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.
The PDM (Provider Data Management) Network Operations Manager oversees provider data changes-including provider additions, new network loads, terminations, and demographic updates-for an assigned region or book of business. The role is accountable for inventory management (volume, aging, and turnaround time performance), operational execution, and cross-functional partnership. This position leads an onshore team and represents PDM within a complex, matrixed environment.
Key Responsibilities
Oversee provider maintenance intake and inventory by assessing current and projected workload, projects, and enterprise initiatives; recommend and execute resource alignment to meet demand.
Serve as a subject-matter expert for HCP data operations, market structures, and provider data-loading tools.
Lead team performance against quality, productivity, and turnaround-time objectives; support resolution of complex data issues and proactively mitigate operational risk.
Monitor operational health through consistent use of tracking and reporting tools; analyze trends in volume, aging, quality, and throughput to identify risks and continuous-improvement opportunities.
Partner with Quality to identify error trends, drive defect reduction, and implement process improvements that improve accuracy and compliance outcomes.
Collaborate with Automation, Solutions, and Technology teams to responsibly deploy efficiency and automation solutions, ensuring accuracy, scalability, and alignment with network, market, and group-loading requirements.
Partner with solutions teams to monitor post-deployment performance, validate expected outcomes, and drive value realization across efficiency, automation, and transformation programs.
Enable strong global service partner performance by partnering on operational readiness, clarity of expectations, and ongoing performance oversight aligned to quality, productivity, and turnaround-time outcomes.
Lead root-cause triage for performance issues, inventory challenges, or quality defects in partnership with global service providers and matrix teams; drive corrective actions and preventative improvements.
Partner with solutions, automation, and global service teams to identify, deploy, and sustain efficiency improvements; support adoption while monitoring impact to operational health, quality, and value realization.
Provide oversight for initiatives requiring onshore PIDM resources by managing milestones, delivery timelines, and resource utilization; serve as project lead as needed.
Establish and maintain strong partnerships with Provider Services, Contracting, Network Solutions & Development (NS&D), Quality, and other matrix stakeholders to support execution of the provider data strategy.
Provide clear, concise status updates to leadership on operational performance, risks, and initiative progress.
Qualifications
Bachelor's degree or higher strongly preferred or equivalent work experience required.
5+ years of experience in provider data management, network operations, healthcare operations, or a related field.
2+ years of people leadership experience, with demonstrated accountability for team performance and development required.
Proven experience managing inventory, turnaround times, and operational throughput in a high-volume, regulated environment.
Experience partnering with Quality, Automation, and Technology teams to deploy operational efficiency solutions responsibly.
Demonstrated ability to analyze operational data, monitor performance trends, and translate insights into actionable improvements.
Experience managing projects or initiatives across matrixed teams, including milestone tracking and resource planning.
Strong communication and stakeholder-management skills, with the ability to provide executive-ready updates.
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.
For this position, we anticipate offering an annual salary of 92,800 - 154,600 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 (https://jobs.thecignagroup.com/us/en/benefits) .
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.
