Provider Data Lead: Data Integrity & Systems Liaison

Cigna Healthcare; Manchester (NH); Hybrid; USD 33,000 - 50,000; Full time

Benefits offered by this job

Medical benefits

Vision benefits

Dental benefits

Well-being and behavioral health

401(k)

Company paid life insurance

Tuition reimbursement

18 days paid time off per year

Paid holidays

Leaves of absence

Job summary

The Cigna Group is seeking a Provider Data Lead Representative to ensure accurate maintenance and integrity of provider data across core systems such as HCPM, CPF, and Facets. You will manage updates, terminations, and corrections while preventing recurrence of fallout in claims and demographics.

Responsibilities include data remediation, contract rule application, and cross-system validation, with opportunities to participate in testing and system improvements.

Qualifications

• High school diploma or GED; some college coursework preferred.
• 2+ years of proficiency using CPF and HCPM.
• Proclaim and Facets preferred.
• Strong understanding of data flow and downstream system impacts.
• Knowledge of provider structures (Practitioners, Groups, Facilities, Ancillaries).
• Understanding of contracts, networks and Market Guidebook standards is highly preferred.
• Familiarity with tools such as DAL, Inventory Manager, ETQS, Activity Manager, Provider Manager, Renaissance, and Knowledge Exchange.

Responsibilities

• Execute provider data additions, terminations, and updates in accordance with procedures.
• Perform data remediation in HCPM, CPF, and Facets to maintain accuracy.
• Implement updates from quality audits and performance analyses to improve data integrity.
• Apply contract terms and network rules for accurate data outcomes.
• Identify operational risks during data load and take corrective action.
• Validate data accuracy across systems and ensure transmission to downstream platforms.
• Conduct root cause analysis to diagnose issues and implement solutions.
• Analyze intake requests from matrix partners to assess impact and updates across systems.
• Adhere to production and quality standards, including DAL documentation.
• Support system enhancements by testing, validation, and checkout activities.
• Collaborate effectively in a team while maintaining accountability.

Skills

Adaptability

Learning agility

Problem solving

Systems thinking

Communication

Execution

Resilience

Education

High school diploma or GED

Tools

CPF

HCPM

Facets

DAL

Inventory Manager

ETQS

Activity Manager

Provider Manager

Renaissance

Knowledge Exchange

Job description

The Cigna Group is seeking a Provider Data Lead Representative to ensure accurate maintenance and integrity of provider data across core systems such as HCPM, CPF, and Facets. You will manage updates, terminations, and corrections while preventing recurrence of fallout in claims and demographics.

Responsibilities include data remediation, contract rule application, and cross-system validation, with opportunities to participate in testing and system improvements.