Cigna Healthcare Africa is a leading international
health insurance provider and part of The Cigna Group, one of the
world’s largest healthcare services organizations. With more than 225 years
of healthcare experience, operations in over 30 countries, and 164
million customer relationships worldwide, Cigna delivers comprehensive
health insurance and employee wellbeing solutions to multinational
corporations, local businesses, NGOs, international organizations, expatriates,
and individuals across Africa.
Through its regional headquarters in Nairobi, Kenya,
Cigna Healthcare Africa provides innovative health insurance solutions covering
inpatient and outpatient care, maternity, wellness, preventive healthcare,
medical evacuation, chronic disease management, mental health support,
telehealth, and employee assistance programmes. The company combines global
healthcare expertise with local knowledge to deliver high-quality healthcare
access through an extensive provider network of over 1.7 million healthcare
providers globally, including more than 3,000 providers across Africa.
Cigna Healthcare Africa offers rewarding career
opportunities in health insurance, customer service, clinical operations,
medical claims, underwriting, actuarial science, finance, sales, business
development, information technology, software engineering, cybersecurity, data
analytics, digital transformation, human resources, legal, compliance,
marketing, and project management. Employees benefit from competitive
compensation, comprehensive healthcare coverage, professional development
programmes, international career opportunities, flexible working arrangements,
and a diverse, inclusive workplace culture.
Claims Representative (GEH) – Provider Service Organisation at Cigna
Job Description
YOUR JOB
Delivers basic technical, administrative, or operative
Claims tasks. Examines and processes paper claims and/or electronic claims from
Healthcare Providers. Completes data entry, maintains files, and provides
support. Understands simple instructions and procedures. Performs Claims duties
under direct instruction and close supervision. Work is allocated on a
day-to-day or task-by-task basis with clear instructions. Entry point into
professional roles.
What are your main Duties/Responsibilities:
- Adjudicate
international medical/dental and vision claims in accordance with policy
terms and conditions to meet personal and team productivity and quality
goals.
- Monitor
and highlight high cost claims and ensure relevant parties are
aware.
- Monitor
turnaround times to ensure your claims are settled within required time
scales, highlighting to your Supervisor when this is not achievable.
- Respond
within the time commitment given to enquiries regarding plan design,
eligibility, claims status and perform necessary action as required, with
first call resolution where possible.
- Interface
effectively with internal and external customers to resolve Provider
issues.
- Have
full ownership of Provider’s Country Cluster assigned.
- Identify
potential process improvements and make recommendations to team
senior.
- Actively
support other team members and provide resource to enable all team goals
to be achieved.
- Work
across European business in line with service needs.
- Carry
out other adhoc tasks as required meeting business needs.
YOUR PROFILE
- Customer
focused with ability to identify and solve problems.
- Ability
to meet/exceed targets and manage multiple priorities.
- Proficient
in Microsoft Office applications.
- Preferred
if English and Arithmetic qualification gained.
- 1 year
experience in medical administration, claims or Accounting
environment.
KEY COMPETENTIES:
- Must
possess excellent attention to detail, with a high level of
accuracy.
- Strong
interpersonal skills with good verbal and written communication to
internal and external clients.
- Strong
customer focus with ability to identify and solve problems.
- Ability
to work under own initiative and proactive in recommending and
implementing process improvements.
- Ability
to organize, prioritize and manage workflow to meet individual and team
requirements.
- Ability
to exercise judgement.
Agile Product Owner at Cigna
Job Description
About the Role
As a Product Owner, you will maximize value delivery for a
Scrum Team by translating product strategy into clear, actionable priorities.
Working closely with the Agile Product Manager, you will balance customer
needs, business outcomes, and delivery commitments to ensure reliable,
high-quality product delivery.
You will support International Organisations Health (IOH)
backend products across Mainframe and Financial Services domains, including
payments, billing, eligibility, finance operations, and related integrations.
What You’ll Do
- Partner
with the Agile Product Manager to support product vision, roadmap
priorities, and business outcomes.
- Act as
the voice of the customer, ensuring backlog priorities align with customer
and business value.
- Translate
features and priorities into clear user stories and maintain a
high-quality backlog in Jira.
- Lead
backlog refinement and support Program Increment (PI) planning activities.
- Collaborate
with developers, testers, Scrum Masters, QA, UAT teams, and business
stakeholders to enable predictable delivery.
- Monitor
delivery, quality, utilization, and customer experience metrics to support
continuous improvement.
- Use
analytics and stakeholder feedback to drive product improvements and value
realization.
What You’ll Bring
- Bachelor’s
Degree.
- Strong
English communication skills.
- Knowledge
of Agile methodologies and experience using Jira or a similar tool.
- Ability
to work effectively with technical and business stakeholders.
- Strong
stakeholder relationship management skills.
- Experience
within healthcare preferred and ability to collaborate across regions and
time zones.
Skills
Soft Skills
- Customer-focused
mindset and empathy.
- Business
and delivery acumen.
- Collaboration
and stakeholder management.
- Ownership
and accountability.
- Problem-solving
and decision-making.
- Continuous
improvement mindset.
- Ability
to manage competing priorities.
Technical / Functional Skills
- Agile
product delivery practices.
- Backlog
management and prioritization.
- User
story refinement.
- Jira
backlog management.
- PI
Planning.
- Analytics
and performance monitoring.
- Knowledge
of financial operations, healthcare administration, user experience
principles, and Agile development practices.
Nice to Have
- SAFe
Product Owner / Product Manager certification.
- Healthcare
industry experience.
- Experience
supporting payments, billing, eligibility, finance operations, or
financial reporting.
- Experience
with internal and external system integrations.
Why Join Us
- Competitive
salary and benefits package.
- Multicultural
and hybrid working environment.
- Private
Medical Insurance.
- Employee
Wellbeing Benefits and Development Programs.
- Opportunity
to support products serving more than 500,000 customers globally.
Claims Associate Representative (GHB) – PSO- Cigna Healthcare
Job Description
Delivers administrative, technical, and operative tasks
related to the processing, validation, and correction of partner claim data.
Works with standardized reports, performs rule‑based corrections in policy
administration system, raises IT tickets where required, and supports the
accuracy of automated data feeds. Understands and applies simple instructions
and procedures. Work is allocated on a daily or task‑by‑task basis with clear
direction. This role is an entry point into administrative operations.
What are your main Duties/Responsibilities:
- Run,
prepare, and categorize the weekly reports, including sorting lines by
error code and updating BAU trackers.
- Correct
basic data issues in the policy administration system (e.g., member
numbers, procedure codes, diagnosis codes, service dates, partner IDs,
net/billed amounts) using defined SOP steps and system prompts.
- Follow
rule‑based instructions for each error category, applying fixes or routing
items to IT when required.
- Escalate
to Supervisor and raise IT tickets for duplicate closures, forced claim
loads, invalid data corrections, or adjustments that cannot be resolved
directly.
- Work
on adjustment and reconciliation reports, documenting claim numbers,
preparing tracking sheets, and reprocessing or reversing claims following
predefined procedures.
- Mailbox
ownership and handling of the escalated cases within the TAT´s.
- Maintain
accurate documentation, add standard claim comments, and ensure reports
and logs are correctly archived per SOP.
- Identify
and report to Supervisor continuous improvement opportunities – Mapping,
reporting, processes.
- Carry
out other administrative tasks as required to support business needs.
YOUR PROFILE
- Excellent
attention to detail with a strong focus on accuracy and data integrity.
- Ability
to follow structured, step‑by‑step procedures without deviation.
- Comfortable
working in multiple internal systems.
- Basic
Excel skills (sorting, filtering, adding columns, structuring tabs).
- Strong
organizational skills with the ability to manage repetitive tasks
efficiently.
- Proficient
in Microsoft Office applications.
- English
language skills required.
- Experience
in administrative operations, data entry, or shared‑services roles is an
advantage but not essential.
- Diploma
or Degree required
KEY COMPETENCIES
- High
attention to detail and accuracy when handling structured data tasks.
