Network Operations Advisor - Evernorth - Remote

The Cigna Group•Bloomfield, CT

1d•$79,700 - $132,800•Remote

About The Position

This is an individual-contributor role with no people-management responsibility. The position supports both ongoing operational needs and project-based automation initiatives. The Business Analytics Advisor supports network automation and provider data accuracy initiatives across multiple lines of business, including Commercial Medical, Behavioral and Client Specific networks. This role serves as a key connection point between business stakeholders and technical teams, ensuring automation solutions are accurate, sustainable, and aligned to defined rules and operational guardrails. The incumbent contributes across automation readiness, data quality remediation, testing, and operational enablement, with a strong emphasis on network modeling, rule validation, and execution support.

Requirements

5+ years of experience working with provider or network data in the healthcare industry.
Strong analytical and problem-solving skills with the ability to assess automation risk and data impacts.
Experience performing complex data analysis and supporting data remediation efforts.
Ability to operate independently within defined frameworks and manage multiple concurrent priorities.
Strong written and verbal communication skills, with the ability to clearly convey technical findings to business and operational audiences.
Experience working in PLANC network automation environments
Advanced knowledge of provider data domains, including demographic, contract/reimbursement, and network structures, with the ability to interpret complex relationships across provider, location, and affiliation data.
Deep understanding of provider network modeling and implementation, including translating network design into scalable, operational configurations that support both manual and automated solutions.
Hands-on experience with API-driven processing and automation workflows, including identifying and resolving API failure (fallout) scenarios.
Ability to translate business requirements into technical/data solutions and clearly communicate findings, risks, and recommendations to both technical and business stakeholders.

Nice To Haves

Bachelor's degree or higher strongly preferred or equivalent work experience required.
Experience supporting network automation initiatives (rule-based systems).
Experience with SQL and healthcare data environments.
Familiarity with healthcare provider networks.

Responsibilities

Evaluate networks for automation suitability by modeling configurations against governing benefit and design requirements.
Assess automation risk and rule behavior and coordinate validation efforts prior to outreach or structural changes.
Develop and execute semi-automated remediation processes to address rule fallout.
Serve as a key business tester for new or enhanced automation rules, validating outcomes and ensuring no unintended downstream impacts.
Lead mid to large-scale remediation efforts by preparing, validating, and testing data for remediation method and outcome impact.
Coordinate with Operations and business partners to confirm safe remediation criteria and exception handling.
Apply deep provider data expertise to ensure remediation approaches align with downstream consumption needs.
Perform sampling of automation rules and fallout to identify defects and improvement opportunities.
Support network accuracy initiatives and targeted remediation tied to strategic directives.
Review and validate access requests related to analytics and provider data usage.
Partner with analytics teams on reporting, data pulls, and troubleshooting access or connectivity issues.