We are seeking a highly motivated and innovative team member to join our growing and dynamic Digital & Analytics team as a Provider Contract & Network Underwriting Lead Analyst. In this role, you will conduct hospital and professional provider contract underwriting/analysis, partnering with Contracting to deliver unit cost results in line with trend/cost expectations to ensure competitive positioning within the marketplace. You will evaluate the impact of proposed terms on profitability, trend a... more details
Summary
We are seeking a highly motivated and innovative team member to join our growing and dynamic Digital & Analytics team as a Provider Contract & Network Underwriting Lead Analyst. In this role, you will conduct hospital and professional provider contract underwriting/analysis, partnering with Contracting to deliver unit cost results in line with trend/cost expectations to ensure competitive positioning within the marketplace. You will evaluate the impact of proposed terms on profitability, trend and other metrics. You will also partner with network management, medical management, and sales units to understand resulting medical expense results and improve future negotiation strategy.
Responsibilities
Analyze impact to trends and economic metrics for facility and professional contract negotiations
Leverage Hospital and Payer Transparency competitor data/insights in contract negotiation modeling
Effectively influence contracting in a strategic fashion and offer meaningful options during negotiations with a provider
Provide ad hoc analysis and deep dives into data as appropriate to support negotiation and provide value to our contracting partners
Summarize and explain findings and recommendations
Proactively identify opportunities for trend reduction and engage contracting to build these into plan where appropriate.
Keep management informed as to the progress of Plan and proactively identify risk and opportunities for meeting the plan results
Work with Provider Management Tool (PMT) Analysts to oversee corrections and update to forecasting tools
Work with matrix partners in the validation and adoption of AMP and NextGen modeling tools
Qualifications
3+ years’ industry experience solving business problems through the application of analytic approaches, particularly in analyzing medical claims experience in TMC and/or Contract Underwriting for Fee for Service and Fee for Value contracts preferred
Knowledge of standard medical coding: CPT, ICD10, HCPC ideal
Proficiency with Excel to perform data mining and reporting functions; familiarity with Access is preferred
Strong analytical and problem solving skills with ability to independently perform analyses and apply statistical models to validate / interpret results
Understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, and utilization management
Strong communication skills to include written, oral and group presentation
Ability to work independently while managing multiple tasks and meeting deadlines
Bachelor's degree in Finance, Economics, Business, Health Policy Analysis, Healthcare Administration, Mathematics or Statistics preferred
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 76,700 - 127,800 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 The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com 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.