- Clear
written and verbal communication with internal stakeholders.
- Ability
to organize workload, prioritize tasks, and follow established processes.
- Strong
problem‑solving within the limits of rule‑based parameters.
- Proactive
in flagging issues, inconsistencies, or system errors.
- Ability
to work independently with close supervision and clear instruction.
Apply: jobs.thecignagroup.com/us/en/job/26012029/Claims-Associate-Representative-GHB-PSO-Cigna-Healthcare
Claims Representative (GEH) – Provider Service Organisation at Cigna
Job Description
YOUR JOB
Delivers basic technical, administrative, or operative
Claims tasks. Examines and processes paper claims and/or electronic claims from
Healthcare Providers. Completes data entry, maintains files, and provides
support. Understands simple instructions and procedures. Performs Claims duties
under direct instruction and close supervision. Work is allocated on a
day-to-day or task-by-task basis with clear instructions. Entry point into
professional roles.
What are your
main Duties/Responsibilities:
- Adjudicate
international medical/dental and vision claims in accordance with policy
terms and conditions to meet personal and team productivity and quality
goals.
- Monitor
and highlight high cost claims and ensure relevant parties are
aware.
- Monitor
turnaround times to ensure your claims are settled within required time
scales, highlighting to your Supervisor when this is not achievable.
- Respond
within the time commitment given to enquiries regarding plan design,
eligibility, claims status and perform necessary action as required, with
first call resolution where possible.
- Interface
effectively with internal and external customers to resolve Provider
issues.
- Have
full ownership of Provider’s Country Cluster assigned.
- Identify
potential process improvements and make recommendations to team
senior.
- Actively
support other team members and provide resource to enable all team goals
to be achieved.
- Work
across European business in line with service needs.
- Carry
out other adhoc tasks as required meeting business needs.
YOUR PROFILE
- Customer
focused with ability to identify and solve problems.
- Ability
to meet/exceed targets and manage multiple priorities.
- Proficient
in Microsoft Office applications.
- Preferred
if English and Arithmetic qualification gained.
- Experience
in medical administration, claims environment or Contact Centre
environment is advantageous but not essential.
KEY COMPETENTIES:
- Must
possess excellent attention to detail, with a high level of
accuracy.
- Strong
interpersonal skills with good verbal and written communication to
internal and external clients.
- Strong
customer focus with ability to identify and solve problems.
- Ability
to work under own initiative and proactive in recommending and
implementing process improvements.
- Ability
to organize, prioritize and manage workflow to meet individual and team
requirements.
- Ability
to exercise judgement.
Claims Representative- Cigna Healthcare
Job Description
Main Duties/Responsibilities:
- Adjudicate
international medical/dental and vision claims in accordance with policy
terms and conditions to meet personal and team productivity and quality
goals.
- Monitor
and highlight high cost claims and ensure relevant parties are
aware.
- Monitor
turn around times to ensure your claims are settled within required time
scales, highlighting to your Supervisor when this is not achievable.
- Respond
within the time commitment given to enquiries regarding plan design,
eligibility, claims status and perform necessary action as required, with
first call resolution where possible.
- Interface
effectively with internal and external customers to resolve customer
issues.
- Identify
potential process improvements and make recommendations to team
senior.
- Actively
support other team members and provide resource to enable all team goals
to be achieved.
- Work
across European business in line with service needs.
- Carry
out other adhoc tasks as required meeting business needs.
Experience Required:
- At
least 1 year of experience in a claims role within a healthcare,
insurance, or related environment.
- Customer
focused with ability to identify and solve problems.
- Ability
to meet/exceed targets and manage multiple priorities.
- Proficient
in Microsoft Office applications.
- Demonstrated
proficiency in mathematics, with strong attention to detail and accuracy
when handling calculations and numerical information.
Skills:
- Must
possess excellent attention to detail, with a high level of
accuracy.
- Strong
interpersonal skills with good verbal and written communication to
internal and external clients.
- Strong
customer focus with ability to identify and solve problems.
- Ability
to work under own initiative and proactive in recommending and
implementing process improvements.
- Ability
to organise, prioritise and manage workflow to meet individual and team
requirements
- Ability
to exercise judgment.
Apply: https://jobs.thecignagroup.com/us/en/job/26011341/Claims-Representative-Cigna-Healthcare
Eligibility Representative – French Speaking at Cigna
Job Description
As an Eligibility Representative, you will play
a critical role in ensuring members have timely access to the healthcare
benefits and services they need. Acting as a key point of contact for clients,
customers, and internal stakeholders, you will manage eligibility
administration, maintain accurate member records, and provide outstanding
service through phone and email interactions.
This role combines customer service, relationship
management, data administration, and problem-solving in a fast-paced
international environment. You will work closely with colleagues across
multiple functions to deliver a seamless member experience while ensuring data
accuracy and operational excellence.
At Cigna Healthcare, you’ll join a diverse and collaborative
team where your contributions directly impact members’ healthcare journeys
every day.
What Does a Typical Day Look Like?
- Administer
and maintain member eligibility information accurately and efficiently
across multiple systems.
- Process
new enrollments, membership updates, terminations, and benefit changes in
line with service-level agreements.
- Update
and maintain eligibility data through automated, direct-connect, and
manual processes.
- Serve
as a primary point of contact for clients, customers, vendors, and
internal stakeholders regarding eligibility-related inquiries.
- Investigate
and resolve discrepancies, data errors, and system issues impacting member
records.
- Generate,
analyze, and validate reports to ensure data integrity and operational
accuracy.
- Provide
technical support and guidance related to eligibility administration
processes.
- Collaborate
with clients and internal teams to resolve complex eligibility issues
while maintaining strong professional relationships.
- Ensure
customer and membership data is processed accurately, confidentially, and
within required timelines.
- Identify
opportunities for process improvement and contribute ideas that enhance
efficiency, service quality, and customer satisfaction.
- Support
business initiatives, projects, and continuous improvement activities
within the Eligibility team.
- Maintain
compliance with data privacy, confidentiality, and regulatory requirements
at all times.
What We’re Looking For
- Diploma,
Bachelor’s degree, or equivalent professional experience.
- Excellent
written and verbal communication skills in English and French.
- Strong
customer service orientation with a passion for delivering exceptional
customer experiences.
- High
level of accuracy and attention to detail.
- Ability
to manage multiple priorities while meeting deadlines in a fast-paced
environment.
- Strong
problem-solving and analytical skills.
- Proficiency
in Microsoft Office applications, particularly Excel and Outlook.
- Ability
to quickly learn new systems, technologies, and processes.
Preferred Skills & Experience
- Experience
working in customer service, healthcare administration, insurance
operations, eligibility management, or a related field.
- Experience
working with customer databases, reporting tools, and case management
systems.
- Strong
technical aptitude and ability to troubleshoot data and system-related
issues.
- Ability
to build and maintain positive relationships with internal and external
stakeholders.
- Excellent
organizational and time-management skills.
- Commitment
to continuous improvement and operational excellence.
You Will Thrive in This Role If You…
- Enjoy
interacting with customers and delivering excellent service.
- Are
passionate about helping others and finding solutions to complex issues.
- Take
ownership of your work and pay close attention to detail.
- Enjoy
working with data, systems, and processes.
- Communicate
confidently in both English and French.
- Are
proactive in identifying improvements and driving positive change.
- Handle
confidential and sensitive information with professionalism and integrity.
- Enjoy
collaborating with colleagues across different teams, cultures, and
countries.
- Adapt
quickly to changing priorities and dynamic business needs.
Apply: jobs.thecignagroup.com/us/en/job/26010614/Eligibility-Representative-French-Speaking
Agile Team Coach Senior Analyst at Cigna
Job Description
Purpose of the Role
The Team Coach is responsible for enabling sustainable and
predictable value delivery through Lean-Agile and Kanban ways of working. The
role focuses on improving team effectiveness, optimizing flow, removing
systemic impediments, fostering collaboration, and supporting continuous
improvement through data-driven coaching.
