Note: The job is a remote job and is open to candidates in USA. Cigna Healthcare is dedicated to improving the health and vitality of those they serve. They are seeking a Program Management Senior Advisor to ensure the accurate execution of regulatory compliance across reimbursement rules and medical policy implementation, acting as the Business Implementation Lead for the Payment Policy and Coding team.
Responsibilities
- Review weekly Regulatory Instructions (RIs), assess applicability and impact across Payment Integrity (PI) and Payment Policy and Coding (PPC), and identify questions, risks, or implementation considerations for discussion with Regulatory and Compliance partners
- Participate in weekly Law Forum and Implementation Forum discussions; engage the State Regulatory Manager, Compliance Manager, New Law Implementation Lead, and other partners to support timely interpretation, planning, and execution of regulatory requirements
- Lead coordination of cross-functional implementation activities by identifying appropriate SMEs, aligning impacted teams, and partnering with other BILs when new laws create cross-business dependencies or sequencing considerations
- Develop, manage, and track implementation action plans, deliverables, timelines, controls, and evidence of compliance, including documentation in OpenPages where RI records are maintained
- Identify barriers to implementation, evaluate alternative solutions, escalate risks or issues as appropriate, and provide ongoing communication to ensure obstacles are addressed and required support is in place
- Coordinate compliance-related requirements and deliverables across applicable implementation vehicles, including ClaimsXten, Prepay, Precertification, Pricing, benefit classing, claim engine logic, and related operational processes
- Maintain information and list management functions for biomarker-related activities and support ongoing compliance alignment for related coding and policy work
- Build and maintain effective working relationships across Payment Integrity, Payment Policy and Coding, Legal, Compliance, Product, Operations, IT, and other internal customer groups to support aligned and sustainable implementation outcomes
Skills
- Experience implementing regulatory mandates and supporting audits, inquiries, disputes, policies, procedures, references, or training in regulated settings is required
- Proficiency with compliance facilitation and business tools, including iComply, OpenPages, Q&A Fast Map, Law Exchange, Microsoft Office, Tableau, and Wrike
- Skilled in leading cross-functional initiatives across Legal, Compliance, Product, Policy, Operations, IT, and other matrixed teams
- Demonstrated ability to work independently, prioritize effectively, and drive high-quality, sustainable results in ambiguous or changing environments
- Strong business acumen with the ability to quickly understand new business areas, assess impacts, and translate requirements into actionable plans
- Proactive, team-oriented collaborator with the ability to build credibility, foster alignment, value diverse perspectives, and gain support across organizational levels
- Excellent written and verbal communication skills, including the ability to produce executive-level and regulator-facing materials
- Bachelor's degree or higher strongly preferred
- 7+ years of program or product management experience working within a complex, regulated environment, with a focus on compliance and regulatory implementation highly preferred
- Strong knowledge of health plan operations, regulatory processes, and compliance requirements highly preferred
- Cigna experience preferred
- Compliance certification preferred, such as CHC, CPCO, CHPC, or CCEP
Benefits
- Annual bonus plan
- 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
- Leaves of absence
Company Overview
Company H1B Sponsorship