Program Management Lead Analyst - Encore Program - Remote
Make a meaningful impact at the intersection of clinical insight and client innovation. As a Program Management Lead Analyst, you will play a critical role supporting our Client Growth & Innovations (CGI) Clinicians by transforming complex clinical and claims data into clear, actionable insights. Your work helps strengthen provider partnerships, supports client decision-making, and advances our commitment to better health outcomes, affordability, and experience.
Key Responsibilities
• Deliver timely, high-quality clinical and claims insights that enable CGI Clinicians to support client and broker engagements.
• Analyze, investigate, and summarize HCC data, including TC131 and TC56 reports, to inform Total Health Insight deliverables and external clinician meetings.
• Conduct comprehensive clinical summary reviews for high-cost claimants in alignment with established clinical and corporate guidelines.
• Interpret medical records and claims data to identify trends, risks, and opportunities that support strategic recommendations.
• Synthesize findings into clear, executive-ready summaries for Market Medical Executives and Nurse Executives.
• Lead or contribute to small- to mid-sized projects focused on improving processes, quality, and efficiency.
• Partner effectively across a matrixed organization, building trust and momentum in a fast-paced, evolving environment.
• Apply a working knowledge of core clinical programs, products, and systems (e.g., ICMS, CCMS, HEV, OneView, TruCare) to support business outcomes.
Required Qualifications
• 3+ years of clinical or clinical support experience.
• Strong analytical and research skills with the ability to interpret complex clinical and claims information.
• Experience reviewing medical records and summarizing clinical findings.
• Effective written and verbal communication skills, with the ability to convey insights clearly to diverse stakeholders.
• Strong organizational and time management skills, with comfort managing multiple priorities.
Preferred Qualifications
• 5+ years of clinical or related healthcare experience.
• Experience with CPT and ICD-10 coding.
• Proficiency in Microsoft Office and healthcare technology platforms.
• Demonstrated ability to influence, collaborate, and drive outcomes across cross-functional 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.About The Cigna Group
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.
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.
If you require reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
Apply Now
Apply Now
Key Responsibilities
• Deliver timely, high-quality clinical and claims insights that enable CGI Clinicians to support client and broker engagements.
• Analyze, investigate, and summarize HCC data, including TC131 and TC56 reports, to inform Total Health Insight deliverables and external clinician meetings.
• Conduct comprehensive clinical summary reviews for high-cost claimants in alignment with established clinical and corporate guidelines.
• Interpret medical records and claims data to identify trends, risks, and opportunities that support strategic recommendations.
• Synthesize findings into clear, executive-ready summaries for Market Medical Executives and Nurse Executives.
• Lead or contribute to small- to mid-sized projects focused on improving processes, quality, and efficiency.
• Partner effectively across a matrixed organization, building trust and momentum in a fast-paced, evolving environment.
• Apply a working knowledge of core clinical programs, products, and systems (e.g., ICMS, CCMS, HEV, OneView, TruCare) to support business outcomes.
Required Qualifications
• 3+ years of clinical or clinical support experience.
• Strong analytical and research skills with the ability to interpret complex clinical and claims information.
• Experience reviewing medical records and summarizing clinical findings.
• Effective written and verbal communication skills, with the ability to convey insights clearly to diverse stakeholders.
• Strong organizational and time management skills, with comfort managing multiple priorities.
Preferred Qualifications
• 5+ years of clinical or related healthcare experience.
• Experience with CPT and ICD-10 coding.
• Proficiency in Microsoft Office and healthcare technology platforms.
• Demonstrated ability to influence, collaborate, and drive outcomes across cross-functional 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.About The Cigna Group
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.
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.
If you require reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
Apply Now
Apply Now