Job Description The ACA Risk Adjustment EDGE Administrator plays a critical role in ensuring compliant, efficient, and high‑quality operation of Cigna’s EDGE server environment supporting ACA Risk Adjustment. This position is ideal for a proactive, detail‑oriented professional with strong technical acumen and a passion for healthcare data. The EDGE Administrator will oversee daily operations, manage data submissions, monitor processing outcomes, and collaborate across business and technical teams to maintain compliance with CMS regulations in a fast‑paced, evolving environment. Responsibilities: - Manage day‑to‑day operations of the CMS EDGE server, including file ingestion, error resolution, and submission monitoring - Coordinate execution of baseline, incremental, and command‑driven processes for Cigna’s AWS‑hosted EDGE environment - Monitor release updates, reference data changes, and deployment timelines to keep the system in sync with CMS schedules - Oversee troubleshooting and remediation of file processing, configuration, and validation errors within the EDGE environment - Interpret CMS technical guidance, ICD updates, O&MM manual changes, and regulatory communications to ensure aligned EDGE operations - Conduct quality checks, reconcile enrollment and claims data, and support risk score accuracy and regulatory compliance - Collaborate with IT security and infrastructure teams to monitor and maintain EDGE instances in accordance with CMS requirements and Cigna policies - Maintain documentation of procedures, system configurations, data flows, and operational controls - Collaborate with teams to maintain and optimize data pipelines using AWS, Databricks, Python, SAS, and Oracle to support EDGE submissions and related analytics Core Competencies: - Strategic Thinking: Anticipates operational impacts of CMS changes and EDGE updates; plans proactively to maintain compliance and performance - Project Management: Manages timelines, dependencies, and deliverables for submissions, deployments, and remediation activities. - Analytical Expertise: Leverages analytical tools to diagnose issues, validate data, and improve system accuracy - Stakeholder Management: Communicates clearly and effectively with technical teams, business partners, and external stakeholders to drive alignment - Adaptability: Adjusts quickly to evolving CMS regulations, new EDGE releases, and shifting marketplace operational needs - Collaboration: Works across cross‑functional teams to deliver high‑quality outputs and coordinated execution Qualifications / Experience: - Bachelor’s degree in Information Systems, Computer Science, Data Analytics, Public Health, or related field (or equivalent experience) - 3+ years of experience in ACA Risk Adjustment and EDGE operations - Deep understanding of ACA Marketplace operations, Risk Adjustment methodology, and CMS EDGE submission requirements - Familiarity with CMS communication channels (e.g., REGTAP, FM Community) and published guidance (e.g., O&MM manuals, ICD, EDGE Server Business Rules) - Hands‑on experience with AWS services relevant to EDGE workflows (e.g., Infrastructure as Code, Terraform) - Proficient in using Databricks to create unity catalogs, pipelines, - Proficiency in SQL and SAS to query, analyze, and manage large healthcare datasets (i.e., preparing ETL and ELT scripts) - Proficiency in Tableau to present insights through reports and dashboards - Fluent in data warehousing, data modeling, and business intelligence concepts and tools - Demonstrated track record of troubleshooting large healthcare data files and EDGE validation errors - Excellent problem‑solving skills with the ability to perform root cause analysis and recommend sustainable solutions - Familiarity with healthcare regulations (e.g., HIPAA) 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 annual salary of 96,400 - 160,600 USD / yearly, 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. 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 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.

• Plan, implement, and monitor the lifecycle of assets. • Ensure that assets are properly acquired, maintained, utilized, and disposed of. • Analyze the performance, risks, and costs of the assets, and recommend improvements or replacements when needed. • Make authoritative recommendations about technical or professional solutions that would significantly improve business performance. • Develop and/or deliver a plan for significant aspects of a research program, with guidance from senior colleagues. • Make authoritative recommendations that have a significant impact on the business over the short and long term. • Develop and/or deliver a plan for significant aspects of internal communications with guidance from senior colleagues.

• Design, build, and maintain insider risk detection use cases and monitoring workflows with a primary focus on Splunk Enterprise Security, UEBA, and SPL content engineering • Write, optimize, and operationalize Splunk searches, correlation rules, dashboards, and alerts to improve fidelity and reduce false positives • Develop and refine detection use cases targeting anomalous user behavior, data exfiltration, policy violations, and suspicious endpoint activity • Investigate alert and case trends to identify opportunities for rule tuning, use case expansion, and operational maturity improvement • Support incident triage, investigation, and response related to insider risk, suspicious user behavior, and potential data misuse • Perform CrowdStrike Falcon alert review, tuning, and incident response support including false positive identification and credible threat escalation • Lead and assist in investigations involving potential insider threats, intellectual property matters, fraud, and high-stakes security incidents • Develop and maintain playbooks and response workflows for insider risk scenarios • Administer and optimize the insider risk toolset: Splunk ES, UEBA, CrowdStrike, Microsoft Purview/Defender/Entra, DLP, and adjacent technologies • Analyze current tool utilization and recommend enhancements to improve detection visibility, investigation efficiency, and operational coverage • Support continuous improvement across Splunk, CrowdStrike, Microsoft, DLP, Databricks, and SOAR platforms • Implement federal government and industry standards related to insider threat programs and maintain programmatic gap analyses • Partner with security operations, insider risk, cyber defense, and business stakeholders to improve detection coverage and response posture • Coordinate with technology and business leaders to develop programmatic solutions and deliver executive-level presentations on findings and program status

