Business Analytics Senior Advisor

Key Skills

Apache Hadoop, Data extraction, Python Programming, SAS

Job Description

The Business Senior Analytics Advisor will be individual contributor responsible for conducting advanced analytics supporting value-based care capabilities with Cigna/Evernorth Accountable Care in partnership with VillageMD. This role will be responsible for executing advanced analytics around ACO/Risk Bearing Entity program design, financial modeling, discovery analytics and network design analytics. This individual will work collaboratively with key technical and non-technical matrix partners inclusive of clinical, network and affordability to provide innovative analytical solutions by executing effective and defensible value-based care program/network, reimbursement model and evaluation. This role will require foundational understanding of value-based care programs, program design, content healthcare domain knowledge, healthcare data knowledge and technical analytical expertise.

Responsibilities

• Collaborate and work closely with stakeholders to design and evaluate Value Based Payment programs. Example areas include hospital and physician Accountable Care Organization (ACO) programs, Episodes of Care/Bundle programs, Nephrology, Oncology Medical Home, etc

• Apply robust and appropriate statistical and clinical rigor using advanced analytic techniques including but not limited to risk adjustment, episode analytics (ETG, Prometheus etc.), statistical modeling, power analysis, matched case control studies etc

• Build financial models and contract modelling for new VBC programs and test and learn pilots for accelerated learnings

• Conduct rationalization analytics to help prioritize within and between new initiatives and pilot ideas in VBC space

• Conduct network analytics for clinically network provider selections for risk bearing entities

• Derive actionable insights from healthcare data (claims, clinical, pharmacy, externally sourced) to engage and enable our provider/clinical partners. Support IM/IT to deploy the actionable insight into accessible solutions for our provider/clinical partners

• Present analytic findings and recommendations to non-technical business partners and leadership to drive data driven strategies

• Explore innovative solutions to business questions/problems

• Manage analytics process, including data and analytic development. Ensure code is appropriately documented and can be understood by other analysts

• Closely partner with business (Evernorth Accountable Care, Clinical, Product) to set and groom high value priorities & roadmap

• Closely partner with IT to validate and scale network health, program KPIs, and reporting

• Focus on providing thought leadership and technical expertise across multiple disciplines

• Understand how our analytics affect the broader business and bridge gap between data science and stakeholders

Qualifications

• 5+ years’ of healthcare analytics industry experience solving business problems through the application of descriptive, diagnostic and prescriptive advanced analytics approaches using statistical methodologies

• 3+ years direct experience in primary care and/or specialty care value-based programs, program design (ACO, bundles, episodes, etc.), value drivers, referral management, etc

• Strong understanding on provider value-based contracting, financial/ reimbursement models (upside/downside, bundles, capitation), design, implementation and monitoring of value-based contracts

• Required experience and training with advanced analytics techniques like episode groupers (Optum ETG, EBM, ERG, Prometheus etc.), provider profiling, network adequacy, steerage analytics, geo-spatial & social network analytics, risk adjustments etc

• Strong technical skills and hands on experience required to extract, transpose, and analyze healthcare Big Data housed in Teradata, Hadoop, cloud based Analytics Platform using SAS/Python/R

• Senior consultant providing counsel and advice to top management on significant technical matters often requiring coordination between organizations; focuses on providing thought leadership across multiple disciplines; recognized internally as “the go-to person” for the most complex analytical assignments in relevant subject matter areas

• Expert-level analytics professional providing content/professional leadership on complex assignments/projects; exercising considerable creativity, foresight, and judgment in conceiving, planning, and delivering initiatives; uses deep analytics knowledge and acumen to advise functional leaders; focuses on providing thought leadership within own discipline but works on broader projects, which require understanding of wider business

• Demonstrated experience in challenging problems and driving outstanding results

• Experience blending creativity, relentless problem-solving, and business acumen

• Strong verbal/written communication skills to work with various matrix partners, including but not limited to actuarial, medical economics, business, marketing, and IT/IM

• Bachelor’s or Advanced degree highly preferred in fields of Statistics, Biostatistics, Econometrics, Economics, Actuarial Science, or Data Science or equivalent work experience

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 107,900 - 179,900 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.