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

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Responsibilities:

The Delegated Credentialing Lead Analyst will be responsible for performing the daily tasks of delegation oversight, including selection and retention of provider group accounts that are seeking or have been awarded delegated credentialing for the Behavioral, Dental, and Medical line of businesses.

Conduct practitioner/provider group credentialing audits for initial, annual and interim assessments in accordance with Cigna and CMS regulatory requirements.

Negotiate and manage delegation contractual agreements.

Be a key contributor for internal and external organization audits.

Analyze and manage delegated provider data.

Maintain working knowledge of regulatory credentialing requirements as applicable for medical, dental and behavioral delegation. 

Collaborate effectively with delegated groups, compliance/legal, direct credentialing, contracting, and other matrix partners, as applicable.

Maintain fundamental understanding of key matrix partners’ operations within the Cigna organization. 

Provide support to and act as a subject matter expert for various projects.  Perform other related duties as assigned. 

Qualifications:

• Bachelor's degree or higher strongly preferred or equivalent work experience required
• 3+ years of credentialing and/or auditing experience required
• Knowledge of NCQA and Medicare standards
• Proficient in Microsoft Access, Excel, Outlook, PowerPoint and Word
• Strong analytical and problem-solving skills
• Excellent communication, collaboration, interpersonal and organizational skills
• Ability to work effectively, both independently and/or in a group setting
• Ability to effectively coordinate and manage multiple projects and prioritize work in a fast-paced environment
• Ability to perform work with minimal supervision while achieving desired outcome
• Minimal travel may be required for audits.

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 55,700 - 92,800 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.

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.

Please note that you must meet our posting guidelines to be eligible for consideration.  Policy can be reviewed at this link.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.