From the employer's hiring system · Verified employer
Intake Care Associate Analyst - Cigna Healthcare
Cigna Healthcare
Job at a glance
- Employer
- Cigna Healthcare
- Position
- Intake Care Associate Analyst - Cigna Healthcare
- Location
- Kenya One Africa Place
- Job type
- Full-time
- Education
- Degree or Diploma
- Salary
- Not stated in the advert
- Application deadline
- 4 November 2026
- Posted on VacancyKE
- 2 November 2026
VacancyKE summary
Cigna Healthcare is hiring an Intake Care Associate Analyst in Nairobi. You will manage preauthorization, claims review, and provider negotiations to ensure clinical appropriateness and cost-effective care delivery.
What stands out about this opportunity
- Rotating 24/7 shift schedule including nights and weekends
- Focus on cost containment and provider negotiation
- Based at One Africa Place, Nairobi
Key responsibilities
- Review and process preauthorization requests for medical services and treatments.
- Assess medical necessity using clinical guidelines and policy criteria.
- Conduct detailed reviews of medical claims for accuracy and coding integrity.
- Identify billing discrepancies, overutilization, and potential cost-saving opportunities.
- Lead negotiations for out-of-network claims and high-cost procedures.
- Collaborate with clinical teams and providers to coordinate complex member care.
- Support appeals, reconsiderations, and audit activities as needed.
- Analyze trends in high-cost claims and recommend process improvements.
Who should apply?
This job suits individuals with a background in healthcare or insurance who possess strong analytical skills and can adapt to rotating 24/7 shift patterns.
Key requirements
- Degree or Diploma qualification
- Claims adjudication knowledge
- Preauthorization process understanding
- Medical necessity assessment skills
- Data interpretation ability
- Willingness to work 24/7 shifts
Nice to have
- Coding certification (e.g., CPC, CCS).
What you should know
- The role operates on a 24/7 schedule with assigned shifts.
- Shifts include night hours (8:00 PM - 6:00 AM or 9:00 PM - 7:00 AM EAT) and day hours (7:00 AM - 3:00 PM EAT).
- Specific shift days vary between Saturday-Wednesday or Wednesday-Sunday.
- Flexibility to work weekends and holidays is required.
- Applications are submitted via the Cigna careers portal.
How to apply
Official source: From the employer's hiring system · cigna.wd5.myworkdayjobs.com. VacancyKE never charges job seekers.
Original employer advertisement
Published by Cigna Healthcare on cigna.wd5.myworkdayjobs.com. Shown for reference; the employer’s version is the official one.
The employer’s advert
About Us
Cigna Healthcare is a global health services and insurance company, that is dedicated to its mission of helping to connecting members, providers, and employers to deliver and manage healthcare coverage, cost, and care outcomes.
Job Description
Intake Care Associate Analyst : The preauthorization, claims review, negotiation and care coordination analyst is responsible for managing the full continuum of care management and cost containment activities-from pre-service authorization through post -service claims review and provider negotiations. This role ensures clinical appropriateness, policy compliance, and cost effective care delivery while coordinating services for complex and high-risk members to improve outcomes and member experience.
Key Responsibilities
Preauthorization/Utilization Management:
· Review and process preauthorization request for medical services, procedures, and treatments
· Assess medical necessity using clinical guidelines, policy criteria, and regulatory requirements
· Collaborate with clinical teams to ensure appropriate level of care and service utilization
· Identify high-risk or high-cost cases early and route for care coordination or case management intervention
· Conduct detailed reviews of medical claims for accuracy, coding integrity, and benefit alignment
· Identify billing discrepancies, overutilization, and potential cost-saving opportunities
· Support appeals, reconsiderations and audit activities as needed
· Analyze trends in high-cost claims and recommend process improvements
· Lead or support negotiations for out-of-network claims, high-cost procedures, and single case assignments
· Partner with provider network and contracting teams to align negotiation approaches
· Document and track savings outcomes, including financial and operational impact
· Partner with case management, clinical teams, and providers to ensure continuity and quality of care
Qualification/Skills
- Degree or Diploma ; additional education in healthcare, business or related fields preferred
- Knowledge of medical claims adjudication, prior authorization processes, medical necessity review, and utilization management guidelines, with the ability to review clinical documentation and apply established coverage criteria.
- Coding certification (e.g., CPC, CCS) a plus but not preferred
- Excellent communication skills both written and oral, with a good telephone manner
- Flexibility and ability to multi-task.
- High level of accuracy and attention to detail.
- Problem solving & decision making.
- Team player
- Ability to interpret key data and identify trends.
- This role operates on a 24/7 schedule. Selected candidates will be assigned to one of the following shifts: 8:00 PM - 6:00 AM EAT (Sat-Wed), 9:00 PM - 7:00 AM EAT (Wed-Sun), or 7:00 AM - 3:00 PM EAT (Sat-Wed). Flexibility to work weekends and holidays is required.
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.
If you require reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.
Cigna Healthcare is a global health services and insurance company, that is dedicated to its mission of helping to connecting members, providers, and employers to deliver and manage healthcare coverage, cost, and care outcomes.
Job Description
Intake Care Associate Analyst : The preauthorization, claims review, negotiation and care coordination analyst is responsible for managing the full continuum of care management and cost containment activities-from pre-service authorization through post -service claims review and provider negotiations. This role ensures clinical appropriateness, policy compliance, and cost effective care delivery while coordinating services for complex and high-risk members to improve outcomes and member experience.
Key Responsibilities
Preauthorization/Utilization Management:
· Review and process preauthorization request for medical services, procedures, and treatments
· Assess medical necessity using clinical guidelines, policy criteria, and regulatory requirements
· Collaborate with clinical teams to ensure appropriate level of care and service utilization
· Identify high-risk or high-cost cases early and route for care coordination or case management intervention
· Conduct detailed reviews of medical claims for accuracy, coding integrity, and benefit alignment
· Identify billing discrepancies, overutilization, and potential cost-saving opportunities
· Support appeals, reconsiderations and audit activities as needed
· Analyze trends in high-cost claims and recommend process improvements
· Lead or support negotiations for out-of-network claims, high-cost procedures, and single case assignments
· Partner with provider network and contracting teams to align negotiation approaches
· Document and track savings outcomes, including financial and operational impact
· Partner with case management, clinical teams, and providers to ensure continuity and quality of care
Qualification/Skills
- Degree or Diploma ; additional education in healthcare, business or related fields preferred
- Knowledge of medical claims adjudication, prior authorization processes, medical necessity review, and utilization management guidelines, with the ability to review clinical documentation and apply established coverage criteria.
- Coding certification (e.g., CPC, CCS) a plus but not preferred
- Excellent communication skills both written and oral, with a good telephone manner
- Flexibility and ability to multi-task.
- High level of accuracy and attention to detail.
- Problem solving & decision making.
- Team player
- Ability to interpret key data and identify trends.
- This role operates on a 24/7 schedule. Selected candidates will be assigned to one of the following shifts: 8:00 PM - 6:00 AM EAT (Sat-Wed), 9:00 PM - 7:00 AM EAT (Wed-Sun), or 7:00 AM - 3:00 PM EAT (Sat-Wed). Flexibility to work weekends and holidays is required.
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.
If you require reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.