Job Information
The Cigna Group Network Operations Advisor - Cigna Healthcare - Remote in Bloomfield, Connecticut
Help shape smarter, more effective provider networks that expand access, ensure compliance, and support the long-term success of our markets. As a Network Operations Advisor, you play a critical role in designing and sustaining alternative access networks—partnering across the enterprise to translate strategy into execution with precision and care.
Responsibilities:
Serve as the subject matter expert for alternative access products in assigned markets, including inclusion and exclusion criteria, anchor providers, and network adequacy standards.
Evaluate network design options and provide clear, data-driven recommendations that balance access, compliance, and market needs.
Lead end-to-end coordination of network builds, reconfigurations, and expansions by translating contracting intent into actionable direction for Network Solutions and Network Operations.
Ensure delivery system criteria are interpreted and applied consistently across tools, processes, and products.
Partner with Compliance to support regulatory submissions, filings, and ongoing adherence to state and federal requirements.
Monitor network adequacy, quality, and performance through ongoing analysis, identifying risks and recommending corrective actions.
Manage implementation milestones and timelines, proactively addressing dependencies and maintenance needs.
Support post-implementation activities including LocalPlus TrueUps, market sign-offs, and ongoing network integrity efforts.
Collaborate with regional and national partners to resolve complex issues, support escalations, and ensure continuity of care.
Contribute to training, documentation, and continuous improvement efforts; provide guidance to other Network Operations Advisors as needed.
Qualifications:
Required
5+ years of experience in managed healthcare or a related field.
3+ years of experience in provider contracting, provider services, network management, product, or compliance.
Demonstrated knowledge of provider networks, network adequacy, and healthcare professional data structures.
Strong analytical, critical thinking, and problem-solving skills.
Ability to work effectively in a fast-paced, matrixed environment and influence across teams.
Proficiency with Excel and data analysis tools.
Preferred
Bachelor’s degree or equivalent professional experience.
Experience supporting commercial and/or government healthcare products.
Familiarity with regulatory requirements related to network adequacy and provider access.
Experience with provider contracting systems and data mining.
Strong project management and stakeholder communication skills.
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 79,700 - 132,800 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 (https://jobs.thecignagroup.com/us/en/benefits) .
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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 require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
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.