Role Summary:

Data Analyst for our Pre/Post Pay Edit editing program. This position will provide the technical component of our Pre/Post Pay Edit editing program in development, implementation, production monitoring and maintenance of our internal Pre Pay edits. Individual will work with our matrix partners to evaluate edit ideas and use business requirements to develop the technical processes to obtain desired results and support strategic initiatives aimed at improving claim accuracy and operational efficiency. Strong technical coding experience will be needed to be successful in this role.

Key Responsibilities:

• Act as technical analyst for Proactive Claim Intervention projects and daily tasks for all aspects of our Pre/Post Pay Edit editing program.
• Data Analyst for the development, installation, execution and maintenance of our Pre/Post Pay Edit editing program.
• Develop and maintain editing on regular and ad-hoc basis, primarily using SAS, Microsoft SQL Server and internally developed ARM rule-based claim editing platform
• Responsible for data mining activities and technology integration of Pre/Post Pay Correction Program to support our Pre/Post Pay Edit editing program.
• Evaluates and appropriately utilizes various approaches to data mining to narrow in on trends and drivers that directly impact outcomes.
• Makes well-thought-out decisions on complex or ambiguous IT architecture issues.
• Participate in all phases of Pre/Post Pay Edit program IT architecture process testing and implementation.
• Ensures that system improvements are successfully implemented and monitored to increase efficiency.
• Works closely with matrix business partners to define data needs, opportunities for improvement and effectively communicates results of analysis and solutions.
• Acts as a resource for mentorship, training and guidance for junior staff.

Required Qualifications:

• Bachelor’s degree or higher strongly preferred in Business Analytics, Data Science, Information Systems, or a related field, or equivalent work experience required.
• 5+ years of experience in healthcare data analytics required.
• 5+ years coding experience required, with proficient skills using SAS and Microsoft SQL Server highly preferred.
• Experience with rule-based editing platforms desired.
• 5+ years of experience in healthcare data with proficient skills in medical analysis and project management.
• Strong data investigation skills to mine healthcare data required.
• Experience with Word, Outlook, PowerPoint, Teams, Webex, Excel (pivot tables/VLOOKUP preferred).
• Strong data analysis skills with the ability to analyze large amounts of healthcare data to translate complex data into meaningful, actionable insights
• Strong project management skills and comfort in ability to create and achieve success in highly matrixed environment.
• Exceptional verbal and written communication skills with demonstrated ability to research, problem solve, trouble shoot, influence and partner across the organization to a drive toward resolution for the client, provider and organization.
• Strong presentation skills. Able to prepare, deliver, and ensure understanding of information regarding any customer-related or process improvement topic across audiences.
• Demonstrated ability to work independently and drive to objectives.

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.

For this position, we anticipate offering an annual salary of 77,500 - 129,100 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here.

About The Cigna Group:

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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: See Yourself@cigna.com for support. Do not email See Yourself@cigna.com 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.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.