Medicare Provider Data Quality & Accuracy-Directory Data Steward - The Cigna Group
Bloomfield, CT
About the Job
Summary
The Directory Data Steward is an Advisor level role within the Provider Data Quality & Accuracy team, responsible for maintaining data lineage, business rules around data elements and documentation and usage of each element.
The team will work with multiple stakeholders across Medicare operations, as defined by the Dedicated Medicare Operating Model (DMOM) project. They will help to drive improvements in the provider data domain to ensure we meet specific goals and metrics, as defined by business and regulatory requirements.
Essential Functions and Responsibilities
+ Coordinate and partner with the key Medicare operations teams, including claims,enrollment, fulfillment, network operations, and technology, to ensure delivery of operational excellence.
+ Monitoring of provider data accuracy leading to CMS compliant provider directories aswell as assisting with improved claims auto-adjudication.
+ Work within the Data Quality management process to champion incremental improvements and deployments that result in measurable improvements in data quality, understanding the business impacts and prioritizing the data quality remediation.
+ Support the development of and oversee quality metrics and monitoring processes to ensure data integrity and accuracy. Implement data cleansing and validation procedures.
+ Identify and mitigate data-related risks. Implement and monitor controls to safeguard data assets and ensure their proper usage.
+ Track KPIs to measure the effectiveness of data governance initiatives. Provide regular reports to senior management on data governance activities and progress.
Qualifications
Candidates should model our team’s core values – Communicate Effectively and Instills Trust. They should also have the following skillset and characteristics.
Preferred Qualifications:
+ Bachelor’s degree
+ At least 5 years of relevant experience, i.e. data governance, data management.
+ The ideal candidate will have experience building their own SQL (Teradata preferred) queries, or willing to learn SQL in the first 6 months.
+ Proficiency in data governance tools and technologies is a plus.
+ Certification in data management (e.g. CDMP, DGSP) is a plus.
+ Preference given to a candidate with experience in working with credentialing data/operations.
+ Strong analytical, synthesizing, & problem-solving skills with emphasis on utilizing business processes & technology to solve business problems.
+ Demonstrated ability to work at both conceptual & detailed levels.
+ Willingness to share opinions and take risks.
+ Experience with client facing business units preferred.
+ Creative thinker with ability to think outside the box & translate strategies into actions.
+ Must possess strong organizational skills with ability to manage multiple priorities simultaneously.
+ Strong, clear, concise, and analytical written and oral communication skills.
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._
The Directory Data Steward is an Advisor level role within the Provider Data Quality & Accuracy team, responsible for maintaining data lineage, business rules around data elements and documentation and usage of each element.
The team will work with multiple stakeholders across Medicare operations, as defined by the Dedicated Medicare Operating Model (DMOM) project. They will help to drive improvements in the provider data domain to ensure we meet specific goals and metrics, as defined by business and regulatory requirements.
Essential Functions and Responsibilities
+ Coordinate and partner with the key Medicare operations teams, including claims,enrollment, fulfillment, network operations, and technology, to ensure delivery of operational excellence.
+ Monitoring of provider data accuracy leading to CMS compliant provider directories aswell as assisting with improved claims auto-adjudication.
+ Work within the Data Quality management process to champion incremental improvements and deployments that result in measurable improvements in data quality, understanding the business impacts and prioritizing the data quality remediation.
+ Support the development of and oversee quality metrics and monitoring processes to ensure data integrity and accuracy. Implement data cleansing and validation procedures.
+ Identify and mitigate data-related risks. Implement and monitor controls to safeguard data assets and ensure their proper usage.
+ Track KPIs to measure the effectiveness of data governance initiatives. Provide regular reports to senior management on data governance activities and progress.
Qualifications
Candidates should model our team’s core values – Communicate Effectively and Instills Trust. They should also have the following skillset and characteristics.
Preferred Qualifications:
+ Bachelor’s degree
+ At least 5 years of relevant experience, i.e. data governance, data management.
+ The ideal candidate will have experience building their own SQL (Teradata preferred) queries, or willing to learn SQL in the first 6 months.
+ Proficiency in data governance tools and technologies is a plus.
+ Certification in data management (e.g. CDMP, DGSP) is a plus.
+ Preference given to a candidate with experience in working with credentialing data/operations.
+ Strong analytical, synthesizing, & problem-solving skills with emphasis on utilizing business processes & technology to solve business problems.
+ Demonstrated ability to work at both conceptual & detailed levels.
+ Willingness to share opinions and take risks.
+ Experience with client facing business units preferred.
+ Creative thinker with ability to think outside the box & translate strategies into actions.
+ Must possess strong organizational skills with ability to manage multiple priorities simultaneously.
+ Strong, clear, concise, and analytical written and oral communication skills.
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
