[Hiring] Delegated Credentialing Lead Analyst @Cigna Healthcare
Role Description
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.
• Conducting practitioner/provider group credentialing audits for initial, annual, and interim assessments in accordance with Cigna and CMS regulatory requirements.
• Negotiating and managing delegation contractual agreements.
• Being a key contributor for internal and external organization audits.
• Analyzing and managing delegated provider data.
• Maintaining working knowledge of regulatory credentialing requirements as applicable for medical, dental, and behavioral delegation.
• Collaborating effectively with delegated groups, compliance/legal, direct credentialing, contracting, and other matrix partners, as applicable.
• Maintaining fundamental understanding of key matrix partners’ operations within the Cigna organization.
• Providing support to and acting as a subject matter expert for various projects.
• Performing 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 outcomes.
• Minimal travel may be required for audits.
Requirements
• 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.
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 your employment.
• 401(k) plan.
• Company paid life insurance.
• Tuition reimbursement.
• A minimum of 18 days of paid time off per year and paid holidays.
• Eligibility to participate in an annual bonus plan.
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.
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.
• Conducting practitioner/provider group credentialing audits for initial, annual, and interim assessments in accordance with Cigna and CMS regulatory requirements.
• Negotiating and managing delegation contractual agreements.
• Being a key contributor for internal and external organization audits.
• Analyzing and managing delegated provider data.
• Maintaining working knowledge of regulatory credentialing requirements as applicable for medical, dental, and behavioral delegation.
• Collaborating effectively with delegated groups, compliance/legal, direct credentialing, contracting, and other matrix partners, as applicable.
• Maintaining fundamental understanding of key matrix partners’ operations within the Cigna organization.
• Providing support to and acting as a subject matter expert for various projects.
• Performing 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 outcomes.
• Minimal travel may be required for audits.
Requirements
• 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.
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 your employment.
• 401(k) plan.
• Company paid life insurance.
• Tuition reimbursement.
• A minimum of 18 days of paid time off per year and paid holidays.
• Eligibility to participate in an annual bonus plan.
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.