Network Operations Advisor - Evernorth - Remote

<div><p><b>Candidates who reside within 50 miles of the following locations may be asked to work in person three days per week: Bloomfield, CT, Chattanooga, TN, Denver, CO, St Louis, MO, or Scottsdale, AZ.</b></p><p></p><p><b>Organization:</b> Automated Network Solutions (ANS) / PX&O</p><p></p><p>This is an individual‑contributor role with no people‑management responsibility. The position supports both ongoing operational needs and project‑based automation initiatives.</p><p></p><p>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.</p><p></p><p>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.</p><p></p><p><b>Key Responsibilities</b></p><p></p><p><b>Automation Readiness & Network Modeling</b></p><ul><li>Evaluate networks for automation suitability by modeling configurations against governing benefit and design requirements.</li><li>Assess automation risk and rule behavior and coordinate validation efforts prior to outreach or structural changes.</li><li>Develop and execute semi‑automated remediation processes to address rule fallout.</li><li>Serve as a key business tester for new or enhanced automation rules, validating outcomes and ensuring no unintended downstream impacts</li></ul><p></p><p><b>Project‑Based Data Cleanup</b></p><ul><li>Lead mid to large‑scale remediation efforts by preparing, validating, and testing data for remediation method and outcome impact.</li><li>Coordinate with Operations and business partners to confirm safe remediation criteria and exception handling.</li><li>Apply deep provider data expertise to ensure remediation approaches align with downstream consumption needs.</li></ul><p></p><p><b>Network Accuracy, Monitoring & Governance Support</b></p><ul><li>Perform sampling of automation rules and fallout to identify defects and improvement opportunities.</li><li>Support network accuracy initiatives and targeted remediation tied to strategic directives.</li><li>Review and validate access requests related to analytics and provider data usage.</li><li>Partner with analytics teams on reporting, data pulls, and troubleshooting access or connectivity issues.</li></ul><p></p><p><b>Qualifications (Required)</b></p><ul><li>5+ years of experience working with provider or network data in the healthcare industry.</li><li>Strong analytical and problem‑solving skills with the ability to assess automation risk and data impacts.</li><li>Experience performing complex data analysis and supporting data remediation efforts.</li><li>Ability to operate independently within defined frameworks and manage multiple concurrent priorities.</li><li>Strong written and verbal communication skills, with the ability to clearly convey technical findings to business and operational audiences.</li><li>Experience working in PLANC network automation environments</li><li>Advanced knowledge of provider data domains, including <b>demographic, contract/reimbursement, and network structures</b><b>,</b> with the ability to interpret complex relationships across provider, location, and affiliation data.</li><li>Deep understanding of <b>provider network modeling and implementation</b>, including translating network design into scalable, operational configurations that support both manual and automated solutions.</li><li>Hands-on experience with API-driven processing and automation workflows, including identifying and resolving API failure (fallout) scenarios.</li><li>Ability to translate business requirements into technical/data solutions and clearly communicate findings, risks, and recommendations to both technical and business stakeholders.</li></ul><p></p><p><b>Preferred</b></p><ul><li>Bachelor's degree or higher strongly preferred or equivalent work experience required.</li><li>Experience supporting network automation initiatives (rule‑based systems).</li><li>Experience with SQL and healthcare data environments.</li><li>Familiarity with healthcare provider networks.</li></ul><p></p><p></p><br/><p></p>If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.<p></p><p></p>For this position, we anticipate offering an annual salary of 79,700 - 132,800 USD / yearly, depending on relevant factors, including experience and geographic location.<p></p><p></p><p>This role is also anticipated to be eligible to participate in an annual bonus plan.</p><p></p><p>At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. 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. For more details on our employee benefits programs, . </p><p></p><p></p><p></p><p></p></div>