Job Description

Job Summary:

This role is a member of the Encounters Risk Adjustment Submissions team. This team is dedicated to submitting risk adjustment data to CMS on behalf of Cigna to support Encounter operational programs and Risk Adjustment.

Core Responsibilities:

• Formulates and defines systems scope and objectives based on both user needs and a thorough understanding of business systems and industry requirements.
• Documents business requirements and process documents to ensure applicability to operational areas when changes are implemented.
• Active participation through all phases of projects in an Agile Development environment.
• Considers the business implications of the application to the current and future business environment.
• Accountable for the effectiveness, quality and timeliness of project design decisions and how easily these designs can be implemented.
• Provides linkage and continuity to business units, development, operations and technical support groups in the testing and implementation of recommendations. Acts as an expert technical resource to client and development management and staff in all phases of the development and implementation process.
• Works with the team to maintain project schedules that consider the priorities, key milestones, time estimates, task sequencing and identification of tasks that may be performed concurrently to achieve objectives.
• Build rapport and a positive working relationship with business sponsors, stakeholders, project members, SMEs and co-workers.
• Partners with Business Analysis and Development teams to understand solution design and related deliverables.
• Ensure clear success criteria are documented within standard test plans and all applicable documentation is drafted and to date for all tasks.

Minimum Qualifications:

• Bachelor\'s degree in Computer Science or a related discipline/or high school diploma plus at least six years of years of solid, diverse work experience in Risk Adjustment/EDI/IT
• SQL working knowledge
• Excellent oral, written, presentation and communication skills.
• Ability to drive to results independently.
• Strong analytical and creative problem-solving skills.
• Proficient in Microsoft Office Suite products
• Proven successful track record in working on application development teams.

Strongly preferred:

• Knowledge of Medicare Advantage Risk Adjustment Model (HCC model)
• Experience in working in an Agile Development environment.
• Familiarity with Medicare or Medicaid Claims and/or Encounters
• Familiarity with KnowledgeXChange
• Knowledge of IRIS platform and customization

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 Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com 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.

eQuest