Reference Data Management Quality Auditor – Provider Data Quality at Cigna Healthcare

Bengaluru, karnataka, India -

Full Time

Start Date

Immediate

Expiry Date

13 Mar, 26

Salary

0.0

Posted On

13 Dec, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Provider Data Management, Data Quality Auditing, Data Cleansing, Validation Processes, Excel, Reporting Tools, Business Rules Interpretation, Attention to Detail, Organizational Skills, Communication Skills, Root Cause Analysis, Process Improvement, Regulatory Compliance, Audit Frameworks, Continuous Improvement Methodologies, Bulk Data Processing Tools

Industry

Hospitals and Health Care

Description

Job Title: Reference Data Management Quality Auditor – Provider Data Quality Location: Bangalore Band: 2 Reports To: Reference Data Management Senior Supervisor Role Summary: The Reference Data Management vertical is a critical piece of the Business Excellence organization in International Health Delivery Services (IHDS). Under the leadership of the Reference Data Management Senior Manager, this vertical focuses on establishing the right operating processes, controls, standardization and strategic roadmaps pertaining to critical and prioritized reference data in IH’s primary operating systems/platforms. One of the key datasets in scope will be Provider Data Management, focusing on international Provider data within Cigna International Markets. The Quality Auditor will ensure the integrity and accuracy of provider data across PRM and PAS systems. This role focuses on auditing data cleansing activities, validating bulk updates, and confirming the quality of changes to provider data elements. The auditor will work closely with Provider Data Quality (PDQ) teams and other stakeholders to maintain compliance with business rules and regulatory standards. Key Responsibilities Audit Data Cleansing Activities: Review and validate data cleansing processes for provider records, ensuring adherence to established standards and guidelines. Bulk Update Quality Checks: Verify the accuracy and completeness of mass uploads or updates to provider data in PRM and PAS. Change Validation: Confirm that any changes to provider data elements (e.g., Critical Data Elements such as PRM ID, bank details, contact info) meet quality and compliance requirements. Root Cause Analysis: Investigate discrepancies or recurring issues in provider data and recommend corrective actions. Reporting & Documentation: Maintain detailed audit logs, prepare reports on findings, and present trends or risks to leadership. Process Improvement: Identify gaps in data management processes and propose enhancements to reduce errors and improve efficiency. Compliance Assurance: Ensure provider data aligns with regulatory requirements and internal policies. Required Skills & Experience Strong understanding of provider data management systems (PRM, PAS – Globalcare, Diamond, Actisure). Experience in data quality auditing, data cleansing, and validation processes. Proficiency in Excel (advanced formulas), and familiarity with reporting tools like Tableau. Ability to interpret complex business rules and apply them consistently. Excellent attention to detail and organizational skills. Strong communication skills for stakeholder engagement and reporting. Minimum 2 years of experience in health insurance or international healthcare provider data management. Analytical mindset with capability to perform root cause analysis and recommend solutions. Preferred Qualifications Experience with bulk data processing tools and automation solutions. Knowledge of regulatory compliance related to provider data. Familiarity with audit frameworks and continuous improvement methodologies. 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. Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Responsibilities

The Quality Auditor will ensure the integrity and accuracy of provider data across PRM and PAS systems, focusing on auditing data cleansing activities and validating bulk updates. They will also maintain compliance with business rules and regulatory standards while identifying gaps in data management processes.