Position Summary

The Revenue Cycle Client Manager (RCM & Claims) is responsible for providing comprehensive Revenue Cycle Management and claims support to the Account Management and Implementation teams, the broader organization, and assigned clients. This role partners closely with clients and internal stakeholders to address claims-related issues and their downstream financial and client experience impacts.

Serving as a strategic liaison between clients, payors, and internal teams, the Revenue Cycle Client Manager combines deep expertise in revenue cycle and claims operations with strong consultative, account-facing communication skills. The role is accountable for proactively monitoring, analyzing, and mitigating claims-related risks and open items, while translating complex technical RCM concepts into clear, actionable insights for both technical and non-technical audiences.

Embedded within the Account Management organization, the Revenue Cycle Client Manager acts as a trusted advisor to clients and payors and a key partner to internal RCM, Claims, and Implementation/Professional Services (PSO) teams. This individual ensures alignment, transparency, and proactive issue resolution across the full client lifecycle, supporting effective collaboration and improved operational and financial outcomes.

Essential Job Functions

• Serve as the primary RCM and claims subject matter expert for assigned accounts, acting as a client- and payor-facing liaison, as well as an internal partner conduit.

• Lead and support discussions with clients and payors regarding claims performance, denial trends, reimbursement issues, and process improvements.

• Translate complex RCM, billing, and claims workflows into clear, non-technical language for clients, payors, and internal stakeholders.

• Build trusted relationships with client and payor counterparts by demonstrating expertise, accountability, and proactive communication.

• Monitor claims performance, open items, denial trends, aging, and reimbursement risks across assigned accounts.

• Proactively identify, flag, and escalate risks, issues, or systemic gaps impacting claims outcomes or client satisfaction.

• Partner with RCM, Operational, and technical teams to drive root cause analysis, mitigation strategies, and corrective action plans.

• Partner with Account Management to track issues through resolution, ensuring visibility, ownership, and timely follow-up.

• Act as a key liaison between Account Management, CSE, RCM, Ops, Product, and Implementation/PSO teams.

• Support Implementation/PSO teams during onboarding, go-lives, and transitions by advising on readiness and risk mitigation.

• Ensure client feedback and payor insights are looped back to internal teams to improve processes and outcomes.

• Advocate for the client internally while balancing operational realities and best practices.

• Contribute to account planning by identifying claims related risks, optimization opportunities, and performance improvement initiatives.

• Support renewal and growth/expansion by providing data-driven insights and RCM expertise.

• Participate in the development of process and procedure improvements

• Clearly communicate the progress of monthly/quarterly initiatives to internal and external stakeholders.

• Identify opportunities to develop process improvements and implement solutions for clients

• Complete assigned tasks and projects according to appropriate timelines agreed upon with stakeholders.

• Atlassian Jira, Smartsheet, and Salesforce knowledge is preferred

• Other duties as assigned

Required Knowledge/Skills/Abilities

• Strong working knowledge of claims lifecycles, denials management, payor rules, reimbursement methodologies, and RCM workflows.

• Experience working directly with healthcare clients and/or payors in a consultative, client-facing capacity.

• Ability to translate technical or operational concepts into clear, business-friendly communication.

• Ability to understand health care industry terminology

• Superior collaboration and interpersonal communication skills, flexibility and responsiveness.

• Ability to communicate effectively and follow written and verbal instructions

• Possess strong analytical and process management skills and have a broad understanding of business strategy and operations.

• Must be able to handle multiple tasks and work in a fast pace environment

• High level of accuracy and attention to detail

• Ability to adapt to changing procedures, policies and work environment

• Critical thinking skills

• Must be able to demonstrate integrity and a commitment to values.

• Excellent documentation skills

• Ability to present to a variety of audiences

• Ability to adapt to changing procedures, policies, and work environment

• Bachelor’s Degree in Health Care, IT, Finance (or related field), preferred

• Master’s Degree preferred

• 5+ years in Revenue Cycle Management, claims operations, billing, or related roles.

• Client/customer service experience required

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.

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. 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.