Escalate risks and recommend mitigation actions before service levels are impacted.
Partner with operational leaders to maintain overall operational stability.
Real-Time Performance Management (RTFM)
Perform real-time operational monitoring and workforce performance tracking.
Continuously monitor service levels against agreed operational targets and client commitments.
Maintain dashboards and operational scorecards to provide visibility of performance trends.
Conduct intraday reviews to identify potential SLA or backlog risks.
Alert leaders and operational teams when performance thresholds are at risk.
Support short-term workload balancing activities to optimize operational capacity.
Risk Identification & Escalation Management
Proactively identify high-risk cases, aging inventories, complex customer issues, and service recovery requirements.
Monitor potential escalations through operational dashboards, complaints, and service trend analysis.
Coordinate intervention activities with operational, clinical, product, technology, and client service teams.
Ensure timely escalation of risks requiring leadership attention.
Maintain governance over action plans until resolution is achieved.
Cross-Functional Issue Resolution
Lead coordination activities across departments to address service delivery challenges.
Facilitate timely resolution of operational issues impacting customer experience, productivity, or SLA performance.
Drive accountability across teams for agreed corrective actions.
Partner with Claims, Authorizations, Client Services, Communications, Clinical Operations, Product, and Technology teams to resolve operational gaps.
Support incident management activities during business disruptions or system outages.
Operational Reporting & Insights
Develop and distribute daily, weekly, and ad-hoc operational health reports.
Provide regular updates to leadership on
Service performance
Key risks
Backlog health
Capacity concerns
Escalation trends
SLA performance
Translate operational data into actionable recommendations.
Highlight recurring issues, root causes, and opportunities for improvement.
Present performance insights during operational governance meetings.
Service Continuity & Incident Coordination
Act as a coordination point during operational incidents, system outages, or business disruptions.
Partner with Technology and business teams to understand operational impact and recovery plans.
Monitor operational recovery activities and service restoration progress.
Ensure stakeholders remain informed of business risks and mitigation actions.
Support business continuity and contingency planning activities.
Continuous Improvement & Operational Excellence
Identify recurring operational issues and drive root cause analysis activities.
Recommend process improvements to strengthen operational resilience and reduce service risk.
Support automation opportunities through improved monitoring, reporting, and exception management.
Contribute to initiatives focused on improving productivity, efficiency, service quality, and customer experience.
Champion a proactive risk-management culture across operational teams.
Stakeholder Management
Internal Stakeholders
META Lead
Claims Leadership
Client Services Leadership
Communications Leadership
Clinical Operations
Product Teams
Technology & IT Teams
Workforce Management
Quality & Training Teams
External Stakeholders
Clients (when operational incidents require visibility)
Strategic vendor partners (where applicable)
Success Measures
Service Performance
SLA attainment consistently maintained within target
Reduction in aged inventory and backlog risk
Reduction in avoidable service escalations
Risk Management
Early identification of operational risks
Reduction in customer-impacting incidents
Timely mitigation and resolution of operational issues
Governance & Reporting
Timely operational health reporting
Accurate risk visibility across leadership teams
Effective escalation and action tracking
Cross-Functional Collaboration
Resolution of operational issues within agreed timelines
Strong stakeholder engagement across business functions
Improved accountability and follow-through on corrective actions
Continuous Improvement
Measurable reduction in recurring operational gaps
Improved operational efficiency and service stability
Increased automation and proactive monitoring capabilities
About The Cigna Group
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.
