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Medicare Revenue Financial Strategist

2 months ago

Nashville, Tennessee, United States Cigna Full time

The role of the Medicare Revenue Financial Strategist within the Medicare Advantage Revenue Finance Team presents a unique opportunity to contribute to our quarterly financial projections and offer strategic insights to leadership regarding the tracking of the company's Medicare Revenue. This position involves collaboration with various stakeholders to establish our risk adjustment strategy.

Reporting directly to the Medicare Advantage Revenue Finance lead, this role will engage with both the broader Medicare finance and operations teams to ensure that suitable risk adjustment objectives are formulated, established, and assessed regularly. This position demands a high degree of independence, analytical skills, critical thinking, creativity, business insight, and persistent problem-solving abilities to effectively assist business partners in reaching their objectives.

Key Responsibilities

  • Evaluates the factors influencing the company's historical Medicare Advantage revenue patterns and compiles essential insights for segment leadership on an annual basis.
  • Projects Medicare Advantage revenue trends for the organization for up to five years ahead.
  • Collaborates with risk adjustment and market-facing business partners to ensure that appropriate risk adjustment targets are set and integrated into reporting and forecasts.
  • Facilitates monthly discussions with leadership regarding risk adjustment progress, priorities, and significant risks and opportunities.
  • Assists analytics partners in assessing risk adjustment initiatives, including both prospective and retrospective coding efforts.
  • Develops and manages tools to measure and report on the progress of prospective coding initiatives.
  • Demonstrates substantial independence, foresight, and judgment in completing tasks.
  • Acquires and maintains an advanced understanding of Medicare Advantage risk adjustment and effectively communicates emerging developments to colleagues.
  • Utilizes existing tools while continuously striving for enhanced data assets and processes.
Qualifications
  • Bachelor's Degree in Finance, Actuarial Science, or a related field is strongly preferred.
  • A minimum of 4 years of experience in developing financial models and using SQL to manipulate large datasets.
  • Experience in collaborating and coordinating across teams to achieve objectives.
  • Proven ability to communicate complex subjects to a non-technical audience.
  • Preference for candidates with some knowledge of Medicare Advantage and risk adjustment.
  • Actuarial experience is a plus, but not mandatory.