Provider Relations Sr. Analyst - Evernorth - Remote

Remote Jobs; United States; Hybrid; USD 58,000 - 97,000; Full time

Job summary

The Cigna Group's Provider Service and Operations team is seeking a Provider Relations Sr. Analyst to improve provider data quality in the BoR/PRIME system and partner with IT to deliver reliable data experiences.

You will work across the business community, define requirements, guide loading rules, and identify remediation to automate data loading while supporting a strong data integrity discipline.

Qualifications

• Bachelor's degree or higher strongly preferred or equivalent work experience.
• Experience in health care/managed care with data quality analytics.
• Expertise with SAS EG, SQL and relational databases.
• Ability to analyze HCP data and load provider data into PRIME/BoR.
• Team player able to work independently with minimal supervision.

Responsibilities

• Writes business, functional and non-functional requirements and supports system design reviews.
• Identifies data elements for provider data loading to PRIME (BoR).
• Understands provider/practitioner demographics, contracts, and PRIME domains.
• Gains understanding of BoR system (PRIME) and related BoR domains.
• Determines load type (update or new) based on data analysis.
• Collaborates with matrix partners to review outcomes and loading guidelines.
• Identifies remediation needs to automate provider data loading and ensure data integrity.
• Reviews validated data elements before BoR ingestion.
• Guides the team in following system process flows.

Skills

SQL

SAS EG

Data analytics

Data quality

Provider data

Stakeholder engagement

Teamwork

Hadoop

Teradata

MS Office

Education

Bachelor's degree

Tools

Teradata

Hadoop

SQL databases

MS Office

Job description

Provider Tax Data Integrity team, work towards improving quality of data in Cigna's Provider Book of Record (BoR) system, by working together with our business partners, to create exceptional data experience for Cigna and our customers. The focus is the execution of strategic vision for enterprise data, and the delivery of quality automation, strengthens our journey to provide one of the most reliable provider data experiences in the industry.

The Provider Relations Sr. Analyst role sits within this team in Provider Service and Operations organization, working across the business community, partnering closely with IT to improve data quality and developing automation capabilities which transforms data, algorithms and processes into most reliable one stop shop for provider data.

Responsibilities:

• Writes business, functional and non-functional business requirements, actively participates in system design reviews, reviews test evidence, and participates in status meetings
• Identifies data elements required for provider data loading to PRIME (BoR)
• Understands all aspects of provider/practitioner demographics, contracts, contract management and PRIME domains
• Develops understanding of existing BoR system (PRIME) and other BoR related to HCPM
• Determines load type (update or new) based on data analysis
• Collaborate with matrix partners to review outcomes and ensure accurate loading guidelines
• Identifies remediation needs to promote increased automated loading of provider data and to support data integrity across all provider systems
• Reviews validated data elements to ensure quality of data before BoR ingestion
• Guide the team in following system process flows

Qualifications:

• Bachelor's degree or higher strongly preferred or equivalent work experience.
• Dedicated to innovation and designing new ways to work
• Knowledge and understanding of Provider Data Domains
• Knowledge of PRIME contractual structure preferred
• Ability to locate and analyze HCP data and perform data maintenance for accurate consumption; ability to extract criteria through data analytics when top-down extraction is not possible.
• Be a team player and able to work independently or with little supervision
• Experience in health care/managed care with direct responsibility for quality analytics and data management with relational database concepts
• Expertise in the use of relational database concepts and applications, specifically use of SAS EG, SQL databases and tools, MS Office Suite
• Proficiency with Structured Query Language (SQL) procedure as a data retrieval tool. Specifically, the ability to write programs to perform queries on data and retrieve data from multiple tables/sources like Hadoop, SQL server and Teradata with SAS and SQL
• Ability to navigate organization, build SME relationships and assist with internal discussions
• Strong data mining skills including the ability to perform research and conduct root cause analyses
• 1+ years of experience as a Business System Analyst highly 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 58,100 - 96,900 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.

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

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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 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.