Payment Integrity Manager - Post Payment - Cigna Healthcare - Remote

Candidates who reside within 50 miles of the following locations may be asked to work in person three days per week: Bloomfield, CT, Chattanooga, TN, Denver, CO, St Louis, MO, or Scottsdale, AZ.

The Operations Manager will lead Cigna’s internal post‑payment overpayment identification and recovery strategy, while driving significant financial impact through effective program execution and team leadership. This role manages a team of overpayment analysts accountable for annual recoveries and partners closely across Payment Integrity, including prepay analytics, vendor operations, and external recovery vendors. The Manager uses analytics and trend insights to identify savings opportunities while ensuring compliance, operational excellence, and strong cross‑functional collaboration.

Responsibilities

• Lead and develop a high‑performing team focused on maximizing internal overpayment identification and recoveries.
• Partner with pre‑pay analytics to shift post‑payment overpayment opportunities upstream where possible.
• Expand and integrate internal overpayment programs across products and lines of business to increase financial impact.
• Collaborate with internal partners (e.g., Client Services, Contracting, Legal, Compliance) to identify and prioritize overpayment initiatives and audits.
• Serve as the subject matter expert for internal overpayment activities, providing education, analysis, reporting, and expectation management to stakeholders.
• Manage partnerships with recovery vendors, ensuring timely and accurate responses and monitoring project performance.
• Ensure program compliance with organizational policies and regulatory requirements.
• Lead and execute projects within tight timeframes to meet financial and operational goals.
• Partner with Technology to enhance systems and tools supporting recovery strategies and business processes.
• Build and execute a people strategy that attracts, develops, and retains talent through coaching, performance management, and succession planning.

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Qualifications

• Bachelor’s degree or higher strongly preferred or equivalent work experience required.
• 5+ years of experience leading and developing high‑performing, diverse operations teams with direct bottom-line impact preferred.
• 5+ years of experience managing large data sets, including claims data; experience with Payment Integrity vendors strongly preferred.
• Claim auditing experience required and advanced knowledge of provider contracts, reimbursement policies, and claim operations required.
• Proven ability to meet or exceed financial and operational goals and to lead change initiatives.
• Strong analytical, problem‑solving, and stakeholder partnership skills; comfortable challenging the status quo to drive improvement.
• Proficiency with Microsoft tools and databases.

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 87,100 - 145,100 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.