbursement.
  • A minimum of 18 days of paid time off per year and paid holidays.

Company Description

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.

Job Requirements

  • High School Diploma or GED required. Bachelor’s degree preferred.
  • 5+ years of experience in Cigna Claims Operations required.
  • Experience in Proclaim, Facets, and Dentacom highly preferred.
  • Proven experience serving as a primary liaison with Global Service Partner is required.
  • Strong track record of managing vendor performance, driving quality, efficiency, and operational results is required.
  • Experience with eMOS or similar operational management tools.
  • Background in Claims Quality programs.
  • Solid understanding of capacity planning, financial modeling, and invoice reconciliation.
  • Ability to interpret contract language and contribute to contract negotiations or renewals.
  • Excellent written and verbal communication skills.
  • Strong organizational skills with the ability to manage multiple priorities in a fast‑paced environment.
  • 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 116,100 - 193,500 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.

Benefits

  • Comprehensive range of benefits, with a focus on supporting your whole health.
  • Health-related benefits including medical, vision, dental, and well-being and behavioral health programs starting on day one of employment.
  • 401(k), company paid life insurance, tuition reimbursement.
  • A minimum of 18 days of paid time off per year and paid holidays.

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