The Team Coach helps teams visualize work, manage work in
progress, improve flow efficiency, establish explicit working agreements, and
continuously evolve their operating model while remaining aligned with Agile
Release Train (ART) objectives and organizational priorities. This role creates
an environment where teams can become increasingly self-managing, adaptive, and
high performing.
About the Role
The Team Coach is a servant leader, facilitator, mentor, and
Lean-Agile practitioner who partners closely with Product Owners, team members,
stakeholders, Release Train Engineers, and other Team Coaches to improve
delivery outcomes.
The Team Coach supports teams in applying Lean thinking,
Kanban practices, flow-based delivery, Built-In Quality, and continuous
improvement techniques. The role enables transparency, collaboration,
psychological safety, and continuous learning while helping teams identify and
remove constraints that limit their effectiveness.
Key Responsibilities
Agile and Team Coaching
- Coach
teams in Lean-Agile principles, Kanban practices, and continuous
improvement.
- Foster
a culture of collaboration, accountability, continuous learning, and
psychological safety.
- Support
teams in becoming increasingly self-managing and outcome focused.
- Facilitate
healthy conflict resolution, decision-making, and strong team dynamics.
- Mentor
team members and stakeholders on Agile values, principles, and flow-based
ways of working.
Kanban System Management
- Support
teams in designing, maintaining, and evolving effective Kanban systems.
- Facilitate
visualization of work, workflows, dependencies, blockers, and demand.
- Help
teams establish and manage Work-In-Progress (WIP) limits.
- Promote
pull-based planning and sustainable delivery practices.
- Ensure
explicit workflows are defined, understood, and continuously improved.
Flow Optimization and Delivery Excellence
- Identify
bottlenecks, delays, waste, rework, aging work items, and systemic
constraints.
- Drive
improvement initiatives that increase flow efficiency, throughput,
predictability, and customer value.
- Support
teams in balancing planned and unplanned work while maintaining
transparent delivery expectations.
- Facilitate
discussions to optimize delivery processes and improve time-to-value.
- Partner
with the Product Owner to support effective intake, prioritization, and
replenishment of work.
Facilitation
- Facilitate
team events and Kanban cadences including Team Syncs, Replenishment
Sessions, Planning, Retrospectives, Reviews, and Improvement Workshops.
- Support
participation in ART-level events including PI Planning, ART Syncs, Coach
Syncs, Inspect & Adapt, and System Demos.
Metrics and Continuous Improvement
- Establish
transparency through meaningful team and flow metrics.
- Use
flow-based measures including throughput, cycle time, Work In Progress,
aging work, blocked work, and delivery predictability.
- Enable
data-driven decision making and evidence-based improvement.
- Facilitate
continuous improvement experiments and evaluate outcomes.
ART and Stakeholder Alignment
- Support
alignment between team objectives, ART goals, and strategic priorities.
- Facilitate
management of dependencies, risks, and impediments impacting value
delivery.
- Collaborate
with Product Owners, Agile Product Managers, Architects, RTEs, and
stakeholders.
- Escalate
systemic impediments as appropriate.
- Promote
transparency and effective communication across teams and stakeholders.
Success in this Role
- Teams
consistently deliver value with improved predictability and flow.
- Kanban
systems are transparent, actively managed, and continuously improved.
- Bottlenecks
and blockers are identified and resolved quickly.
- Teams
demonstrate strong self-management and ownership.
- Stakeholders
have clear visibility into delivery progress, risks, and dependencies.
- Continuous
improvement becomes an embedded team capability.
- ART
objectives are supported through effective collaboration and alignment.
Required Qualifications, Skills & Experience
- Knowledge
of software delivery lifecycles, technology development practices, and
DevOps concepts.
- Demonstrated
experience coaching Agile teams in a Lean-Agile environment.
- Strong
practical experience with Kanban and flow-based delivery practices.
- At
least 4 years of experience in Team Coach/Scrum Master role.
- Experience
facilitating team development and continuous improvement initiatives.
- Strong
understanding of Lean principles, systems thinking, and Agile delivery.
- Experience
visualizing work, managing WIP, and improving workflow efficiency.
- Experience
using delivery metrics to support continuous improvement.
- Experience
working within Scaled Agile Framework (SAFe) environments.
- Excellent
facilitation, coaching, mentoring, and conflict resolution skills.
- Strong
stakeholder management and communication skills.
- Ability
to influence without formal authority.
- Strong
analytical and problem-solving skills.
- Ability
to work effectively with cross-functional and geographically distributed
teams.
Quality Audit Analyst at Cigna
Job Description
YOUR JOB
As a Quality Audit Analyst, you play a key role
in safeguarding operational excellence across service delivery teams. You will
be responsible for conducting quality audits, reviewing case accuracy,
identifying process gaps, and ensuring adherence to internal procedures,
regulatory guidelines, and customer commitments.
You will provide actionable feedback to team leaders and
staff, support continuous improvement, and contribute to building a culture of
quality, compliance, and consistency across Operations.
This role acts as a bridge between frontline teams,
supervisors, and quality leaders by bringing insight, evidence-based
recommendations, and root‑cause analysis into daily operations.
KEY RESPONSIBILITIES
Quality Review & Audit Execution
- Conduct
routine and targeted audits across operational workstreams (e.g., Claims,
Eligibility, Admin, Customer Service, Client Support).
- Assess
accuracy, completeness, compliance, and alignment to SOPs and regulatory
requirements.
- Review
system entries, documentation, case handling, and communication quality.
- Ensure
audit scoring is objective, consistent, and aligned with the quality
framework.
Insights, Feedback & Coaching Support
- Provide
clear, constructive audit feedback to team members and supervisors.
- Highlight
high‑risk errors and recurring themes that require escalation.
- Support
team leaders in delivering quality coaching sessions.
- Maintain
accurate audit logs and records for reporting & governance.
Risk & Compliance Support
- Identify
potential compliance gaps, regulatory breaches, or quality risks.
- Escalate
critical findings promptly to supervisors and Quality leads.
- Support
adherence to audit requirements for internal control, risk management, and
governance processes.
Continuous Improvement
- Recommend
improvements to processes, documentation, and training materials.
- Assist
in revising SOPs or workflows when audit trends indicate the need for
change.
- Identify
opportunities for automation to improve process quality.
- Participate
in mini‑projects or working groups aimed at service improvement.
Data & Reporting
- Define
appropriate outcome-based metrics for aligned process
- Compile
quality metrics, error trends, and monthly/quarterly dashboards.
- Support
root‑cause analysis to identify systemic issues.
- Contribute
to MOR input, audit summaries, and performance packs where required.
Cross‑Team Collaboration
- Work
closely with supervisors, trainers, SMEs, transitions and QA colleagues to
maintain consistent quality standards.
- Support
readiness for new releases, process changes, training classes or quality
framework updates.
- Participate
in calibration sessions to ensure fairness and consistency of audit
scoring.
YOUR PROFILE
- Minimum 3-5
years experience in an operations or quality‑related role.
- Strong
understanding of operational processes (claims preferred).
- Good
working knowledge of operational systems and tools (e.g., workflow
systems, QA tools, CRM platforms, Excel).
- Excellent
attention to detail and accuracy.
- Strong
analytical capability with ability to interpret data and identify trends.
- Clear
communicator, capable of giving balanced and constructive feedback.
- Ability
to prioritise workload, manage deadlines, and work independently.
- Strong
problem‑solving skills and process‑driven mindset.
- Customer‑focused,
with a commitment to driving quality and service improvement.
- Fluent
in English; additional languages are an advantage.
- Demonstrates
integrity, fairness, and objectivity in audit assessment.
Agile Team Coach Senior Analyst at Cigna
Job Description
Job Role: Team Coach for Kanban Team
Location: Nairobi, Kenya
Purpose of the Role
The Team Coach is responsible for enabling sustainable and
predictable value delivery through Lean-Agile and Kanban ways of working. The
role focuses on improving team effectiveness, optimizing flow, removing
systemic impediments, fostering collaboration, and supporting continuous
improvement through data-driven coaching.
