Lead Analyst – Healthcare Economics

Lead Analyst – Healthcare Economics

Franklin, Tennessee, United States of America

Virtual, US

Category

Data & Analytics

Job Id23006712

Role Overview:

eviCore, part of Evernorth Health Services at The Cigna Group, has a diversified portfolio of proven medical cost management solutions that enable our clients to improve the quality and efficacy of care while at the same time reducing medical expense. We believe and have demonstrated that better healthcare is inherently less expensive. We are looking for an individual with a background in financial, actuarial, hospital, or medical analysis to join our Healthcare Economics team. The role of the Healthcare Economics Lead Analyst supports our data-driven culture by leveraging technology and an analytical mindset to improve company-wide operations and financial performance. The position reports on program results and identifies opportunities to enhance program effectiveness for new and existing customer relationships using claims data and revenue detail data. The Healthcare Economics Lead Analyst will report to the Manager of Healthcare Economics and will work closely with our Account Management team, Finance, Informatics, Medical, Sales and Marketing staff, including direct involvement with customers in the form of written and verbal presentations to support corporate-wide strategic decision-making that impacts revenue, medical expense and product growth. The ideal candidate will be a results-oriented individual who enjoys working in a fast-paced multitasking environment.

Role Responsibilities:

• Provide analytical support, program design assistance, and reporting of revenue and medical expense in client-facing environment.
• Work with IT and data warehousing counterparts to develop and design deliverables to support the economics team, client reconciliations, and customer reporting needs.
• Conduct baseline and trend analyses for targeted eligibility lines of business, geographies and segments.
• Calculate baseline and trend metrics (e.g., PMPM and Utilization per 1000).
• Apply analytical concepts and tools to enhance understanding of membership, utilization, cost and revenue trends across networks and products.
• Validate findings against established benchmarks.
• Monitor program effectiveness from the perspective of cost saving to both internal and external customers.
• Effectively communicate results to key stakeholders and policy makers. Communication of results include clean and well organized presentations to reflect analytic methods used, key decision points with sufficient detail to support comprehension and replication of the analysis.
• Provide analyses that support all areas of the business: pricing, claims reconciliation, eligibility and revenue reconciliation, financial operations reporting, provider network analysis, and fee schedule pricing.
• Relate analytic findings to business questions and objectives. This includes integrating information from multiple sources, discern implications for future analysis and identify opportunities for enhancing the integrity of data results.

Qualifications:

• BA/BS degree in accounting, finance, economics, statistics, math or other quantitative background.
• 4-7 years of progressive, financial operations or analytical experience in a healthcare or corporate setting.
• Experience with, or ability to quickly understanding of managed care metrics (PMPM, Utilization/K and Average Cost).
• Experience with or ability to quickly understand medical claims and membership data from Commercial, Medicaid and Medicare organizations.
• Thorough expertise using Excel.
• Ability to self-serve data via SQL is a plus
• Business intelligence software applications experience.
• Ability to reason, convince and influence internal stakeholders in order to accomplish objectives
• Ability to present performance to technical and non-technical audiences
• Desire to work with both internal and external customers with a constructive, customer-service focus.
• Demonstrate problem solving and critical thinking skills.
• Strong organizational and time management skills.

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 72,800 – 121,400 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. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll 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 Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. 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.

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.