Provider Data Lead Representative - Evernorth - Remote

The Cigna Group•Remote,

1d•$24 - $36•Remote

About The Position

The Provider Data Lead Representative is responsible for maintaining, correcting, and safeguarding provider data to support network quality. The role manages provider information across HCPM, CPF, and Facets through timely additions, updates, corrections, and terminations. It also resolves claim, demographic, and contract-related issues to prevent recurrence, improve data accuracy, and enhance the customer and provider experience. The representative analyzes requests from matrix partners and assesses their impact before carrying out provider-, network-, or criteria-level updates across systems. The position supports data quality through audits, performance analysis, root-cause investigation, system validation, and corrective action. It also contributes to system enhancement testing and collaborates with teammates while remaining accountable for individual results. For employees working from home occasionally or permanently, the internet connection must be provided by a cable broadband or fiber optic service with speeds of at least 10 Mbps download and 5 Mbps upload. The anticipated hourly rate is $24–$36, depending on relevant factors such as experience and geographic location. The position is anticipated to be eligible for an annual bonus plan.

Requirements

High school diploma or GED.
At least 2 years of demonstrated proficiency using CPF and HCPM.
Strong understanding of data flow and downstream system impacts.
Knowledge of provider structures, including Practitioners, Groups, Facilities, and Ancillaries.
Ability to meet production and quality standards and maintain accurate, timely documentation.
Adaptability, learning agility, and ability to work effectively in uncertain or evolving environments.
Analytical problem-solving skills, including identifying root causes and implementing practical solutions.
Ability to communicate clearly and professionally, listen actively, and collaborate across stakeholders.
Ability to organize workload, prioritize competing demands, meet deadlines, and persist through challenges.

Nice To Haves

Some college coursework.
Experience with Proclaim and Facets.
Solid understanding of contracts, networks, and applicable Market Guidebook standards.
Working knowledge of DAL, Inventory Manager, ETQS, Activity Manager, Provider Manager, Renaissance, and Knowledge Exchange.

Responsibilities

Execute provider data additions, terminations, and updates according to established procedures and business needs.
Perform data remediation in HCPM, CPF, and Facets to maintain system accuracy and consistency.
Implement updates identified through quality audits and performance analyses to improve data integrity.
Apply contract terms and network business rules to support accurate and compliant data outcomes.
Identify operational risks and issues during data loads and take appropriate corrective action.
Validate data accuracy across systems and confirm successful transmission to downstream platforms.
Conduct root-cause analysis and implement solutions aligned with desired outcomes.
Analyze intake requests from matrix partners, assess their impact, and execute appropriate provider-, network-, or criteria-level updates across systems.
Meet production and quality standards, including accurate and timely documentation in the Daily Activity Log (DAL).
Support system enhancement initiatives through testing, validation, and checkout activities as directed.
Collaborate effectively within a team while remaining accountable for individual contributions and results.