Healthcare Analytics Consultant

1 week ago

Morris, United States The Cigna Group Full time
Overview

The Digital and Analytics division provides cutting-edge solutions that deliver actionable insights to both internal and external business partners and clients, aiming to lower healthcare expenses, enhance outcomes, ensure financial stability, and assess/forecast business performance. The Advanced Supply Analytics & Design team spearheads the vision and implementation of solutions to optimize healthcare affordability through provider profiling and network products designed for directing patients to high-performing providers. This position will focus on advanced analytics to identify superior providers, facilitating steerage, geographic access, network adequacy, and the design of competitively priced network products. Furthermore, this role will collaborate on the advanced analytics roadmap, engaging with the Data Science Center of Expertise to enhance technical and methodological capabilities using the Analytics Platform. This position will provide 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 key strategic asset
  • Influence business partners through analytic insights
  • Develop prototypes for analytics, methodologies, modeling, and reporting for production deployment
  • Collaborate with production and engineering teams during deployment and monitoring phases

Role Summary

This individual contributor will be responsible for executing advanced network and provider profiling analytics, generating actionable insights and resources while collaborating with agile development teams to maximize 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 promote 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 drive market value by engaging in a highly matrixed environment with business stakeholders and an Agile model that fosters the evolution of new concepts and ideas to enhance 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 experience
  • 3-5 years of experience in healthcare analytics, addressing business challenges through descriptive, diagnostic, and prescriptive analytics approaches. A statistical mindset, including 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, provider profiling, network adequacy, steerage analytics, geo-spatial & social network analytics, and risk adjustments.
  • Technical Skills - Strong technical abilities and hands-on experience are required to extract, transpose, and analyze data stored in cloud-based Analytics Platforms using advanced tools, including 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, strong understanding of healthcare and/or health plan business for developing actionable guidance using key metrics presented in an easily understandable manner, and a demonstrated comprehension of healthcare and delivery system processes, along with strong clinical knowledge applicable 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
  • Capacity to navigate and contribute effectively in a highly matrixed environment with diverse stakeholders across the organization
  • Excellent verbal and written communication skills to collaborate with various matrix partners, including clinical, actuarial, medical economics, contracting, business, marketing, and IT/IM.

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