AI-Driven Healthcare Ops Transformation Lead

As the Operations Senior Advisor of Transformation, you will play a pivotal role in driving innovation and efficiency in our prior authorization review processes. Leveraging your expertise in data analytics, artificial intelligence (A.I.) tools, and automation, you will be responsible for identifying and implementing new business solutions to enhance our operations and improve patient outcomes.

Key Responsibilities:

• Lead the identification and evaluation of opportunities to optimize prior authorization review processes using healthcare data, A.I. tools, and automation.
• Collaborate with cross-functional teams, including operations, technology, and clinical staff, to understand business needs and develop innovative solutions.
• Conduct in-depth analysis of existing processes, workflows, and data to identify areas for improvement and optimization.
• Design and implement A.I. algorithms and machine learning models to automate decision-making and improve efficiency in prior authorization reviews.
• Develop comprehensive project plans, timelines, and resource allocations to ensure successful implementation of transformation initiatives.
• Monitor key performance indicators (KPIs) and metrics to assess the effectiveness of implemented solutions and make data-driven recommendations for continuous improvement.
• Stay abreast of industry trends, best practices, and emerging technologies in healthcare operations and transformation.

Qualifications:

• Minimum of 5 years of experience developing business solutions leveraging data, A.I. tools and automation, health care experience preferred.
• Proven track record of successfully leading transformational initiatives, communication skills via multidisciplinary channels and implementing innovative solutions.
• Strong analytical skills and proficiency in data analytics tools and techniques.
• Experience with A.I. technologies, including generative AI, chatbots, interactive voice response, machine learning, natural language processing, and predictive analytics.
• Excellent communication and collaboration skills, with the ability to effectively engage and influence stakeholders at all levels of the organization.
• Project management experience, with a demonstrated ability to manage multiple projects simultaneously and drive results in a fast-paced environment.

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 10

Mbps download/5

Mbps upload.

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email:  for support. Do not email  for an update on your application or to provide your resume as you will not receive a response.