The Team Coach helps teams visualize work, manage work in
progress, improve flow efficiency, establish explicit working agreements, and
continuously evolve their operating model while remaining aligned with Agile
Release Train (ART) objectives and organizational priorities. This role creates
an environment where teams can become increasingly self-managing, adaptive, and
high performing.
About the Role
The Team Coach is a servant leader, facilitator, mentor, and
Lean-Agile practitioner who partners closely with Product Owners, team members,
stakeholders, Release Train Engineers, and other Team Coaches to improve
delivery outcomes.
The Team Coach supports teams in applying Lean thinking,
Kanban practices, flow-based delivery, Built-In Quality, and continuous
improvement techniques. The role enables transparency, collaboration,
psychological safety, and continuous learning while helping teams identify and
remove constraints that limit their effectiveness.
Key Responsibilities
Agile and Team Coaching
- Coach
teams in Lean-Agile principles, Kanban practices, and continuous
improvement.
- Foster
a culture of collaboration, accountability, continuous learning, and
psychological safety.
- Support
teams in becoming increasingly self-managing and outcome focused.
- Facilitate
healthy conflict resolution, decision-making, and strong team dynamics.
- Mentor
team members and stakeholders on Agile values, principles, and flow-based
ways of working.
Kanban System Management
- Support
teams in designing, maintaining, and evolving effective Kanban systems.
- Facilitate
visualization of work, workflows, dependencies, blockers, and demand.
- Help
teams establish and manage Work-In-Progress (WIP) limits.
- Promote
pull-based planning and sustainable delivery practices.
- Ensure
explicit workflows are defined, understood, and continuously improved.
Flow Optimization and Delivery Excellence
- Identify
bottlenecks, delays, waste, rework, aging work items, and systemic
constraints.
- Drive
improvement initiatives that increase flow efficiency, throughput,
predictability, and customer value.
- Support
teams in balancing planned and unplanned work while maintaining
transparent delivery expectations.
- Facilitate
discussions to optimize delivery processes and improve time-to-value.
- Partner
with the Product Owner to support effective intake, prioritization, and
replenishment of work.
Facilitation
- Facilitate
team events and Kanban cadences including Team Syncs, Replenishment
Sessions, Planning, Retrospectives, Reviews, and Improvement Workshops.
- Support
participation in ART-level events including PI Planning, ART Syncs, Coach
Syncs, Inspect & Adapt, and System Demos.
Metrics and Continuous Improvement
- Establish
transparency through meaningful team and flow metrics.
- Use
flow-based measures including throughput, cycle time, Work In Progress,
aging work, blocked work, and delivery predictability.
- Enable
data-driven decision making and evidence-based improvement.
- Facilitate
continuous improvement experiments and evaluate outcomes.
ART and Stakeholder Alignment
- Support
alignment between team objectives, ART goals, and strategic priorities.
- Facilitate
management of dependencies, risks, and impediments impacting value
delivery.
- Collaborate
with Product Owners, Agile Product Managers, Architects, RTEs, and
stakeholders.
- Escalate
systemic impediments as appropriate.
- Promote
transparency and effective communication across teams and stakeholders.
Success in this Role
- Teams
consistently deliver value with improved predictability and flow.
- Kanban
systems are transparent, actively managed, and continuously improved.
- Bottlenecks
and blockers are identified and resolved quickly.
- Teams
demonstrate strong self-management and ownership.
- Stakeholders
have clear visibility into delivery progress, risks, and dependencies.
- Continuous
improvement becomes an embedded team capability.
- ART
objectives are supported through effective collaboration and alignment.
Required Qualifications, Skills & Experience
- Demonstrated
experience coaching Agile teams in a Lean-Agile environment.
- Strong
practical experience with Kanban and flow-based delivery practices.
- At
least 4 years of experience in Team Coach/Scrum Master role.
- Experience
facilitating team development and continuous improvement initiatives.
- Strong
understanding of Lean principles, systems thinking, and Agile delivery.
- Experience
visualizing work, managing WIP, and improving workflow efficiency.
- Experience
using delivery metrics to support continuous improvement.
- Experience
working within Scaled Agile Framework (SAFe) environments.
- Excellent
facilitation, coaching, mentoring, and conflict resolution skills.
- Strong
stakeholder management and communication skills.
- Ability
to influence without formal authority.
- Strong
analytical and problem-solving skills.
- Ability
to work effectively with cross-functional and geographically distributed
teams.
- Knowledge
of software delivery lifecycles, technology development practices, and
DevOps concepts.
Desired Qualifications
- SAFe
Scrum Master (SSM) / SAFe Advanced Scrum Master (SASM) / SAFe Practice
Consultant (SPC) / Kanban Management Professional (KMP) / Professional
Scrum with Kanban (PSK) / or equivalent Scrum or Kanban certification.
- Experience
supporting product, platform, operational, or service-based delivery
teams.
- Experience
facilitating organizational change and Agile transformation initiatives.
- Working
knowledge of Jira, Confluence, Mural, or similar collaboration tools.
Claims Representative at Cigna
Job Description
The Position:
We are looking for a detail-oriented claims processor to
join our insurance team. You will be responsible for preparing claim forms,
verifying information, and corresponding with agents and beneficiaries. You
will also handle client inquiries, review policies, determine coverage,
calculate claim amounts, and process payments.
To be successful as a claim’s processor, you should have
excellent organizational and interpersonal skills. You should also be able to
work under pressure and perform a range of clerical functions with great
attention to detail.
Main Duties / Responsibilities
- A
medical claims processor validates the information on all medical claims
from patients seeking payment from their insurance company.
- Claims
must be thoroughly reviewed to ensure that there is no missing or
incomplete information.
- In
addition, a processor must keep meticulous records of claims and follow up
on lapsed cases.
- Medical
claims processors are expected to have an extensive knowledge of medical
terminology, as well as experience using a computer.
- Recording
and maintaining insurance policy and claims information in a database
system.
- Determining
policy coverage and calculating claim amounts.
- Processing
claims payments.
- Answering
queries related to Policy coverage criteria and guidelines.
- Complying
with federal, state, and company regulations and policies.
- Since
medical claims processors must approve or deny payment to doctors, it is
vital that they know how to correctly read and assess medical documents.
- Good
communication skills are necessary to converse with doctors’ offices or
insurance companies if there is a problem with the claim.
- Performing
other clerical tasks, as required.
Claims Processor Requirements:
- Medical
Qualification Background will be an added advantage.
- At
least 2 years of experience as a claim’s processor or in a related role.
- Knowledge
of Medical Terminologies, CPT codes and ICD-9 codes.
- Working
knowledge of the insurance industry and relevant federal and state
regulations.
- Computer
literate and proficient in MS Office.
- Excellent
critical thinking and decision-making skills.
- Good
administrative and organizational skills.
- Strong
customer service skills.
- Ability
to work under pressure.
- High
attention to details
Apply: jobs.thecignagroup.com/us/en/job/26009330/Claims-Representative
Claims Representative – International Organisation Health at Cigna
Job Description
Job Summary
As a Claims Representative, you will assess,
process, and adjust medical claims accurately and efficiently while ensuring
compliance with company policies, quality standards, and service level
commitments.
Reporting to the Claims Supervisor, you will work closely
with global colleagues to deliver excellent customer outcomes and maintain the
highest standards of confidentiality and accuracy.
Key Responsibilities
- Review,
assess, and process medical claims accurately and within agreed turnaround
times.
- Maintain
accurate data entry across multiple systems.
- Apply
analytical thinking and sound judgment when evaluating claims.
- Manage
workload effectively while meeting quality and productivity targets.
- Escalate
complex or unclear claims as appropriate.
- Identify
opportunities to improve processes and efficiency.
- Communicate
professionally with internal stakeholders.
