Operations Governance Sr Business Analyst - eviCore

520 eviCore healthcare MSI, LLC; Franklin (TN); Hybrid; USD 65,000 - 108,000; Full time

Job summary

The Operations Governance Business Sr. Analyst at Cigna Health and Life Insurance Company will assist Agile Product Owners in delivering enterprise initiatives including eviCore Platform, UCX, and UPX, collaborating with client services, claims, implementations, clinical, non-clinical, and IT to craft scope of work and level-of-effort estimates.

You will monitor operations backlogs, identify performance improvements, and translate business rules into pathway algorithms while documenting

Qualifications

• 2+ years of experience in healthcare operations or technology function.
• Proficiency with MS Word, Excel and MS PowerPoint (Visio preferred).
• Ability to learn basic SQL queries as needed.
• Ability to collaborate with various business partners & organize effectively.
• Strong verbal and written communication skills.
• Understanding of requirements creation and development.
• General understanding of conditional logic.
• Agile Experience a plus.

Responsibilities

• Gain an understanding for utilization management, claims operations, IT operations, and call center operations.
• Develop operational specific expertise in becoming a subject matter expert in the technical and operational aspects of the company.
• Provide operational expertise to client services and client operations managers in research and resolution of issues and requests.
• Work with Operations Product Owners to develop, monitor, maintain, and groom backlogs.
• Build presentations and completes analyses to assist the Operations Product Owners in communications to senior management.
• Translate business rules into pathway algorithms; evaluates existing pathways for operational efficiencies.
• Document and maintain business workflows, pathways, requirements or supports central teams that manage these functions.
• Coordinate with key leaders to execute projects.

Skills

SQL

Collaboration

Communication

Requirements gathering

Logic basics

HTML

Java

Visual Basic

Agile

Education

High School diploma or GED

Bachelor’s Degree

Tools

MS Word

MS Excel

MS PowerPoint

Visio

Job description

Are you excited about the changes that Cigna and eviCore are making using technology to streamline the UM experience for Providers, Clinicians and Clients? Have you been interested in using a more Agile framework to accomplish new initiatives? Look no further! The Operations Governance Business Sr. Analyst will assist Agile Product Owners in delivering on enterprise initiatives to include eviCore Platform, Universal Clinical Experience (UCX), and Universal Provider Experience (UPX). Additionally, this person will lead and provide subject matter expertise in collaboration with client services, claims, implementations, clinical, Non-Clinical, and IT organizations in order to develop scope of work and level of effort estimates. Finally, you’ll help monitor overall operations backlogs and identify ways to improve or enhance operational performance.

RESPONSIBILITIES

• Gain an understanding for utilization management, claims operations, IT operations, and call center operations
• Develop operational specific expertise in becoming a subject matter expert in the technical and operational aspects of the company
• Provide operational expertise to client services and client operations managers in research and resolution of issues and requests
• Work with Operations Product Owners to develop, monitor, maintain, and groom backlogs
• Build presentations and completes analyses to assist the Operations Product Owners in communications to senior management
• Translate business rules into pathway algorithms; evaluates existing pathways for operational efficiencies
• Document and maintain business workflows, pathways, requirements or supports central teams that manage these functions
• Coordinate with key leaders to execute projects

QUALIFICATIONS

• High School diploma or GED required.
• Bachelor’s Degree preferred.
• 2+ years of experience in healthcare operations or technology function.
• Demonstrated success leading initiatives toward operational improvement in technology and/or the healthcare fields
• Must have proficiency with MS Word, Excel and MS PowerPoint (Visio preferred as well)
• Ability to learn basic SQL queries as needed
• Ability to collaborate with various business partners & organize effectively
• Strong verbal and written communication skills
• Understanding of requirements creation and development
• General understanding of conditional logic.
• Ability to read HTML, JAVA, and visual basics for applications preferred.
• Agile Experience a plus

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 64,600 - 107,600 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.

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), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence.

For more details on our employee benefits programs, click here.

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.

If you need a reasonable accommodation to complete the online application process, please email [e-mail] for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

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.