Health Plan Analytics offers innovative solutions that provide actionable insights to internal and external business partners and customers that help reduce health costs, improve outcomes, provide financial security and measure/forecast business performance. The Provider Contracting and Network Performance Experience Group drives the vision and delivery of solutions to maximize healthcare affordability through the provider profiling and tiered network products for steerage to high performing providers. This role will lead a data science team focused on the identification of higher performing providers to enable steerage, geo-access, network adequacy & design of competitively affordable network products. Additionally this role will oversee an advanced analytics roadmap including working with the Data Science Center of Expertise to progress technical and methodological capabilities using the Analytics Platform. This role will provide insights, influence business strategy, and execute in partnership with stakeholders, product management and IT via agile delivery teams.
So, you’re excited and motivated to take over this challenging role by becoming the newest member of this team? Great choice! Let’s check some boxes to see if you fit the bill:
- Provide vision and thought leadership to achieve healthcare affordability
- Champion data science as a strategic capability
- Influence business partners using analytic insights
- Assemble and nurture high performing team
- Drive value through Agile development patterns
- Advance Evernorth’s affordability and analytics strategies
This person will be a leader who manages a data science team to provide analytic insights and methodology design while working with agile development teams to scale solutions for maximum business impact and flexibility.
This position is with Evernorth, a new business within the Cigna Corporation.
- Setting strategic analytics direction to optimize results from our network of provider partners
- Execute effective and externally defensible provider performance methodologies to drive steerage
- Execute and apply advanced analytical techniques to deploy robust valuation improvement focused on cost, quality and access
- Execute on effective prediction and monitoring of results from our provider networks
- Closely partner with business (Clinical and Product) to set and groom high value priorities & roadmap
- Execute the talent strategy required to achieve business needs and organizational goals by managing and cultivating a high functioning team of data scientists
- Lead proactive industry research and pre-test assessment of relevancy to Evernorth’s strategy
This position requires healthcare and insurance content knowledge, advanced analytics expertise and leadership skills related to leading highly functional data science team. Such team will drive market value by participating in a highly matrixed structure with business stakeholders and Agile model that enables and evolves new concepts and ideas to supercharge Evernorth's Affordability strategy.
- 7+ years’ of healthcare analytics industry experience solving business problems through the application of descriptive, diagnostic and prescriptive analytics approaches
- 5+ years of hands on experience with healthcare data (e.g., claims, eligibility, profiling, EMR), statistical and observational studies,
- 3+ years 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.
- Industry experience through conferences and relationship management, strong healthcare and / or health plan business acumen for developing actionable guidance using key metrics communicated in an easy to understand manner, demonstrated understanding of health care and delivery system processes, strong clinical knowledge and applications into relevant analytics
- Strong technical skills and hands on experience required to extract, transpose, and analyze Big Data housed in Teradata, Hadoop, cloud based Analytics Platform using SAS/R/Python
- Experience with advanced visualization tools including, but not limited to Tableau/R/Python, Dash app, ArcGIS and Geo-spatial tools; ML/AI, deep learning, model governance experience will be preferred, hands on experience with at least one object oriented language and version control software
- Dedicated to meeting the expectations and requirements of clients; gets first-hand customer information and uses it for improvements in products and services; acts with customers in mind. Ability to successfully navigate and contribute in a highly-matrixed business stakeholders including but not limited to product, clinical, contracting, IT/IM and Agile teams
- Ability to think strategically, anticipate future consequences and trends, and incorporate them into strategic roadmap and delivery; fast paced translation of business needs into practical applications and solutions; nimble with leveraging existing Evernorth’s solutions and data/insights assets to make informed decisions
- Experience in managing team of advanced degree equivalent analytic resources. Exceptional capacity for managing and leading people and cross-functional data science and business analytics teams; capacity to enforce accountability, develop and empower top-notch analytics staff from the bottom up, lead from the top down, cultivate entrepreneurship, and learn the strengths and weaknesses of the team so as to put people in a position to succeed
- Strong persuasion skills and effective communicator; ability to create and communicate a compelling vision internally and externally
- Advanced degree in a quantitative field such as Computer Science, Statistics, Biostatistics, Actuarial Science, Data Science, Epidemiology highly preferred
This position is not eligible to be performed in Colorado.
Evernorth, Cigna Corporation’s health services segment, exists to elevate health for all. We're building on our legacy and redefining health care as we know it. Unbiased in how we think, we create without limitation. We partner without constraints, deliver value differently and act in the interest of humanity. Solving across silos, closing gaps in care, and empowering clients, customers, and people everywhere to move onward and upward. When you work with us, you’ll be empowered to solve the problems others don’t, won’t or can’t. Join us. What difference will you make?
Cigna is an American multinational managed healthcare and insurance company based in Bloomfield, Connecticut. Its insurance subsidiaries are major providers of medical, dental, disability, life and accident insurance and related products and services, the majority of which are offered through employers and other groups.