Provider Data Management Specialist Hybrid

Provider Data Management Analyst

Are you ready to make a difference in healthcare analytics Join our Market Analytics Pricing & Solutions team as a Provider Data Management Analyst and help drive innovation accuracy and compliance in provider data management. If you thrive on solving complex challenges and collaborating with talented colleagues this is your opportunity to grow and make an impact.

Responsibilities

• Manage and maintain Healthcare Professional (HCP) contracted rates and demographic data for assigned markets ensuring accuracy and compliance.

• Lead monthly review sessions with the contracting team to ensure the best line of sight on rate schedules and projections.

• Oversee the claim match and rating area review processes driving improvements in data quality and operational efficiency.

• Collaborate with project teams to develop and test new PMT features enhancements or fixes.

• Recommend new tools or processes to enhance the Provider Management Tool and related systems.

• Ensure compliance with PMT Rate Sheet History (RSH) and Chargemaster Input Tool (CMI) policies and procedures.

• Support continuous improvement by identifying opportunities to streamline data management and reporting.

Qualifications

Required

• Strong analytical and problem-solving skills.

• Excellent written oral and group presentation communication skills.

• Understanding of managed care business processes data systems and applications for claims payment enrollment benefit design and utilization management.

• Familiarity with data mining and reporting tools such as Microsoft Excel & Access.

• Ability to work independently while managing multiple tasks and meeting deadlines.

• Experience working with claim data and familiarity with standard medical coding (CPT ICD9 HCPC preferred).

• Minimum 2 years of relevant experience.

Preferred

• Bachelors degree in Finance Economics Business Health Policy Analysis Healthcare Administration Mathematics or Statistics.

• Experience collaborating with cross-functional teams and leading process improvements.

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

At The Cigna Group 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) 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

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.