The Risk Adjustment Quality & Review Analyst supports IFP Risk Adjustment programs by applying medical coding and HCC expertise to review documentation, validate data accuracy, ensure compliance, and identify opportunities for continuous improvement. **Key Job Functions** + **Conduct medical record reviews** with accurate ICD‑10‑CM diagnosis code abstraction in alignment with official guidelines, Cigna IFP standards, HHS protocols, and applicable rule sets. Validate HCC assignments for the correct Benefit Year using the HHS Risk Adjustment Model. + **Perform documentation and data audits** to identify errors, gaps, and compliance risks across IFP Risk Adjustment programs, including RADV and Supplemental Diagnosis submissions. Support vendor coding quality reviews and collaborate with partners on coding and RA education. + **Coordinate with internal and external stakeholders** to ensure efficient, compliant RA program execution. Escalate risks promptly and communicate clearly across audiences. + **Support program processes and guideline updates** to maintain CMS/HHS compliance, including contributing to Cigna IFP Coding Guideline revisions and policy decisions. **Education & Certification** + High school diploma required. + Minimum **2 years** experience with one of the following AHIMA/AAPC certifications: + CPC, CCS‑P, CCS‑H, RHIT, RHIA, or CRC + **Non‑CRC holders must obtain CRC within 6 months of hire.** **Minimum Qualifications** + Experience with medical documentation audits and chart reviews + Strong knowledge of ICD‑10‑CM guidelines + Familiarity with CMS Risk Adjustment regulations for inpatient/outpatient documentation + HCC coding experience preferred + Proficiency with Excel, Word, and Adobe Acrobat + Detail‑oriented, organized, and self‑motivated + Understanding of medical claims submission preferred + Ability to meet productivity, accuracy, and timeline standards 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. For this position, we anticipate offering an hourly rate of 25 - 38 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here (https://jobs.thecignagroup.com/us/en/benefits) . **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:_ _SeeYourself@cigna.com_ _for support. Do not email_ _SeeYourself@cigna.com_ _for an update on your application or to provide your resume as you will not receive a response._ _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._