Opportunity Overview: We are seeking a Lead Data Governance Specialist to join our exceptional team. team. As the Lead Data Governance Specialist, your responsibility will be to ensure that the data in our application and analytics platform is trustworthy, reliable, organized, and well-managed to support real-time transactions and downstream analytics needs. You will be the data steward of key data assets for our organization - improving the governance and usability of the data. You will work with engineering, products, analytics, clinical and operations to improve data quality, ensure proper data use, accessibility, and improve data literacy. The work will be fast-paced yet enterprise-centric, with evolving needs - requiring discipline, flexibility, curiosity, and grace under pressure. At a growing organization, this is a position that offers the ability to make a substantive mark on the company and its partners with exponential growth opportunities. You will be part of the Data & AI organization and build a Cohere data platform to support our downstream teams to optimize patient care paths. What you’ll do: - Drive best practices in data and information management throughout Cohere’s application and analytic platforms - Work cross-functionally to establish and maintain an enterprise data catalog, capturing business, clinical & operational nuance and specificity, including data lineage and metric definitions - Provide training and support to promote data discoverability and establish guardrails to ensure proper data use - Work with data producers, data engineering, and consumers to establish and maintain data contracts and data quality standards - Monitoring and maintaining a range of data quality dimensions, including but not limited to, data accuracy, completeness, consistency, and timeliness - Accelerate our “shift left” data governance framework, including adherence to standards related to data validation, storage, access, and management - Collaborate with compliance and IT to establish proper data security and privacy controls What you’ll need: - Bachelor's in health informatics, data analytics, or related areas (Master's preferred) - 5+ years of data experience at a health technology company where health outcomes were critical to the mission, preferably a healthcare analytics company or population health organization - Passionate about improving the U.S. healthcare system and helping ensure every patient receives the best care possible - 3+ years of hands-on experience with health technology data, including administrative, clinical, and patient outcome data, conducting in-depth analysis to support data-driven decision making - Expertise in data governance practices, including data cataloging, lineage, and quality management - Proven track record in leading through influence, ability to drive cross-functional complex data projects in a fast-paced and high-intensity “scale-up” environment desired - Excellent interpersonal skills to collaborate with business, technical, and clinical leaders to define and govern data quality metrics Pay & Perks: 💻 Fully remote opportunity with about 10% travel 🩺 Medical, dental, vision, life, disability insurance, and Employee Assistance Program 📈 401K retirement plan with company match; flexible spending and health savings account 🏝️ Flex Time Off + company holidays 👶 Up to 14 weeks of paid parental leave 🐶 Pet insurance  The salary range for this position is $125,000 to $140,000 annually; as part of a total benefits package which includes health insurance, 401k and bonus. In accordance with state applicable laws, Cohere is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including but not limited to qualifications for the role, experience level, skillset, and internal alignment. Interview Process*: - Connect with Talent Acquisition for a Preliminary Phone Screening - Meet your Hiring Manager! - Behavioral Interview(s) *Subject to change About Cohere Health: Cohere Health’s clinical intelligence platform delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics. Cohere Health works with over 660,000 providers and handles over 12 million prior authorization requests annually. Its responsible AI auto-approves up to 90% of requests for millions of health plan members. With the acquisition of ZignaAI, we’ve further enhanced our platform by launching our Payment Integrity Suite, anchored by Cohere Validate™, an AI-driven clinical and coding validation solution that operates in near real-time. By unifying pre-service authorization data with post-service claims validation, we’re creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately. Cohere Health’s innovations continue to receive industry wide recognition. We’ve been named to the 2025 Inc. 5000 list and in the Gartner® Hype Cycle™ for U.S. Healthcare Payers (2022-2025), and ranked as a Top 5 LinkedIn™ Startup for 2023 & 2024. Backed by leading investors such as Deerfield Management, Define Ventures, Flare Capital Partners, Longitude Capital, and Polaris Partners, Cohere Health drives more transparent, streamlined healthcare processes, helping patients receive faster, more appropriate care and higher-quality outcomes. The Coherenauts, as we call ourselves, who succeed here are empathetic teammates who are candid, kind, caring, and embody our core values and principles. We believe that diverse, inclusive teams make the most impactful work. Cohere is deeply invested in ensuring that we have a supportive, growth-oriented environment that works for everyone. We can’t wait to learn more about you and meet you at Cohere Health! Equal Opportunity Statement: Cohere Health is an Equal Opportunity Employer. We are committed to fostering an environment of mutual respect where equal employment opportunities are available to all. To us, it’s personal. #LI-Remote #BI-Remote