# Intake Care Associate Analyst

**Company**: Cigna Healthcare
**Location**: Kenya One Africa Place
**Job type**: full-time
**Category**: Healthcare
**Industry**: Healthcare

**Apply**: https://cigna.wd5.myworkdayjobs.com/en-US/cignacareers/job/Kenya-One-Africa-Place/Intake-Care-Associate-Analyst--Cigna-Healthcare_26012976?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/jobs/job_601691eb-94c

## 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 requests 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 and 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.

## Skills

### Required
- medical claims adjudication
- prior authorization processes
- medical necessity review
- utilization management guidelines
- clinical documentation
- coverage criteria
- coding certification
- communication skills
- problem-solving
- decision-making

### Nice to have
- additional education in healthcare, business, or related fields
- coding certification (e.g., CPC, CCS)

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Source: [Apply at cigna.wd5.myworkdayjobs.com](https://cigna.wd5.myworkdayjobs.com/en-US/cignacareers/job/Kenya-One-Africa-Place/Intake-Care-Associate-Analyst--Cigna-Healthcare_26012976?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)