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This position reports to the Business Analytics Manager for Provider Advanced Analytics and is responsible for a wide variety of operational and financial analysis related to the Medicare Advantage business. The broader organization, Medical Economics, has responsibility for analytics in support of key business partners in our Finance, Provider Networks, and local Market teams.
This role will have a wide variety of responsibilities across the business analytics continuum including project management, data wrangling, subject expertise, data analysis, storytelling, and design/visualization. The provider advanced analytics team develops products to analyze network performance (quality, referral patterns, etc.), advanced clinical models (episodes of care, other FFV programs), and also support clinical member stratification (predictive modeling). Other various reporting and research needs include: medical and pharmacy expense trends, membership demographics, social determinants of health, chronic conditions, health outcomes, value based care, STAR/HEDIS measures, risk stratification, hospital utilization, care gaps, episodes of care and data modeling.
The ideal candidate will be able to:
Work collaboratively and partner with departments across the organization to ensure deliverables are accomplished
Be able to handle ambiguity and drive results through use of technology, stakeholder engagement and creativity
Analyze complex end user needs to determine optimal means of meeting deliverables
Consistently improve the department through positive attitude, attention to detail and thorough documentation of deliverables
Willingness to learn and apply new skills to improve processes
Strong organization skills and detail oriented
Extract and analyze of large healthcare claims data using SAS, SQL, R, Python, Teradata etc. Perform descriptive, and multivariate statistical analyses Analyze and track performance indicators including: STARs/Hedis measures, standards of care, health outcomes and evidence based practices where applicable Use Prometheus Episodes of Care, Optum ETGs, or other episode grouper to help evaluate network/provider performance Analyze market dynamics between PPO and HMO products as it relates to provider/member behavior Report development and execution Find root causes/opportunities within big data and work with business leaders and operators to answer complex healthcare questions.
Build dashboards using various reporting tools (i.e., Tableau, Excel, SAS, R (ggplot, matplotlib etc.)) with a focus on performance and UI design
Identify areas that need attention by business leaders and clarify which factors influence behavior
Visualize relationships and patterns within data
Bachelor's Degree in Public Health, Business, Finance, Analytics, Biostatistics, Statistics, Mathematics, or equivalent training.
Minimum 1 year experience in analytics; or any combination of education and experience.
Experience using SQL, Excel, Python, Tableau, SAS, or R
Strong interpersonal skills that can be leveraged to deliver market focused presentations to our customers and provide interpretation of analysis performed.
Excellent oral and written communication skills
Ability to present meaningful results to a business audience
Passionate about delivery of valuable BI products to drive insight-based decision making
Experience with CMS healthcare data (MMR, Claims, Eligibility, Provider)
Understanding of provider performance and innovation (APM Framework, CMS Innovation Center)
Familiarity with medical and pharmacy claims, ICD10, DRG, APC, HCPCS, CPT
Experience with Teradata, Hadoop, or other big data platforms
Experience using GIT for code versioning and automated deployments
Experience with Modern analytic app development in Python - Plot.ly Dash, R Shiny, D3, Flask, etc
Qualified applicants will be considered without regard to race, color, age, disability, sex (including pregnancy), childbirth 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 an accommodation based on your physical or mental disability please email: SeeYourself@cigna.com. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.