Data Measurement & Reporting Advisor - Small Group Risk Operations

Data Measurement & Reporting Advisor - Small Group Risk Operations

Job Summary:

The Data Management & Reporting Advisor is a hands-on data role that will be relied on to further drive Cigna's risk adjustment accuracy in Individual and Family Plans (IFP) to be best in class. The advisor will need to use data to answer business critical questions, monitor operational activities, and develop new capabilities to further enhance the risk adjustment programs: Risk Validation Program (RVP) and Risk Adjustment Validation Audit (RADV).

The Data Management & Reporting Advisor will be expected to connect the dots and apply knowledge to future strategic discussions for IFP risk initiatives. Some of the risk operation related initiatives impact Cigna's customers directly, and the advisor will be expected to put the customer "first" in these situations - keeping a strong customer focus at all times while improving Cigna's position in the marketplace.

Upon starting in the position the advisor will need to be on the lookout for process automation and efficiency areas by proposing and then modifying the business programs/processes to streamline the day to day operations managed by the team. In addition to a continual improvement mindset the advisor will also be expected to maintain quality documentation around the business objectives and procedures that can be understood by other team members.

Core Responsibilities:

• Driving end-to-end design, proto-typing/development & deployment of processes, reporting solutions, dashboards, and analytics
• Support the medical chart retrieval and coding business processes via data and oversight
• Develop key control reporting processes and metrics to ensure data quality and mitigate emerging risks
• Continually improve existing business process and programs by coding or proposing new ways to streamline operations
• Perform analytics on business critical questions and present findings and recommendations for next steps to broader team
• Ensure code, processes, and findings are appropriately documented and can be understood by other analyst
• Maintain analytical skillset by understanding new technologies, modeling techniques, and apply those to future work
• Exhibit full understanding of data and leverage data in an appropriate way (correct sources, clear assumptions, approved by business)
• Collaborate with matrix partners across Business, Operations and IT to ensure priorities are aligned and goals are achieved
• Ensure a strong "customer centricity" focus throughout the development lifecycle

Qualifications:

• 3+ years informatics experience required

• Prior experience in database architecture, design and development & ability to make sound business decisions by analyzing data and key metrics required

• Proficiency with SQL/SAS Enterprise Guide/Python strongly preferred

• Previous management/leadership experience preferred

• Experience in automation or scheduling jobs to reduce manual intervention, experience with a software development lifecycle (SDLC) and/or Agile methodologies, and experience with Microsoft Excel functions and Pivot table preferred

• Healthcare industry experience (ideally in medical claim data) preferred

• Batch scripting experience & experience with large volume of file movement and storage preferred

• Experience with the HHS Risk Adjustment Methodology 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 Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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.