Business Analytics Advisor (Provider Contract & Network Underwriting - Liberty Valley Market) - Hybrid
Business Analytics Advisor (Provider Contract & Network Underwriting - Liberty Valley Market) - Hybrid
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1 Vacancy
Job Description
Summary
We are seeking a highly motivated and innovative team member to join our growing and dynamic Global Data & Analytics team as a Provider Contract & Network Underwriting this role you will conducts 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 assist contractors in creating network solutions and provider contracts to ensure our competitive position in the market. You will use financial models to evaluate the impact of proposed terms on profitability trend and other metrics. You will also partner with network management medical management and sales units to understand resulting medical expense results and improve future negotiation strategy.
Responsibilities
Analyze impact to trends for facility contract negotiations
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
Independently and effectively manage the planning process for assigned markets and drive the plan to meet overall corporate planning objectives
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
Qualifications
5 years of experience in health care/managed care work experience
Strong Experience with various data mining and reporting tools such as Microsoft Excel skills Microsoft Access or SAS/SQL language
Experience in TMC and/or Contract Underwriting preferred
Experience working with claim data and familiarity with standard medical coding: CPT ICD9 HCPC preferred
Understanding of managed care business processes data systems and applications for claims payment enrollment benefit design and utilization management
Strong analytical and problem solving skills
Strong communication skills to include written oral and group presentation
Ability to work independently while managing multiple tasks and meeting deadlines
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 96000 - 160000 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.
We want you to be healthy balanced and feel secure. Thats why youll enjoy a comprehensive range of benefits with a focus on supporting your whole health. Starting on day one of your employment youll be offered several health-related benefits including medical vision dental and well-being and behavioral health programs. We also offer 401(k) with company match 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 visit Life at Cigna Group.
About Cigna Healthcare
Cigna Healthcare a division of The Cigna Group is an advocate for better health through every stage of life. We guide our customers through the health care system empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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: for support. Do not email 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.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