- Support
a positive, collaborative team environment.
- Adhere
to confidentiality requirements when handling sensitive medical
information.
What We’re Looking For
Education
- Bachelor’s
Degree in Business, Healthcare Administration, Insurance, Finance, or a
related field.
Language Skills
- Fluent
in English.
- Additional
languages such as French, Portuguese, Spanish, German, or Arabic are an
advantage.
Key Skills
- Attention
to detail and accuracy
- Analytical
thinking and problem-solving
- Time
management and organization
- Ability
to work across multiple systems
- Adaptability
and learning agility
- Collaboration
and teamwork
- Customer
focus
- Integrity
and confidentiality
Data Engineering Advisor at Cigna
Job Description
The Position
The International Health Data Engineering team sits at the
heart of the International Health Delivery Services organization and is
responsible for Cigna’s Data Integration Hub, which ingests data from multiple
sources, including all the policy admin systems, and makes it available to
numerous downstream consumers. The team is central to provisioning the data
behind a range of key initiatives, including all the web portals and multiple
integrations, both internal and external.
As a Senior Developer within the team, you will provide
expert technical leadership on the design, development, and support of our data
integration and ETL solutions. Drawing on deep SQL Server expertise, you will
act as a principal designer for complex data solutions, help define the
standards and practices for how our solutions are built, and take ownership of
resolving complex issues to keep business-critical data flowing reliably. You
will be encouraged to contribute your own ideas and expertise, and to keep your
skills up to date through training and learning.
You will engage with teams across a range of technical
disciplines and geographies. Recognised internally as a subject matter expert,
you will provide thought leadership within Data Engineering while contributing
to broader initiatives that require an understanding of the wider business.
Core Responsibilities
- Act as
the principal designer and technical lead for complex data initiatives.
- Design,
develop, document, test, and support ETL processes and data integration
solutions.
- Troubleshoot
and resolve complex SQL Server-related issues.
- Model
and document data mapping solutions, collaborating with business and
technical teams to agree the best approach.
- Support
regular releases and monitor scheduled data processing batches.
- Proactively
suggest improvements to code, tools, and ways of working.
Essential Skills
- 8+
years in Data management, with a minimum of 5 years experience in
Microsoft SQL Server development and support.
- Experience
leading/managing a team
- Advanced
T-SQL skills, including development and optimization of stored procedures,
views, and functions.
- Strong
understanding of database design, data modelling, query optimization, and
performance tuning.
- Experience
developing and supporting ETL solutions using SQL Server Integration
Services (SSIS).
- Knowledge
of OLTP and OLAP database environments.
- Experience
analysing business requirements and translating them into technical
solutions.
- Experience
with source control and CI/CD pipelines for database development and
deployment.
- Strong
troubleshooting, root cause analysis, and problem resolution skills.
- Experience
working with Agile methodologies.
Highly Desirable
- Experience
with C# and Python.
- Experience
with modern data engineering technologies, including PySpark and
Databricks.
- Experience
working with cloud technologies and services.
- Experience
with AI-assisted development tools such as GitHub Copilot, Cursor AI, or
similar technologies.
- Experience
working with health insurance or healthcare data.
Data Engineering Lead Analyst at Cigna
Job Description
The Position
The International Health Data Engineering team sits at the
heart of the International Health Delivery Services organization and is
responsible for Cigna’s Data Integration Hub, which ingests data from multiple
sources, including all the policy admin systems, and makes it available to
numerous downstream consumers. The team is central to provisioning the data
behind a range of key initiatives, including all the web portals and multiple
integrations, both internal and external.
As a member of this team, you will contribute to the
development and maintenance of our existing systems, as well as establishing
how our data-driven solutions are developed and coded. You will be encouraged
to contribute your own ideas and expertise, as well as to keep your skills up
to date through training and learning.
You will have the opportunity to engage with multiple teams
across a number of different technological disciplines and geographical
locations.
Core Responsibilities
- Support
the design, development, testing, and maintenance of ETL processes and
data integration solutions.
- Troubleshoot
and help resolve SQL Server-related issues.
- Work
closely with senior database developers to document requirements, design
technical solutions, and attend project workshops and meetings.
- Develop
changes in T-SQL and SSIS for both “business as usual” and project work
streams.
- Model
and document data mapping solutions, working with business and technical
teams to decide on the best approach.
- Assist
with regular releases and monitor scheduled data processing batches.
- Proactively
suggest improvements to code, tools, and ways of working.
Essential Skills
- Minimum
of 5 years’ experience in developing and supporting SQL Server solutions.
- Expertise
in T-SQL, including writing complex stored procedures, views and
functions.
- Strong
understanding of database concepts and experience with query optimization
and performance tuning.
- Experience
of developing ETL routines utilising SSIS.
- Knowledge
and experience of OLAP and OLTP environments.
- Excellent
problem-solving skills and a flair for reverse engineering complex code.
- Experience
working with Agile development methodologies.
Highly Desirable
- Exposure
to C# and Python.
- Familiarity
with modern data engineering technologies, such as PySpark and Databricks.
- Basic
experience with cloud technologies and services.
- Exposure
to source control (e.g. Git) and CI/CD practices.
- Exposure
to AI-assisted development tools such as GitHub Copilot, Cursor AI, or
similar technologies.
- Experience
working with health insurance or healthcare data.
Customer Service Representative at Cigna Group
We are growing our Customer Service presence in Nairobi and
we have an exciting permanent opportunity to join Cigna as a Customer
Service Representative where you will be part of our Global Service
Centre supporting clients from across the globe.
What are your main responsibilities?
- You
are responsible for the client communication for designated account
relationships and Contracts.
- You
are required to response to the client on timely manner providing full and
accurate information in one go.
- Handle
calls and e-mails and respond to simple and complex inquiries regarding
eligibility, cards status, envoy registration/navigation, policy
benefits, issue certificates of insurance, claims status and other related
information and provide solutions for customers and clients.
- Receives
requests by mail, telephone, or in person regarding insurance
claims/policies. Responds to inquiries from policy holders, clients,
brokers and/or others.
- Performs
research to respond to inquiries and interprets policy provisions to
determine most effective response.
- Mails
or routes claim forms and supporting documentation to various units for
final processing.
- Excellent
interpersonal skills, ability to understand and interpret policy
provisions. Independently responds to inquiries, grievances, complaints,
or appeals ranging from routine to moderate complexity.
- May
seek assistance with complex customer services issues.
Qualifications
- Must
have a diploma or bachelor’s degree certificate
- Excellent
English written and oral communication skills
- Exceptional
organizational and time-management focus
- Independently
responds to inquiries, grievances, complaints or appeals ranging from
routine to moderate complexity.
- 1+
years of customer service experience analyzing and solving customer
problems required; call center experience a plus
- Ability
to perform in a high volume, fast paced call center environment
- Proven
ability to work independently as well as a productive member of a team
- Intermediate
proficiency in Microsoft office suite; high level capacity to multitask
independently and on a computer
- Knowledge
of medical terminology a plus
Billing Analyst Africa Business at Cigna Group
Description
Manage and maintain a client portfolio through timely and
accurate invoicing in accordance with agreed premiums and frequency,
coordinating with various internal stakeholders regarding new business,
renewals, credit control. Support broker relationships with management of
broker set-up and processing of commission payments.
Responsibilities
- Review
and set up new groups for related products, premiums, benefits and
enrolment.
- Review
and bill clients in accordance with the agreed billing frequency.
- Engage
with clients to build working relationships and education around invoicing
and payment ensuring consistency across regions
- Co-ordinate
and maintain the individual portfolio, liaising with the Middle East and
European finance teams
- Communicate
with clients as necessary to ensure accuracy of information.
- Respond
to client queries regarding eligibility and billing and liaise with Sales
and Client Management Team as appropriate.
- Provide
reports on invoicing, commissions, credit control to management as
required.
- Follow
up and report on outstanding premium payments in line with credit control
procedures, liaising with Client Manager, Credit Controller and Legal
Services as necessary.
