What are the responsibilities and job description for the Network Operations Advisor - Evernorth - Remote position at Evernorth Health Services?
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.
Organization: Automated Network Solutions (ANS) / PX&O
This is an individual‑contributor role with no people‑management responsibility. The position supports both ongoing operational needs and project‑based automation initiatives.
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.
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.
Key Responsibilities
Automation Readiness & Network Modeling
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.
This role is also anticipated to be eligible to participate in an annual bonus plan.
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, click here.
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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
Organization: Automated Network Solutions (ANS) / PX&O
This is an individual‑contributor role with no people‑management responsibility. The position supports both ongoing operational needs and project‑based automation initiatives.
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.
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.
Key Responsibilities
Automation Readiness & Network Modeling
- Evaluate networks for automation suitability by modeling configurations against governing benefit and design requirements.
- Assess automation risk and rule behavior and coordinate validation efforts prior to outreach or structural changes.
- Develop and execute semi‑automated remediation processes to address rule fallout.
- Serve as a key business tester for new or enhanced automation rules, validating outcomes and ensuring no unintended downstream impacts
- Lead mid to large‑scale remediation efforts by preparing, validating, and testing data for remediation method and outcome impact.
- Coordinate with Operations and business partners to confirm safe remediation criteria and exception handling.
- Apply deep provider data expertise to ensure remediation approaches align with downstream consumption needs.
- Perform sampling of automation rules and fallout to identify defects and improvement opportunities.
- Support network accuracy initiatives and targeted remediation tied to strategic directives.
- Review and validate access requests related to analytics and provider data usage.
- Partner with analytics teams on reporting, data pulls, and troubleshooting access or connectivity issues.
- 5 years of experience working with provider or network data in the healthcare industry.
- Strong analytical and problem‑solving skills with the ability to assess automation risk and data impacts.
- Experience performing complex data analysis and supporting data remediation efforts.
- Ability to operate independently within defined frameworks and manage multiple concurrent priorities.
- Strong written and verbal communication skills, with the ability to clearly convey technical findings to business and operational audiences.
- Experience working in PLANC network automation environments
- Advanced knowledge of provider data domains, including demographic, contract/reimbursement, and network structures, with the ability to interpret complex relationships across provider, location, and affiliation data.
- Deep understanding of provider network modeling and implementation, including translating network design into scalable, operational configurations that support both manual and automated solutions.
- Hands-on experience with API-driven processing and automation workflows, including identifying and resolving API failure (fallout) scenarios.
- Ability to translate business requirements into technical/data solutions and clearly communicate findings, risks, and recommendations to both technical and business stakeholders.
- Bachelor's degree or higher strongly preferred or equivalent work experience required.
- Experience supporting network automation initiatives (rule‑based systems).
- Experience with SQL and healthcare data environments.
- Familiarity with healthcare provider networks.
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.
This role is also anticipated to be eligible to participate in an annual bonus plan.
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, click here.
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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.