Network Operations Advisor - Cigna Healthcare - Remote
About the position
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.
Requirements
• 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.
Nice-to-haves
• 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.
Benefits
• 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.
Apply Now
Apply Now
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.
Requirements
• 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.
Nice-to-haves
• 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.
Benefits
• 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.
Apply Now
Apply Now