- Ensure
accurate and timely settlement of commission due.
- Maintain
Africa market specific requirements ensuring they are adhered to.
- Identify
potential improvements and make recommendations to Team Leader.
- Maintain
accurate files for each client in respect of related products, coverage
and contacts.
Experience & Competencies
- Minimum
Bachelor’s degree or Diploma
- High
proficiency in MS office, excel in particular
- Understanding
of regulatory requirements and its practical application
- Great
rapport building and communication skills
- Strong
problem solving, leadership skills, analytical and decision-making skills
- Minimum
of 3 years’ experience of the insurance market
- 1-2
years Billing experience is desired
- Ability
to organise, prioritise and manage workflow to meet individual and team
production standards
- Attention
to detail, with high level of accuracy
- Ability
to work under pressure/own initiative
- Good
analytical skills
- Excellent
numeric skills
- Customer
focused with developed problem-solving abilities and a proactive approach
to proposing/implementing process improvements
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an
advocate for better health through every stage of life. We guide our customers
through the health care system, empowering them with the information and
insight they need to make the best choices for improving their health and
vitality. Join us in driving growth and improving lives.
Billing Analyst Africa Business at the Cigna Group
Description
Manage and maintain a client portfolio through timely and
accurate invoicing in accordance with agreed premiums and frequency,
coordinating with various internal stakeholders regarding new business,
renewals, credit control. Support broker relationships with management of
broker set-up and processing of commission payments.
Responsibilities
- Review
and set up new groups for related products, premiums, benefits and
enrolment.
- Review
and bill clients in accordance with the agreed billing frequency.
- Engage
with clients to build working relationships and education around invoicing
and payment ensuring consistency across regions
- Co-ordinate
and maintain the individual portfolio, liaising with the Middle East and
European finance teams
- Communicate
with clients as necessary to ensure accuracy of information.
- Respond
to client queries regarding eligibility and billing and liaise with Sales
and Client Management Team as appropriate.
- Provide
reports on invoicing, commissions, credit control to management as required.
- Follow
up and report on outstanding premium payments in line with credit control
procedures, liaising with Client Manager, Credit Controller and Legal
Services as necessary.
- Ensure
accurate and timely settlement of commission due.
- Maintain
Africa market specific requirements ensuring they are adhered to.
- Identify
potential improvements and make recommendations to Team Leader.
- Maintain
accurate files for each client in respect of related products, coverage
and contacts.
Experience & Competencies
- Minimum
Bachelor’s degree or Diploma
- High
proficiency in MS office, excel in particular
- Understanding
of regulatory requirements and its practical application
- Great
rapport building and communication skills
- Strong
problem solving, leadership skills, analytical and decision-making skills
- Minimum
of 3 years’ experience of the insurance market
- 1-2
years Billing experience is desired
- Ability
to organise, prioritise and manage workflow to meet individual and team production
standards
- Attention
to detail, with high level of accuracy
- Ability
to work under pressure/own initiative
- Good
analytical skills
- Excellent
numeric skills
- Customer
focused with developed problem-solving abilities and a proactive approach
to proposing/implementing process improvements
Case Associate Analyst – Africa at The Cigna Group
We are looking for a Care Associate for our growing office
Nairobi.
Role Purpose
Responsible to review and approve medical services requested
by providers or customers according to medical necessity review guidelines.
Will ensure customers receive the best quality care, diagnostics and treatment
and avoid over or under-utilization of clinical services. Ability to review,
investigate and respond to external and internal inquiries/complaints. Provide
guidance to other clinical and non-clinical staff related to medical necessity.
Your Job
- Assess
and process medical approvals using the company system in accordance with
conditions & terms of medical policies.
- Give
evidence-based advice on preauthorization and medical claims considering
internationally accepted protocols and local and or regional customs and
regulations. Will use Cigna coverage policy and MCG guidelines.
- Identify
and refer cases to the clinical programs team for case management, disease
management and other clinical services and assure quality of performance
against QA standards to promote optimal service delivery. Give appropriate
corrective action if necessary.
- To
assist queries from providers and payers via phone calls or e-mails.
- Ensure
that hospitals worldwide receive expertise advisory and all necessary
documents for a plan member’s admission within the best possible terms.
- Undertaking
of hospital admission approvals and declines.
- Ensure
appropriate Turnaround Time is adhered to in issuing inpatient and
outpatient guarantee of payment approvals.
- Seeking
medical clarifications including medical reports, copies of investigation
reports, etc.
- Maintain
relations by communicating all necessary admission guarantee of payment
decisions on a timely basis.
- Ensuring
guarantee of payments undertakings are issued in line with the policy
provisions. Likewise for declines, ensuring that the decisions are
accurate and a correct interpretation of the policy.
- Work
with the provider claims reviewers for inpatient claims and coordinating
on any information noted in the inpatient claim submitted especially in
cases where further information provided changes the position undertaken
previously on the claim.
- Interacting
with clients, brokers and clinicians as needed, to resolve problems in a
manner that is legal, ethical, and consistent with the principles of the
policy.
- Checking
and confirming membership validity and benefits from policy documents.
- Vetting
and confirming validity of the service given by the service provider in
relation to the benefits covered, treatment given, adherence to provider
panel rules and cost of treatment.
- Obtaining
additional required information on claims from providers, brokers, or
clients.
- Liaising
with our eligibility section on scope of cover for various contracts.
- Training
new colleagues in the team.
- You
organize the in- and outflow of all incoming communication with special
attention to the quality of the messages and to the response turnaround
times.
- All of
these tasks are performed in English or other languages. French,
Portuguese or Spanish an added advantage.
YOUR PROFILE
Qualifications
- Medical
related degree or Diploma
- Healthcare/insurance
experience or professional qualification is a plus
- Proficient
in the use of Microsoft Office Suite and packages
Relevant Experience
- You
have 2-3 years of clinical experience preferably in a hospital setup or
insurance medical management, case management, disease management programs
and tools are an advantage.
- You
have knowledge of utilization, cost containment services, and insurance
coverage.
- You
are flexible to work on shifts/varying work schedules.
- You
work accurately and have ability to work under pressure and meet
tight deadlines.
- You
are strong in communication.
- You
are service-minded.
- You
have a strong sense of responsibility.
- You
can easily handle procedures regarding document verification.
- You
can easily work with several software applications. simultaneously.
- You
are analytical and like taking initiative.
- You
handle confidential information in a discrete manner.
- You
work autonomously but also enjoy working as part of a team.
General Clerk Associate Representative at Cigna
Cigna is a global health service company dedicated to helping
people improve their health, well-being and sense of security. Cigna has
over 70,000 employees who service 85 million customer relationships throughout
the world. The Cigna office in Kenya is as an operation hub servicing clients
within the African and Global Markets.
We are looking for General Clerk Associate Representatives
to join our growing Provider Intake Team at our Nairobi office.
YOUR JOB
You are responsible for organizing efficiently and
processing correctly the flow of incoming and outgoing electronic documents,
faxes, claims, etc. Some of your tasks include:
- Receiving
and documenting claims within Intake and processing systems.
- Sorting,
processing and vetting of claims firsthand for claims payment.
- File
management and classification of data within Kofax.
- Electronic
transfer of received claims to the various platforms in Cigna
- Triaging
the flow of provider claims/queries and GOP Requests on Salesforce
- Indexing
and managing the Intake provider claims and any other departmental tasks
within stipulated TAT’s
- Managing
the different channels through which claims are received.
- Any
other tasks as allocated.
YOUR PROFILE
- You
speak and write fluent English.
- You
are accurate and pays attention to detail.
- You
can work with different systems and applications in your day to day.
- You
are organized and have excellent time management skills.
- You
can deal with confidential information with the utmost discretion.
- You
can accurately handle large quantities of electronic documents.
- You
thrive in a fast-paced environment and can prioritize set tasks
accordingly
- You
are optimistic and resilient.
