Business Analytics Advisor (Medicare Advantage TMC) - Hybrid - The Cigna Group
Franklin, TN
About the Job
Summary
The Medical Economics Business Analytics Advisor role will support the total medical cost analytics for the Government Business Segment (Primarily Medicare Advantage business). This role will be responsible for developing medical expense analysis, detailed data drill downs of trend drivers, and execution of key initiatives designed to address medical cost trend.
The ideal candidate will have a collaborative and creative mindset and be able to:
+ Creatively solve problems to drive results through use of project management, technology, and processes
+ Consistently improve the department through positive attitude, attention to detail, and thorough documentation of deliverables
+ Effectively manage projects using agile principles
+ Handle ambiguity well
This position will have exposure to a broad spectrum of the Government Business Segment as findings and reports will be shared with various departments including but not limited to: Finance, Risk Management, Operations, Contracting, Provider Relations, Health Services, Product, and local market leadership.
Responsibilities
+ Monthly analysis of financial performance across key markets and payment methodologies
+ Developing business relationships in multiple markets to determine actionable insights to be developed by the team
+ Influence adoptions of key cost-saving initiatives with key matrix partners
+ Support matrix partners with ad hoc needs and user story development for broader analytics organization efforts
+ Become an expert in CMS reimbursement methodologies and understand how to identify trends and hot spots by payment area
+ Monitor industry publications and assess internal data against rising industry "hot spots"
+ Assessing payment changes and financial impacts to our organization (e.g., IPPS, OPPS, ASC, SNF rate change evaluation exercises)
+ Create monthly highlights to assist markets in focusing efforts and identification of actionable trend drivers
Qualifications
+ 5+ years’ experience in healthcare analytics
+ Experience with CMS healthcare data (MMR, Claims, Eligibility, Provider) and/or CMS payment methodologies (IPPS, OPPS, etc) preferred
+ Familiarity with medical and pharmacy claims, ICD10, DRG, APC, HCPCS, CPT highly desired
+ Experience using Excel, SQL and Tableau; experience with Python highly desired
+ Experience with Teradata, Hadoop, or other big data platforms
+ Strong interpersonal skills that can be leveraged to deliver market focused presentations to our customers and provide interpretation of analysis performed
+ Excellent oral and written communication skills
+ Ability to present meaningful results to a business audience
+ Passionate about delivery of valuable BI products to drive insight-based decision making
+ Proven ability to work effectively in a matrixed environment
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 95,200 - 158,600 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.
We want you to be healthy, balanced, and feel secure. That’s why 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) with company match, 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, visit Life at Cigna Group .
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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._
The Medical Economics Business Analytics Advisor role will support the total medical cost analytics for the Government Business Segment (Primarily Medicare Advantage business). This role will be responsible for developing medical expense analysis, detailed data drill downs of trend drivers, and execution of key initiatives designed to address medical cost trend.
The ideal candidate will have a collaborative and creative mindset and be able to:
+ Creatively solve problems to drive results through use of project management, technology, and processes
+ Consistently improve the department through positive attitude, attention to detail, and thorough documentation of deliverables
+ Effectively manage projects using agile principles
+ Handle ambiguity well
This position will have exposure to a broad spectrum of the Government Business Segment as findings and reports will be shared with various departments including but not limited to: Finance, Risk Management, Operations, Contracting, Provider Relations, Health Services, Product, and local market leadership.
Responsibilities
+ Monthly analysis of financial performance across key markets and payment methodologies
+ Developing business relationships in multiple markets to determine actionable insights to be developed by the team
+ Influence adoptions of key cost-saving initiatives with key matrix partners
+ Support matrix partners with ad hoc needs and user story development for broader analytics organization efforts
+ Become an expert in CMS reimbursement methodologies and understand how to identify trends and hot spots by payment area
+ Monitor industry publications and assess internal data against rising industry "hot spots"
+ Assessing payment changes and financial impacts to our organization (e.g., IPPS, OPPS, ASC, SNF rate change evaluation exercises)
+ Create monthly highlights to assist markets in focusing efforts and identification of actionable trend drivers
Qualifications
+ 5+ years’ experience in healthcare analytics
+ Experience with CMS healthcare data (MMR, Claims, Eligibility, Provider) and/or CMS payment methodologies (IPPS, OPPS, etc) preferred
+ Familiarity with medical and pharmacy claims, ICD10, DRG, APC, HCPCS, CPT highly desired
+ Experience using Excel, SQL and Tableau; experience with Python highly desired
+ Experience with Teradata, Hadoop, or other big data platforms
+ Strong interpersonal skills that can be leveraged to deliver market focused presentations to our customers and provide interpretation of analysis performed
+ Excellent oral and written communication skills
+ Ability to present meaningful results to a business audience
+ Passionate about delivery of valuable BI products to drive insight-based decision making
+ Proven ability to work effectively in a matrixed environment
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 95,200 - 158,600 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.
We want you to be healthy, balanced, and feel secure. That’s why 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) with company match, 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, visit Life at Cigna Group .
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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._
Source : The Cigna Group
