Payment Integrity Manager - Post Payment - Cigna Healthcare

About the position 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.

Requirements

• 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.

Benefits

• 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.

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