About Us

Cigna is a global health service company, dedicated to helping the people we serve improve their health, well-being and sense of security. Cigna has almost 40,000 employees who service over 80 million customer relationships around the world. Within its international division, a dedicated unit - headquartered in Belgium - focuses on the needs of International Organisations. This unit is specialised in servicing customers in remote areas as well as central hubs with five service centres in each time zone (Miami, Antwerp, Madrid, Nairobi and Kuala Lumpur) and local representations on every continent. When you work at Cigna, you can count on a different kind of career. >> Why join us? Healthy careers Cigna gives you the opportunity to grow and develop professionally and personally. Because we know our success begins with yours. Healthy returns We offer you monetary and non-monetary rewards. Our compensation is differentiated among employees based on responsibilities and performance. Healthy culture We stand for a work environment that includes the beliefs, values, norms, and management style of our company. Communication is key to our culture. Healthy life We show commitment to our employees’ health, well-being and security, with a strong focus on wellness.

MAJOR RESPONSIBILITIES

• Part of a clinical team that provides medical management services to customers worldwide but mainly in Africa region.
• Give evidence-based advice on pre-authorization, considering internationally accepted protocols and local and/or regional customs and regulations.
• Assessing pre-authorization requests claims in line with the policy coverage and medical necessity.
• Identify and refer cases to the Cigna Clinical team for case management, disease management and other clinical services
• Assist and support the team in cost containment, assist in projects and service delivery to meet goals.
• To assist queries from providers and payers via phone calls or e-mails
• Be fully versed with medical insurance policies for various groups / beneficiaries.
• Might be required to assist in training colleagues and sharing knowledge.
• Ability to review, investigate, and respond to external and internal inquires/complaints and provide guidance to other clinical and non-clinical staff related to medical necessity.
• Assist in fraud detection
• Meeting the defined qualitative and quantitative key performance metrics for the assigned job role.
• Ensure adherence to the predefined TATs for pre-approvals Achieving required targets assigned by the team leader on daily, weekly, and monthly basis.
• Ensure compliance to any changes in terms of system parameters or process. Other duties as assigned 

REQUIREMENTS

• University degree of Medical /Nursing specialization with international healthcare experience. 2-3 years of clinical experience preferable in a payer setting on medical management.
• Experience in the Africa region & International market
• Fluent in English along with either French, Portuguese or Spanish, any other language is a plus
• Strong interpersonal and communication skills. Must be a computer literate
• Knowledge of utilization, cost containment services, insurance coverage.
• Ability to build solid working relationships with staff, clients, customers, and healthcare providers.
• Demonstrates pro-active problem-solving and analytical skills Ability to work under pressure and meet tight deadlines
• Flexible to work on shifts/varying work schedules. 

How to Apply

Interested and qualified? Go to:Cigna on jobs.cigna.com to apply