Medical Economics Manager - Individual & Family Plans

Key Skills

Apache Hadoop, C Programming, C++, Data science techniques, Java Programming, Machine learning techniques, MapReduce, Python Programming, PyTorch, R Programming, Scala Programming, SQL, TensorFlow

Job Description

In this role, you will have the opportunity to lead a team and deliver analyses that proactively identify areas of risk and opportunity as it relates to medical, behavioral, and pharmacy experience for Cigna’s Individual & Family Plans (IFP) – a fast-growing and dynamic business segment. This role will work collaboratively with a variety of key stakeholders in the IFP market, including partners in finance, actuarial, network operations & analytics, risk management, etc.

You will be responsible for supporting the segment’s network and provider strategy through reporting and analyses on medical expense trend, utilization rates & patterns, expansion market analysis, provider value-based contracting, etc. You will form consultative partnerships and balance multiple stakeholder requests concurrently to become a trusted partner across the IFP business.

Responsibilities

• Consult independently with stakeholders across the IFP business to prioritize and define key strategic analyses, particularly around financial performance and claim experience
• Support the development, reporting and evaluation of Fee-For-Value provider contracts
• Oversee national & market-level trend analytics & reporting to identify emerging risks/opportunities
• Partner with various stakeholders to design and evaluate incentive payment processes across the segment
• Develop clear and thoughtful materials to communicate results/recommendations to business partners
• Work effectively and efficiently on multiple tasks and deadlines, while producing high quality results
• Ensure quality and integrity of data collected and analyses performed
• Conduct additional in-depth research with goal of breaking new ground in business data analytics and challenge the status quo
• Manage the documentation process and analysis design to ensure reusability and understanding for others

Qualifications

• 3+ years’ healthcare or related experience solving business problems through the application of analytic approaches
• Strong Excel & SQL skills with self-driven perspective towards researching and understanding various financial and operational issues
• Ability to quickly and effectively learn relevant technology/software to wrangle data and perform analytics (SQL, SAS, Teradata, Tableau or other visualization software)
• Proven track record of extracting meaningful insights form large and complex data sets using creativity, relentless problem-solving, and business acumen
• Familiarity with medical and pharmacy claims, ICD10, DRG, APC, HCPCS, CPT considered a plus

This position is not eligible to be performed in Colorado.

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you’ll enjoy meaningful career experiences that enrich people’s lives. What difference will you make?