Business Analytics Advisor - Healthcare Economics - EviCore

Cigna Health and Life Insurance Company; Franklin (TN); On-site; USD 110,000 - 160,000; Full time

Job summary

The Cigna Group is seeking a Business Analytics Advisor to join the Healthcare Economics team in Franklin, TN. The role focuses on designing, developing, and reporting on claims data using BI tools, applying actuarial concepts to understand utilization and costs across networks and geographies.

Ideal candidates bring 8+ years in healthcare analytics or actuarial/financial analysis, experience with ACO/IPA/MCO settings, and strong SQL/data warehouse skills.

Qualifications

• BA/BS degree in finance, economics, statistics or other quantitative background.
• 8+ years of progressive, analytical experience in a healthcare setting.
• Experience in ACO/IPA/MCO settings and/or bundled payments preferred.
• Knowledge of big data and data warehouses; data extractions and manipulations.

Responsibilities

• Oversee and assist in design, development, analysis and reporting of claims data.
• Calculate baseline and trend metrics (PMPM, Utilization per 1000).
• Develop Savings Forecast and Pricing and present results to stakeholders.
• Support New Sales and Product Development with analyses (IBNR, Provider Network Overlap, pricing).

Skills

Healthcare analytics

SQL/database skills

Data visualization

Education

BA/BS in finance, economics, statistics

Tools

SQL

Data warehousing

IBNR calculations

Job description

POSITION SUMMARY

EviCore’s diversified portfolio of proven medical cost management solutions enables our clients to improve the quality and efficacy of care while at the same time reducing medical spend. We believe and have demonstrated that better healthcare is inherently less expensive. We are looking for an individual with a background in medical, financial or actuarial analysis to join our Healthcare Economics team. The role of Business Analytics Advisor will be to oversee and assist in the design, development, analysis and reporting of claims data using business intelligence tools, statistical and analytical techniques to better understand healthcare trends, report on overall program results as well as identify opportunities in support of the sales team to expand our product offering to new and existing customers. The Business Analytics Advisor will report to the Business Analytics Senior Manager 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 come from a managed care, insurance, actuarial, or hospital background, and will be a results-oriented individual who enjoys working in a fast-paced and challenging environment.

ESSENTIAL FUNCTIONS

Work with IT and data warehousing counterparts to develop and design deliverables to support the economics team and customer reporting needs.

• Conduct baseline and trend analyses for targeted medical cost categories, geographies and segments.


• Calculate baseline and trend metrics (e.g., PMPM and Utilization per 1000). Apply actuarial concepts and tools to enhance understanding of utilization and cost trends across networks, products and geography. Validate findings against established benchmarks.


• Use baseline metrics and trends to establish Savings Forecast and Pricing. Creating and delivering results in an accurate and timely manner 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 additional analyses that support New Sales and Product Development by being able to manipulate and analyze claims data to perform IBNR calculations, Provider Network Overlap, Fee Schedule Pricing, trend mitigation and population mix-shifts.

QUALIFICATIONS

BA/BS degree (a Master's degree is preferred) in finance, economics, statistics or other quantitative background.

• 8+ years of progressive, analytical experience in a healthcare setting.


• Experience working in an ACO, IPA or MCO setting and/or with bundled payments is a preferred.


• Knowledge of using big data and data warehouses, data extractions, manipulations, dimension, fact, and reference tables in order to obtain necessary information.


• Extensive experience using data directly from a SQL or similar database, not simply through a present reporting GUI.


• Strong understanding of managed care metrics (PMPM, Utilization/K and Average Cost).

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.

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.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

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.