Continuous Improvement Advisor - Prior Authorization - Remote

The Continuous Improvement / Business Process Engineer (CI/BPE) supports operational improvement initiatives across healthcare call center and claims operations. This role focuses on executing well‑defined improvement work, documenting and analyzing processes, and supporting the implementation of efficiency, quality, and capacity improvements through structured continuous improvement methodologies, data analysis, and automation enablement.

This is a hands‑on individual contributor role that partners closely with operations leaders, frontline subject matter experts, and technology teams. This role will work within scoped initiatives and priorities, applying standard tools and playbooks while developing deeper continuous improvement and process engineering skills.

Responsibilities

Process Improvement & Operational Execution

• Support identification of inefficiencies, bottlenecks, and sources of rework within defined processes or functional areas
• Apply Lean, Six Sigma, and continuous improvement tools as taught to reduce waste, cycle time, and operational friction
• Execute assigned improvement initiatives from problem definition through implementation with guidance from senior practitioners or leaders
• Assist in tracking benefits such as cost savings, capacity gains, quality improvements, and risk reduction
• Participate in cross functional improvement efforts and support change adoption activities

Business Process Documentation & Analysis

• Conduct current state and future state process mapping using standard modeling techniques and templates
• Participate in interviews, working sessions, and observations to understand operational workflows
• Document and standardize processes to improve clarity, consistency, and handoff effectiveness
• Maintain process documentation in partnership with business and technology stakeholders
• Translate process information into clear, usable documentation for frontline and operational audiences

Automation & Technology Support

• Identify opportunities where automation, workflow tools, or AI may reduce manual effort or errors, with guidance
• Partner with technology and automation teams to support solution design and feasibility assessment
• Assist with operational impact analysis of proposed tools or process changes
• Contribute to business case inputs by documenting effort, assumptions, and expected benefits
• Support requirements documentation, testing, and implementation readiness activities as needed

Data Analysis & Reporting

• Use operational and performance data to support analysis and validate improvement opportunities
• Develop and maintain basic metrics, trackers, and reporting to measure outcomes
• Summarize findings and insights into clear, factual updates for project teams and leaders
• Support benefits tracking and post implementation measurement activities

Stakeholder Partnership & Communication

• Partner primarily with frontline SMEs, supervisors, and project team members
• Communicate progress, risks, and dependencies to project leads and senior CI/BPEs
• Escalate key issues, decisions, or tradeoffs appropriately
• Prepare written and verbal updates, including meeting materials and status summaries, with guidance

Success Measures

• Timely and accurate delivery of assigned improvement tasks and deliverables
• Clear, usable process documentation that supports operational readiness
• Demonstrated reductions in manual effort, rework, or cycle time within scoped initiatives
• Accurate tracking and reporting of improvement metrics and benefits
• Positive feedback from project leads, frontline partners, and senior CI/BPEs
• Continued development of CI, process engineering, and analytical skills

Qualifications

• High School diploma required, Bachelors degree preferred
• Minimum of 5 years experience in continuous improvement within operations, preferably healthcare
• Foundational knowledge of Lean and/or continuous improvement methodologies with practical application
• Experience with basic process mapping, documentation, and analysis
• Comfort using data to support analysis and reporting (Excel required; BI tools a plus)
• Ability to manage assigned tasks and priorities in a structured project environment
• Willingness to learn, apply feedback, and build CI/BPE capability over time
• Healthcare, pharmacy, claims processing, or call center operations exposure preferred

• Prior authorization or utilization management familiarity preferred
• Exposure to automation or workflow tools (RPA, low‑code, AI‑enabled tools)
• Experience using Visio, SharePoint, Confluence, or similar documentation platforms
• Detail‑oriented, execution‑focused, and collaborative working style

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

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 93,200 - 155,400 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.