Operations Specialist-CGHB North American Claims Cost Containme
Cigna - Wilmington, DE

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Job Description

Responsible for driving cost containment initiatives within the North American CGHB Claim organization by continuing to help develop and strengthen our current cost containment processes. This person will assist with managing internal/external partner relationships to ensure we are driving improved cost savings results. This role will also be responsible for helping to manage ongoing cost containment projects along with working to implement new processes and initiatives..

  • Will help lead cost containment projects or initiatives within the claim organization
  • Assist with managing external vendor relationships by facilitating monthly calls, developing agendas and managing takeaways ensuring we driving improved cost savings results
  • Drive improved cost containment results by assisting with implementation of new vendor relationships
  • Help develop and implement improved cost containment strategies such as overpayment recovery, worker’s comp/COB, and subrogation initiatives
  • Coordinate with internal partners such as operational control, clinical operations and network operations to drive process improvement/cost savings.
  • Partner with claim leads to create and deliver up training/feedback on cost containment to staff
  • Research and Analyze data to identify Cost Containment/Recovery opportunities
  • Update/Develop improved cost containment reporting
  • Fosters an environment of critical thinking and process improvement.
. Requirements


  • Requires Bachelor's degree or equivalent work experience.
  • Excellent verbal and written communication skills required.
  • Project management skills and comfort in ability to create and achieve success in highly matrix management environment.
  • Ability to work independently, as well as part of a team
  • Requires strong organization and project management skills.
  • Ability to manage several projects while also attending to immediate business requests.
  • Ability to multi-task and prioritize requests
  • Ability to work independently or with a team to manage day to day priorities
  • Demonstrates strong analytical skills
Competencies for Success in this role include:
Managing and Measuring Work


Cross Cultural Agility

Motivating Others

Business Acumen

Conflict Management.

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