Business Analytics Lead Analyst-Work from Home-eviCore

The Business Analytics Lead Analyst role will support the Claims Operations department, maintaining a strong focus on facts and data to understand the quality of claims data and claims repricing A/R reconciliation. The Business Analytics Lead Analyst should be proficient in SAS, SQL, sample audits, claims A/R reconciliation, assisting in the development and enhancement of quality measures, implementing quality inspections, and analyzing results to improve quality outcomes.

• Develop reporting and proactively monitor claims data, communicate decisive and distinct information on impacts through various analytic techniques on issues related to business, programs, processes and technology.
• Identify areas of improvement, analyze root cause, gather data, conduct analysis and recommend controls or other actions to ensure accuracy of claims data, adherence to internal and contracted SLAs, and scorecard measurements, as well as CMS and state compliance.
• Conduct baseline and trend analyses related to claims processing and repricing A/R reconciliation for Commercial, Medicaid and Medicare lines of business, member network markets, clients and programs.
• Effectively communicate results to key stakeholders and policy makers. Communication of results include clean and well organized presentations to reflect analytic methods used, key decision points with sufficient detail to support comprehension and replication of the analysis.
• Actions have significant impact on key department objectives.

Essential Functions:

• Define reporting strategies in order to optimize the use of claims data to effectively meet the organizations business objectives as it relates to claims and claim related processes.
• Participate in the definition of the database requirements; analyze existing models and reports in order to improve their efficiency and resolve technical problems.
• Gather and define baseline business metrics primarily to illustrate impact of business to Executives, Business Owners, and Process Owners.
• Establish and utilize trending analysis to identify opportunities in claims processes, business and program processes, repricing A/R reconciliation.
• Analyze the quality of input data from clients and internal departments
• Partners with departments to analyze problems and recommend improvement opportunities associated with business processes.
• Skilled in managing multiple complex, time sensitive projects designed to deliver targeted outcomes.
• Organize efforts to identify, prioritize and assess the impacts of business process problems and consumption defects
• Can lead efforts to develop data collection plans and data reporting

Required Skills:

• Experience working in Healthcare Commercial, Government Business/Medicare/Medicaid
• Experience with medical claims, fee schedules, provider and membership data from Commercial, Medicaid and Medicare organizations.
• Experience managing and working with financial reconciliation of claims A/R.
• Solid research skills.
• Advanced Excel skills - v-lookups, macros, pivot tables
• Strong SQL and SAS experience
• Exceptional analytical and conceptual thinking skills
• Strong communication skills to include written, oral, and group presentations
• Highly organized, detail-oriented, with strong documentation skills
• Deep healthcare claims data analysis experience
• Ability to independently perform data analysis while managing multiple projects and meeting strict deadlines

Competencies:

• Problem Solving
• Action Oriented
• Decision Quality
• Situational Adaptability
• Being Resilient
• Resourcefulness
• Optimizes Work Processes
• Interpersonal Savvy
• Process Efficiency Focus
• Problem Resolution
• Team player with the ability to perform analytical work independently
• Adept in quickly gaining thorough understanding of business processes
• Ability to present performance to technical and non-technical audiences
• Exceptional attention to detail
• Performs other duties as assigned

Preferred Skills:

• Business intelligence software applications experience, preferred
• Experience with Tableau, MicroStrategy, preferred
• Knowledge of 835 and 837 X12 processes, preferred

Minimum Education, Licensure and Professional Certification requirement:

• Bachelor's degree strongly preferred, ideally in Healthcare Analytics, Mathematics, Economics, Statistics or related field

Minimum Qualifications required :

5+ years in financial operations and analytical experience in a healthcare, with focus on claims data and claim data financial reconciliations

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 70,400 - 117,400 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.

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives. What difference will you make?

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.

Cigna 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.