- You
are a team player and can collaborate and engage with both your own team
and with different teams.
- You
have graduated with a Diploma or Degree from a recognized institution
OUR OFFER
- A
challenging job in an international and growing enterprise.
- A
dynamic, young and entrepreneurial company culture that values and
stimulates initiative.
- Market
– related salary conditions
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an
advocate for better health through every stage of life. We guide our customers
through the health care system, empowering them with the information and
insight they need to make the best choices for improving their health and
vitality. Join us in driving growth and improving lives.
Claims Representative – Africa Business at Cigna Group
We are looking for a detail-oriented Claims Representative
to join our claims team. You will be responsible for verifying information and
corresponding with agents and beneficiaries. You will also handle client
inquiries, review policies, determine coverage, calculate claim amounts,
and process payments.
To be successful as a claim’s processor, you should have excellent
organizational and interpersonal skills. You should also be able to work
under pressure and perform a range of clerical functions with great attention
to detail.
Main Duties / Responsibilities
- A
medical claims processor validates the information on all medical claims
from patients seeking payment from the company.
- Claims
must be thoroughly reviewed to ensure that there is no missing or
incomplete information.
- In
addition, a processor must keep meticulous records of claims and follow up
on lapsed cases.
- Medical
claims processors are expected to have an extensive knowledge of medical
terminology, as well as experience using a computer.
- Recording
and maintaining insurance policy and claims information in a database
system.
- Determining
policy coverage and calculating claim amounts.
- Processing
claims payments.
- Answering
queries related to Policy coverage criteria and guidelines.
- Complying
with federal, state, and company regulations and policies.
- Since
medical claims processors must approve or deny payment to doctors, it is
vital that they know how to correctly read and assess medical
documents.
- Good
communication skills are necessary to converse with doctors’ offices or
insurance companies if there is a problem with the claim.
- Performing
other clerical tasks, as required.
Claims Processor Requirements:
- A
medical-related Diploma or Degree qualification is required.
- At
least 1 year as a medical claims processor.
- Familiarity
with medical terminologies and understanding of CPT codes and ICD-9 codes.
- Working
knowledge of the insurance industry and relevant federal and state
regulations.
- Computer
literate and proficient in MS Office.
- Excellent
critical thinking and decision-making skills.
- Good
administrative and organizational skills.
- Strong
customer service skills.
- Ability
to work under pressure.
- High
attention to details.
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an
advocate for better health through every stage of life. We guide our customers
through the health care system, empowering them with the information and
insight they need to make the best choices for improving their health and
vitality. 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.
Medical Advisor at Cigna
The Medical Advisor is a member of the medical team, part of
IHT, who develops and manages health and wellness programs for Cigna customers.
Together with a team of nurses and physicians she/he will ensure attainment of
quality, production, timeliness, customer advocacy, cost containment goals, and
excellent customer satisfaction for both internal and external customers. In
his role, the Medical Advisor would embrace Cigna’s vision, culture and values,
representing Integrated Health Team mission in front of our customers, clients
and other external and internal stakeholders.
He/she works with a multicultural population and is
constantly aware of the cultural differences among that population and the
geographical regions, combining health care global expertise with regional
knowledge to better service our customers, partners and clients.
Ability to review, investigate, and respond to external and
internal inquires/complaints. Provides guidance and acts as a mentor or coach
for the nurses and other non-clinical staff.
Major responsibilities and desired results:
- Makes
part of Integrated Heatlh Team, providing medical management services to
customers worldwide
- Gives
evidence-based advice on medical claims, taking into account
internationally accepted protocols and local and/or regional customs and
regulations.
- Supports,
coaches, and monitors the Case Management Team and Care Team through our
different Health and Clinical Case Management services and programs.
Ensuring quality of performance, promoting optimal service delivery and
accurate reporting. Gives advice on appropriate corrective action if
necessary.
- Assist
in the coordination of processes for improving quality of care and health
outcomes for specifically delineated projects or populations.
- Assist
and support the team’s cost containment strategy, projects, and service
delivery to meet our yearly affordability goals.
- Serves
as a resource/educator regarding specific areas of expertise. Able to
create and implement appropriate educational clinical programs content for
internal and external audiences and link with Cigna University resources.
- Assists
other functional areas:
- Underwriting
Team, providing clinical advise on Underwriting processes and
non-disclosure post-sale detection
- Payment
Integrity Team:
- Providing
clinical advice and recommending best practices to prevent and detect
fraud, waste and abuse.
- Providing
support to our Network Management Team.
- Health
and Wellbeing Teams: Collaborating to develop, implement and deploy
wellness solutions.
- Clinical
Operations: Work together with the team on quality improvement and
clinical management projects.
- Client
Management and Client Support Teams
- Sales
and Marketing Teams
- LPS
team
- Makes
part of the business continuity plan to ensure operational continuity to
our customers
- Supports
emergent/urgent out of office hours requests from Care Team and Case
Management Team where MNR services are required.
- Other
duties as assigned
Requirements:
- Medical
Doctor Degree with international healthcare experience
- 3-5
years of clinical experience preferable in a payer setting on medical
management
- Experience
in utilization management, case management, disease management, cost
containment, insurance coverage and underwriting. Experience on disease
management programs and tools is an advantage
- Experience
in medical claims revision
- Strong
interpersonal and communication skills
- Pro-active
problem-solving and analytical skills.
- Ability
to operate a personal computer, proficient with Microsoft office products,
call center software, and a variety of software for medical management.
- Ability
to work remotely, working from home
- Ability
to build solid working relationships with staff, matrix partners, clients,
customers and healthcare providers
- Stress
resistant and efficient, finding a good balance between quality and
quantity
- Ability
to speak, write and read English and any other languages are an advantage
Eligibility Representative- GHB at Cigna
Main Duties/Responsibilities:
- Database
Entry and/or Database Management experience essential.
- Process
requests from internal and external customers reviewing the request and
taking the appropriate action, in a timely and accurate manner.
- Internal
and external clients depend on our accuracy and efficiency when processing
client data, so you will be accountable for providing these high levels of
service in accordance with the company standards and customer
expectations.
Your Profile
- Strong
interpersonal skills with excellent written/verbal communication skills
- Must
possess excellent attention to detail, with a high level of accuracy
- Must
be able to review information and exercise judgement
- Ability
to organise, prioritise and manage workflow to meet individual and team
production standards
- Ability
to work under own initiative
- Customer
focused with developed problem-solving abilities and a proactive approach
to proposing/implementing process improvements
- Good
analytical skills
- Ability
to navigate systems and applications with ease
- Regulatory
awareness
- Ability
to work within a large team
- Adaptable
to change with a flexible approach to supporting team tasks
- Proficient
in Microsoft Word, Excel and Outlook – advanced Excel would be
advantageous
- Minimum
of a diploma, bachelor’s degree or higher qualification is required.
- Experience
from an insurance background preferred
- Spanish
Speaking/Reading/Writing would be advantageous
Claims Representative – Africa Business at Cigna
We are looking for a detail-oriented claims Representative
to join our claims team. You will be responsible for verifying information and
corresponding with agents and beneficiaries. You will also handle client
inquiries, review policies, determine coverage, calculate claim amounts,
and process payments.
To be successful as a claim’s processor, you should have excellent
organizational and interpersonal skills. You should also be able to work
under pressure and perform a range of clerical functions with great attention
to detail.
Main Duties / Responsibilities
- A
medical claims processor validates the information on all medical claims
from patients seeking payment from the company.
- Claims
must be thoroughly reviewed to ensure that there is no missing or
incomplete information.
- In
addition, a processor must keep meticulous records of claims and follow up
on lapsed cases.
- Medical
claims processors are expected to have an extensive knowledge of medical
terminology, as well as experience using a computer.
- Recording
and maintaining insurance policy and claims information in a database
system.
- Determining
policy coverage and calculating claim amounts.
- Processing
claims payments.
- Answering
queries related to Policy coverage criteria and guidelines.
