Healthcare Analytics Consultant

2 weeks ago

Morris, United States The Cigna Group Full time
Overview

The Cigna Group's Digital and Analytics division provides cutting-edge solutions that deliver actionable insights to both internal and external stakeholders, aimed at reducing healthcare expenses, enhancing outcomes, ensuring financial stability, and assessing business performance. The Advanced Supply Analytics & Design team is dedicated to realizing and implementing strategies that optimize healthcare affordability through comprehensive provider profiling and network products that guide patients to high-quality providers. This position will spearhead advanced analytics initiatives focusing on identifying top-performing providers to facilitate steerage, geographic access, network adequacy, and the design of competitively priced network offerings. Furthermore, this role will engage in the development of an advanced analytics roadmap, collaborating with the Data Science Center of Expertise to enhance technical and methodological capabilities utilizing the Analytics Platform. This position will generate insights, influence business strategies, and work in partnership with stakeholders, product management, and IT through agile delivery teams.

Are you ready to embrace this challenging opportunity and become a vital member of our team? Let's evaluate your fit:

  • Advocate for advanced analytics as a strategic asset
  • Influence business stakeholders through analytic insights
  • Develop prototypes for analytics, methodologies, modeling, and reporting to be implemented in production
  • Collaborate with production and engineering teams during deployment and monitoring phases

Role Summary

This individual contributor will be responsible for conducting sophisticated network and provider profiling analytics, generating actionable insights and resources while collaborating with agile development teams to scale solutions for maximum business impact.

Key Responsibilities:

  • Implement effective and defensible provider performance methodologies to drive steerage
  • Apply advanced analytical techniques to enhance valuation focused on cost, quality, and access
  • Monitor and predict outcomes from our provider networks effectively
  • Collaborate closely with business units (Clinical and Product) to establish and implement high-value analytics enhancements
  • Present analytic findings and recommendations to non-technical business partners and leadership to foster data-driven strategies
  • Investigate innovative solutions to business challenges

Qualifications & Competencies Required

This role necessitates knowledge of healthcare and insurance, advanced analytics expertise, and leadership capabilities. The position will enhance market value by engaging in a highly matrixed environment with business stakeholders and an Agile model that fosters and evolves new concepts and ideas to strengthen The Cigna Group's Affordability strategy.

  • A minimum of an advanced degree in a quantitative discipline such as Computer Science, Statistics, Biostatistics, Actuarial Science, Data Science, Epidemiology, or equivalent professional experience
  • 3-5 years of experience in healthcare analytics, addressing business challenges through descriptive, diagnostic, and prescriptive analytics approaches. A statistical mindset—understanding significance testing, confidence intervals, bias, and variance—is essential
  • Healthcare Analytics Expertise – 3+ years of practical experience with healthcare data (e.g., claims, eligibility, profiling, EMR), statistical and observational studies, and at least 1 year of experience with advanced analytics techniques such as episode groupers (Optum ETG, EBM, ERG, Prometheus, etc.), provider profiling, network adequacy, steerage analytics, geo-spatial & social network analytics, and risk adjustments.
  • Technical Skills - Strong technical proficiency and hands-on experience required to extract, transform, and analyze data within a cloud-based Analytics Platform using advanced tools including, but not limited to, R/Python, Tableau, ArcGIS, and geo-spatial tools; experience with model governance is preferred, and familiarity with at least one object-oriented programming language is advantageous, along with a willingness to learn Git/Github.
  • Healthcare Subject Matter Expertise – 2+ years of direct industry experience through conferences and relationship management, demonstrating strong healthcare and/or health plan business acumen for developing actionable guidance using key metrics communicated in an easily understandable manner, along with a solid understanding of healthcare and delivery system processes, and strong clinical knowledge applied to relevant analytics.
  • Proficiency in executing graph and social network analysis to define provider networks
  • Ability to consistently deliver on time while managing multiple projects simultaneously
  • Capability to navigate and contribute effectively in a highly matrixed environment with various stakeholders across the organization
  • Strong verbal and written communication skills, along with leadership abilities to collaborate with diverse matrix partners, including but not limited to clinical, actuarial, medical economics, contracting, business, marketing, and IT/IM.

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