Claim Business Project Sr Advisor - Remote

Position Summary

Leads key components of large, high‑priority projects within PX&O Claim, with a primary focus on Proclaim Auto Adjudication, Claim Attachments, and automation initiatives. Serves as the business lead, partnering closely with technology teams to define scope, set priorities, manage risks, and deliver solutions on time. Uses Agile methods to drive enterprise initiatives, align stakeholders, and ensure the business is ready for successful implementation.

Key Responsibilities

• Identify and lead initiatives that improve efficiency, quality, and service across PX&O Claim operations.
• Provide data, insights, and business context to support leadership decision‑making and prioritization.
• Act as the Business Lead for Proclaim Auto Adjudication, partnering with business SMEs and Core Technology.
• Lead technology consultants delivering robotic process automation for complex claim processes.
• Apply Agile practices to define epics, features, and user stories; influence backlog priorities to meet business needs.
• Approve solution designs and testing criteria; partner with operations and change management to ensure readiness.
• Provide clear status updates, manage risks, and track outcomes to measure business impact.
• Offer thought leadership in business project management and mentor less‑experienced analysts.

Qualifications

• High School Diploma or GED required. Bachelor’s degree preferred.
• 10+ years Provider Claims operations experience, including Proclaim medical claim operations required.
• 5+ years of experience in driving claim automation and process improvement initiatives highly preferred.
• Deep knowledge of Provider Experience and Claim Operations; recognized as a subject‑matter expert.
• Strong project management and organizational skills with the ability to manage multiple initiatives, often using Agile methodologies.
• Proven ability to collaborate and influence in a matrixed environment.
• Strategic thinker with strong problem‑solving skills.
• Excellent written and verbal communication skills.
• Ability to work independently in a fast‑paced, remote environment with a strong customer focus.

 

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 112,100 - 186,800 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.

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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance.  Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

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.