Provider Data Lead — Remote Data Integrity & Updates

Cigna Health and Life Insurance Company; New Hampshire; Hybrid; USD 33,000 - 50,000; Full time

Benefits offered by this job

Health benefits

401(k)

Life insurance

Tuition reimbursement

Paid time off (18 days)

Job summary

The Cigna Group is seeking a Provider Data Lead Representative to maintain, correct, and ensure the integrity of provider data across core systems (HCPM, CPF, Facets). You will resolve fallout related to claims, demographics, and contracts, improving data accuracy and customer experience.

The role entails data remediation, updating provider records, and collaborating with teams to ensure compliant data outcomes. A focus on audits, quality, and system validation is required.

Qualifications

• High school diploma or GED required; some college preferred.
• 2+ years of experience using CPF and HCPM; Proclaim and Facets preferred.
• Knowledge of provider structures (Pracitioners, Groups, Facilities, Ancillaries).
• Understanding of contracts, networks, and Market Guidebook standards.
• Working knowledge of listed tools (DAL, Inventory Manager, ETQS, etc.).

Responsibilities

• Execute provider data additions, terminations, and updates per procedures.
• Perform data remediation in HCPM, CPF, and Facets for accuracy.
• Implement updates from quality audits to improve data integrity.
• Apply contract terms and network rules for compliant data outcomes.
• Identify risks in data load processes and take corrective action.
• Validate data accuracy across systems and transmission to downstream platforms.
• Conduct root cause analysis and implement solutions.
• Analyze intake requests from matrix partners and update provider data accordingly.
• Adhere to DAL production standards and document activities.
• Support testing, validation, and checkout for system enhancements.
• Collaborate in a team while owning individual accountability.

Skills

Adaptability

Learning Agility

Problem Solving

Systems Thinking

Communication

Collaboration

Execution & Time Management

Resilience

Education

High school diploma or GED

Some college coursework

Tools

DAL

Inventory Manager

ETQS

Activity Manager

Provider Manager

Renaissance

Knowledge Exchange

CPF / HCPM (Proclaim / Facets)

Job description

The Cigna Group is seeking a Provider Data Lead Representative to maintain, correct, and ensure the integrity of provider data across core systems (HCPM, CPF, Facets). You will resolve fallout related to claims, demographics, and contracts, improving data accuracy and customer experience.

The role entails data remediation, updating provider records, and collaborating with teams to ensure compliant data outcomes. A focus on audits, quality, and system validation is required.