Business Analytics Lead

1 week ago


Tucson, Arizona, United States The Cigna Group Full time

About the Role

The Cigna Group is seeking a highly motivated and innovative team member to join our growing and dynamic Digital & Analytics team as a Provider Contract & Network Underwriting Lead Analyst. In this role, you will conduct hospital and professional provider contract underwriting/analysis, partnering with Contracting to deliver unit cost results in line with trend/cost expectations to ensure competitive positioning within the marketplace.

Key Responsibilities

  • Analyze the impact of proposed terms on profitability, trend, and other metrics for facility and professional contract negotiations.
  • Leverage Hospital and Payer Transparency competitor data/insights in contract negotiation modeling.
  • Effectively influence contracting in a strategic fashion and offer meaningful options during negotiations with a provider.
  • Provide ad hoc analysis and deep dives into data as appropriate to support negotiation and provide value to our contracting partners.
  • Summarize and explain findings and recommendations.
  • Proactively identify opportunities for trend reduction and engage contracting to build these into plan where appropriate.
  • Keep management informed as to the progress of Plan and proactively identify risk and opportunities for meeting the plan results.
  • Work with Provider Management Tool (PMT) Analysts to oversee corrections and update to forecasting tools.
  • Work with matrix partners in the validation and adoption of AMP and NextGen modeling tools.

Requirements

  • 3+ years' industry experience solving business problems through the application of analytic approaches, particularly in analyzing medical claims experience in TMC and/or Contract Underwriting for Fee for Service and Fee for Value contracts preferred.
  • Knowledge of standard medical coding: CPT, ICD10, HCPC ideal.
  • Proficiency with Excel to perform data mining and reporting functions; familiarity with Access is preferred.
  • Strong analytical and problem-solving skills with the ability to independently perform analyses and apply statistical models to validate/interpret results.
  • Understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, and utilization management.
  • Strong communication skills to include written, oral, and group presentation.
  • Ability to work independently while managing multiple tasks and meeting deadlines.
  • Bachelor's degree in Finance, Economics, Business, Health Policy Analysis, Healthcare Administration, Mathematics, or Statistics preferred.


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