Summary

Supports the medical cost position of assigned markets through analysis of healthcare provider contracts, analysis of high performing network solutions, analysis of medical expense reports, data drill downs of trend drivers, and execution of key initiatives designed to address medical expense and product pricing trends.  Partners with network management and pricing units to deliver medical expense results in line with trend/cost expectations to ensure strong competitive positioning within the marketplace.

Responsibilities

• Provide analytical and strategic support of health care provider rate negotiations

• Identify opportunities for medical cost reduction, lead action plan development, and drive execution

• Assess the cost and quality efficiency of health care providers

• Collaborate with network team to develop and maintain high performing network solutions

• Assess competitiveness of standard and high performing network products

• Analyze reports and present findings to business partners at various levels of the organization

• Support business partners and team members on an ad hoc basis as needed to support various integral business needs

• Maintain strong communication with other analysts to identify new opportunities and share best practices

• Mentor/train direct report, other analysts and business partners

• Own tracking tool maintenance and institute data validation processes

• Collaborate with developers on tool enhancements

Qualifications

• 5+ years' experience with health care data analysis required

• Technical sophistication with various data mining and business intelligence tools such as SAS, SQL and advanced Microsoft Excel skills

• Knowledge of standard medical coding including CPT-IV, ICD-10, DRG, revenue codes, and HCPCS

• Understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, and utilization management

• Experience with medical cost trend analysis and health care provider contract analysis preferred

• Strong analytical and problem-solving skills with a proven track record of success

• Ability to independently perform data analysis while managing multiple projects and meeting strict deadlines

• Strong ability to validate and interpret results

• Ability to influence and drive strategic planning and execution through engagement of business partners, education on key drivers and actionable levers, and thorough understanding of market-level dynamics

• Strong communication skills to include written, oral, and group presentation

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 112,800 - 188,000 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.

At The Cigna Group, 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), 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, click here.

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: [email protected] for support. Do not email [email protected] 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.