Business Analytics Advisor (Northeast Market) - Hybrid - The Cigna Group
Manchester, NH
About the Job
Summary
Cigna is seeking a highly motivated and innovative team member to join our growing and dynamic Global Data & Analytics team as a Provider Contract & Network Underwriting Advisor for the Northeast Market's Team, concentrating on Maine, Massachusetts, New Hampshire, Rhode Island and Vermont providers. In this role, you will assist contractors in creating network solutions and provider contracts to ensure Cigna’s competitive position in the market. You will use financial models to evaluate the impact of proposed terms on profitability, trend and other metrics. You will also partner with network management, medical management, and sales units to understand resulting medical expense results and improve future negotiation strategy.
Responsibilities
+ Effectively influence contracting in a strategic fashion and offer meaningful options during negotiations with a provider
+ Independently and effectively manage the planning process for assigned markets and drive the plan to meet overall corporate planning objectives
+ Proactively identify opportunities for trend reduction and engage contracting to build these into plan where appropriate
+ Work with PCD and Pro fee analysts to oversee corrections and update to forecasting tools
+ Provide ad hoc analysis and deep dives into data as appropriate to support negotiation and provide value to our contracting partners
+ Summarize and explain findings and recommendations
+ Mentors Jr UWs
Qualifications
+ 5+ years of experience in health care/managed care work experience
+ Experience in TMC and/or Contract Underwriting preferred
+ Strong analytical and problem solving skills
+ Strong communication skills to include written, oral and group presentation
+ Understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, and utilization management
+ Familiarity various data mining and reporting tools, such as Microsoft Excel skills Microsoft Access, or SAS/SQL language
+ Ability to work independently while managing multiple tasks and meeting deadlines
+ Experience working with claim data and familiarity with standard medical coding: CPT, ICD9, HCPC preferred
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.
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._
Cigna is seeking a highly motivated and innovative team member to join our growing and dynamic Global Data & Analytics team as a Provider Contract & Network Underwriting Advisor for the Northeast Market's Team, concentrating on Maine, Massachusetts, New Hampshire, Rhode Island and Vermont providers. In this role, you will assist contractors in creating network solutions and provider contracts to ensure Cigna’s competitive position in the market. You will use financial models to evaluate the impact of proposed terms on profitability, trend and other metrics. You will also partner with network management, medical management, and sales units to understand resulting medical expense results and improve future negotiation strategy.
Responsibilities
+ Effectively influence contracting in a strategic fashion and offer meaningful options during negotiations with a provider
+ Independently and effectively manage the planning process for assigned markets and drive the plan to meet overall corporate planning objectives
+ Proactively identify opportunities for trend reduction and engage contracting to build these into plan where appropriate
+ Work with PCD and Pro fee analysts to oversee corrections and update to forecasting tools
+ Provide ad hoc analysis and deep dives into data as appropriate to support negotiation and provide value to our contracting partners
+ Summarize and explain findings and recommendations
+ Mentors Jr UWs
Qualifications
+ 5+ years of experience in health care/managed care work experience
+ Experience in TMC and/or Contract Underwriting preferred
+ Strong analytical and problem solving skills
+ Strong communication skills to include written, oral and group presentation
+ Understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, and utilization management
+ Familiarity various data mining and reporting tools, such as Microsoft Excel skills Microsoft Access, or SAS/SQL language
+ Ability to work independently while managing multiple tasks and meeting deadlines
+ Experience working with claim data and familiarity with standard medical coding: CPT, ICD9, HCPC preferred
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.
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._
Source : The Cigna Group
