Business Project Senior Analyst, MRC Manual Pricing - Cigna Healthcare - Remote

Cigna Healthcare

2d•Remote

About The Position

This role plays a critical part in supporting non-participating cost containment efforts by ensuring accurate, timely, and thoughtful manual pricing decisions. You will collaborate with experienced professionals to evaluate complex claims and contribute to solutions that drive consistency, quality, and positive customer outcomes across the organization. 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.

Requirements

3+ years of experience in claims analysis, pricing, reimbursement, or related healthcare operations role.
Strong analytical and problem-solving skills, with the ability to assess complex data and make sound recommendations.
Experience working in fast-paced environments requiring prioritization, independent decision-making, and attention to detail.
Strong written and verbal communication skills, with the ability to explain pricing decisions clearly and professionally.
Proficiency with Microsoft Office tools, including Excel, Word, PowerPoint, and SharePoint.

Nice To Haves

Knowledge of healthcare claim payment methodologies and reimbursement practices.
Experience with claims systems such as Proclaim, PMHS, Facets, or SANP.
Experience supporting pricing strategy, appeals, or reimbursement analysis.

Responsibilities

Perform manual pricing for Maximum Reimbursable Charge (MRC1/MRC2) claims, ensuring accuracy, compliance, and alignment with pricing guidelines.
Analyze complex, sensitive, or escalated claims and recommend pricing outcomes that balance cost containment with customer experience.
Evaluate system and process challenges, identifying practical solutions that improve efficiency, accuracy, and overall results.
Provide clear analysis, pricing rationale, and guidance to internal and external partners requesting manual pricing support.
Take informed, decisive action on priority issues while managing multiple requests in a fast-paced environment.
Contribute to continuous improvement by sharing knowledge, strengthening functional expertise, and supporting team learning.
Support quality and accuracy initiatives that enhance appeal outcomes and improve member and provider experiences.