- Complying
with federal, state, and company regulations and policies.
- Since
medical claims processors must approve or deny payment to doctors, it is
vital that they know how to correctly read and assess medical
documents.
- Good
communication skills are necessary to converse with doctors’ offices or
insurance companies if there is a problem with the claim.
- Performing
other clerical tasks, as required.
Claims Processor Requirements:
- Diploma
or Degree Qualification.
- Knowledge
of Medical Terminologies, CPT codes and ICD-9 codes is an added advantage.
- Computer
literate and proficient in MS Office.
- Excellent
critical thinking and decision-making skills.
- Good
administrative and organizational skills.
- Strong
customer service skills.
- Ability
to work under pressure.
- High
attention to details
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an
advocate for better health through every stage of life. We guide our customers
through the health care system, empowering them with the information and
insight they need to make the best choices for improving their health and
vitality. Join us in driving growth and improving lives.
Data Management Strategy and Governance Manager at Cigna
Job Title: Data Quality & Governance Lead
Location: Madrid, Nairobi, or Bengaluru
Job Type: Full-Time
About the Role: We are seeking a highly skilled and
experienced hands-on lead to join our team. The ideal candidate will be
responsible for leading the definition, development and implementation of data
governance initiatives and implementing a global DQ (Data Quality) framework
that enhances trust in data across the enterprise . This role requires a deep
understanding of data governance and data quality concepts, strong delivery
focus, and the ability to manage and mentor a team. This role will report
to the Data Strategy & Governance Lead, within our Data & Analytics
function.
Key Responsibilities:
- Lead
the design, development, and implementation of updated data governance
frameworks, policies, and procedures.
- Design
and implement a global data quality strategy aligned with enterprise data
governance and regulatory requirements.
- Develop
and operationalize a data quality framework, including standards, metrics,
and controls, with automation at its core. Develop a data quality
improvement roadmap, that sets data quality targets and lead delivery in
meeting the agreed targets.
- Manage
a team, providing guidance, mentorship, and support to ensure high
performance and professional growth.
- Collaborate
with cross-functional teams, data owners, stewards, engineering, and
analytics teams to embed DQ practices into data pipelines and business
processes. Oversee the delivery of data governance products and solutions
to production, ensuring they meet quality, performance, regulatory, and
security standards.
- Support
regulatory compliance efforts by ensuring data quality processes meet
regional and global standards.
- Establish
monitoring and reporting mechanisms to track data governance initiatives,
identifying areas data quality KPIs and drive continuous improvement.
Focus on metadata management, data quality, and the use of AI-based tools
to enhance data governance practices.
- Implement
strategies to make data more available and accessible across the
organization while ensuring robust audit and control mechanisms are in
place.
- Stay
up-to-date with industry trends and advancements in data governance and
related technologies, incorporating relevant innovations into the
organization’s practices.
- Maintain
a strong delivery focus, ensuring that projects are completed on time and
within scope, with clear milestones and timelines.
- Build
and maintain strong business partner relationships to align data
governance initiatives with business needs and priorities.
- Develop
and deliver training programs to enhance data literacy and embed
governance practices across the organization.
- Act as
a trusted advisor to senior stakeholders on data quality risks and
opportunities.
Qualifications:
- Bachelor’s
degree in Computer Science, Information Technology, or a related field;
advanced degree preferred.
- Proven
experience in data governance, data quality and management, or a related
field, with a strong understanding of data governance and quality concepts
and best practices.
- Hands-on
experience with Collibra and AWS data services (e.g., S3, Glue, Redshift).
with experience in delivering data governance products to
production.
- Experience
integrating data quality processes into BI/reporting tools such as
QlikSense.
- Familiarity
with data quality automation and scalable data validation
techniques.
- Demonstrated
experience in managing and leading engineering teams, with a focus on
fostering collaboration and innovation.
- Excellent
problem-solving skills and the ability to think strategically about data
governance challenges and solutions.
- Strong
communication and interpersonal skills, with the ability to effectively
convey complex technical concepts to non-technical stakeholders.
- Experience
with data governance tools and technologies, such as data catalogs,
metadata management, and data quality solutions (e.g. Collibra).
- Knowledge
of regulatory requirements and industry standards related to data
governance and data protection (e.g., GDPR, NBB, CCPA).
Preferred Skills:
- Certification
in data governance or data management (e.g., CDMP, DAMA).
- Experience
working in regulated industries (e.g., financial services,
healthcare).
- Knowledge
of data mesh or federated data governance models.
- Experience
with cloud-based data platforms and services (e.g., AWS, Azure, Google
Cloud).
- Familiarity
with data privacy and security best practices.
- Experience
with AI-based tools and technologies to enhance data governance and data
quality.
Why Join Us:
- Opportunity
to lead and shape the data governance and quality strategy of a dynamic
and innovative organization.
- Collaborative
and inclusive work environment that values diversity and professional
growth.
- Delivery-focused
and mission-oriented role with a strong emphasis on engineering and
collaboration.
- Located
within the Data & Analytics Organization, with a focus on revising
data governance and data risk frameworks.
- Clear
focus on delivering projects on time and within scope, with established
timelines and milestones to track progress and ensure successful
delivery.
- Build
and maintain strong business partner relationships to ensure alignment
with business needs.
- Develop
and deliver training programs to enhance data literacy and governance
practices across the organization.
Technical Customer Support Analyst at Cigna
About the job
Cigna, a leading global health insurer, is experiencing an
exciting period. We are looking to recruit an experienced IT Service Analyst in
Nairobi. The successful candidate will be a member of the Technology,
Engineering, and Operations group.
Reporting to the Service Desk Team leader, you will provide
operational support and account administration to the Service Desk team.
The successful candidate will be a high-performing
individual who is methodical, inquisitive, and passionate about technology and
service.
You will work about 66% from the Cigna office and 34% from
home.
Main duties and responsibilities
- Provide
technical support to onsite and remote users.
- Install,
configure and support (IMAC) end-user devices.
- Manage/monitor
IT Service Desk Incidents and Service Request via the call management
system.
- Manage
User system access for various applications.
- Identify
ways to improve the quality of the service provided and/or the efficiency
of the processes within the team.
- Ensure
all incidents are managed following targets set out in SLA.
- Escalate
any issues/ outages to the IT End User Services Team leader.
- Prioritising
and allocating all requests within IT Support teams.
- Working
every 3 weeks on Saturday from 8 AM until 1 PM (from home).
- Working
every 7 weeks (Mon-Fri) from 4 PM until midnight (from home).
Required Skills
- Two
years of experience within an IT support team
- Incident
management skills
- Experience
with a call management system
- Experience
with Microsoft Office
- Windows
11 support and build experience. ( both OS and pc hardware)
- Active
Directory
- Citrix
Support
- SCCM
- Exchange
account maintenance
- Networking
& patching
Desirable Skills
- ITIL
Foundation certified.
- Microsoft
certification.
- Experience
with Service Now.
- Avaya
Telephony
About You
- Communicate
clearly and effectively.
- Excellent
communication skills and be able to correspond efficiently and
effectively. This includes both verbal and written formats.
- A
positive ‘can-do’ attitude with a strong commitment to customer support.
Receptionist Vacancy
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an
advocate for better health through every stage of life. We guide our customers
through the health care system, empowering them with the information and
insight they need to make the best choices for improving their health and
vitality. Join us in driving growth and improving lives.
YOUR PROFILE
- Bachelor’s
degree in relevant field, prior front office /customer service experience
preferred. Minimum 3 years work experience. Excellent
communicator both oral and written.
- Organizational
skills: you can assess different tasks and proceed according to
priorities; you are able to plan ahead in order to ensure daily workflows
are respected, you are able to work in close cooperation with your
colleagues You can rapidly and accurately handle a large quantity of
documents You can keep a clear overview of the work to be done, even
in busy times.
- Strong
energy and drive to work across cultures and time zones
- You
can deal with (confidential) information with the utmost discretion.
- You
can perform accurate data entry.