Three months ago I did the Cigna onsite for a senior SWE role on their data platform team. This was fully virtual (they call it a "virtual onsite" but it was just a full day of video calls). Here's the actual structure.
They scheduled it as a 5-hour block with 30-minute breaks built in. I had 4 scheduled interviews and then an informal 30 minutes with the hiring manager at the end.
Interview 1: Coding (60 min). Two problems on CoderPad. Java or Python, your choice. Problems were medium difficulty. I got one on array manipulation with a hash map optimization, and one that was basically a BFS traversal with some edge cases. Neither was a twist problem or a gotcha. They were testing that you write clean, working code under pressure more than they were testing obscure knowledge.
Interview 2: System design (60 min). I got a healthcare-specific prompt (something around designing a notification system for care gap alerts). The interviewers here were more senior. They pushed me on scalability, reliability (what happens when the downstream EMR system is unavailable), and how you prioritize which alerts go out when there's congestion. I mentioned Kafka, they engaged with it. I mentioned circuit breakers, they engaged with that too. Very collaborative tone, not adversarial.
Interview 3: Behavioral (45 min). Two interviewers. Heavy on leadership and conflict resolution. Questions like "describe a time you disagreed with a technical decision made by your team" and "tell me about a time you had to deliver bad news to stakeholders." Standard STAR. One interviewer took notes, one listened. Not particularly tough if you've prepped.
Interview 4: Cross-functional (45 min). This was with a product manager and someone from the clinical informatics team. They asked how I'd work with clinical stakeholders who have different velocity expectations than engineers. This felt like a culture/fit round more than a hard eval, but I was told afterward that this round influences the hiring decision meaningfully.
HM chat (30 min). Not on paper an eval. But I treated it like one. Asked good questions, showed I'd done research on what the team was building. The HM asked what I was most excited about working on. Have an answer for that.
Offer extended 6 business days later. Total process from application to offer was about 8 weeks which tracks with other reports I've seen here.