IFP Business Analytics Advisor – ACA HHS Risk Adjustment - The Cigna Group
Bloomfield, CT
About the Job
Profile Summary:
Individual & Family Plans (IFP) is a fast-paced Cigna Healthcare business unit serving the Affordable Care Act (ACA) market. In this role within Evernorth, you will join the IFP Analytics team responsible for identifying and sizing new risk adjustment opportunities that not only create better health outcomes for patients but also enable Cigna Healthcare to remain compliant and competitive in the dynamic federally regulated Risk Adjustment space.
There’s no shortage of deep dives and insights to be uncovered, and in this role, you’ll have the agency to drive real, measurable change within the healthcare ecosystem. If you’re continually curious, eager to try new things, and passionate about making a difference for your peers, the organization, and the real people Cigna Healthcare has the privilege to serve, then this role is for you!
This role will primarily focus on analytics related to the large operational activities involved in prospective outreach (encouraging members to visit their doctor) and retrospective chart reviews. This role will own, maintain, and continually enhance the targeting analytics inputs and outputs that our clinical business operations teams rely on.
Data is at the backbone of everything that this team does, and you will be viewed as a data and analytics expert. Therefore, you have experience working with large databases and combining different healthcare data domains together using SQL.
Key Responsibilities:
+ Own prospective outreach identification and impact evaluation - ensuring there is coordination between different business teams for the best patient outcome
+ Own retrospective targeting selection and impact to determine which medical records Cigna Healthcare clinicians should review for accuracy
+ Adapt quickly to changing business processes and new technologies (including clinical data integration and GenAI tech)
+ Develop clear and thoughtful materials to communicate results/recommendations to varying levels of individuals and teams within the organization
+ Navigate and lead initiatives effectively in a cross functional organization
Qualifications:
+ Bachelor’s Degree or higher in a quantitative field (e.g. mathematics, statistics, data science, business, MIS, actuarial science, finance, etc.)
+ Preferred MS/MPH in public health, statistics, economics, or related fields; or ASA/FSA
+ 3-5 years of work experience in health insurance analytics or actuarial/finance analysis
+ Strong familiarity with medical claims data
+ Experience with ACA risk adjustment scoring algorithms and targeting models
+ Strong database manipulation and SQL coding (or comparable programming experience) skills
+ Ability to work with business partners in consultative manner
+ Strong communication skills (e.g. experience translating complex analyses into easy-to-follow slides/materials)
+ Ability to independently prioritize and manage multiple responsibilities
+ Prior experience with ACA risk adjustment program strongly 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.
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._
_Qualified applicants with criminal histories will be considered for employment in a manner_
_consistent with all federal, state and local ordinances._
_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._
Individual & Family Plans (IFP) is a fast-paced Cigna Healthcare business unit serving the Affordable Care Act (ACA) market. In this role within Evernorth, you will join the IFP Analytics team responsible for identifying and sizing new risk adjustment opportunities that not only create better health outcomes for patients but also enable Cigna Healthcare to remain compliant and competitive in the dynamic federally regulated Risk Adjustment space.
There’s no shortage of deep dives and insights to be uncovered, and in this role, you’ll have the agency to drive real, measurable change within the healthcare ecosystem. If you’re continually curious, eager to try new things, and passionate about making a difference for your peers, the organization, and the real people Cigna Healthcare has the privilege to serve, then this role is for you!
This role will primarily focus on analytics related to the large operational activities involved in prospective outreach (encouraging members to visit their doctor) and retrospective chart reviews. This role will own, maintain, and continually enhance the targeting analytics inputs and outputs that our clinical business operations teams rely on.
Data is at the backbone of everything that this team does, and you will be viewed as a data and analytics expert. Therefore, you have experience working with large databases and combining different healthcare data domains together using SQL.
Key Responsibilities:
+ Own prospective outreach identification and impact evaluation - ensuring there is coordination between different business teams for the best patient outcome
+ Own retrospective targeting selection and impact to determine which medical records Cigna Healthcare clinicians should review for accuracy
+ Adapt quickly to changing business processes and new technologies (including clinical data integration and GenAI tech)
+ Develop clear and thoughtful materials to communicate results/recommendations to varying levels of individuals and teams within the organization
+ Navigate and lead initiatives effectively in a cross functional organization
Qualifications:
+ Bachelor’s Degree or higher in a quantitative field (e.g. mathematics, statistics, data science, business, MIS, actuarial science, finance, etc.)
+ Preferred MS/MPH in public health, statistics, economics, or related fields; or ASA/FSA
+ 3-5 years of work experience in health insurance analytics or actuarial/finance analysis
+ Strong familiarity with medical claims data
+ Experience with ACA risk adjustment scoring algorithms and targeting models
+ Strong database manipulation and SQL coding (or comparable programming experience) skills
+ Ability to work with business partners in consultative manner
+ Strong communication skills (e.g. experience translating complex analyses into easy-to-follow slides/materials)
+ Ability to independently prioritize and manage multiple responsibilities
+ Prior experience with ACA risk adjustment program strongly 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.
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._
_Qualified applicants with criminal histories will be considered for employment in a manner_
_consistent with all federal, state and local ordinances._
_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