Senior Medical Cost Analytics Advisor (Remote)

cigna; United States; Remote; USD 113,000 - 188,000; Full time

Benefits offered by this job

Annual bonus plan

Medical, dental, vision coverage

401(k)

Paid holidays and PTO

Remote-friendly work setup

Job summary

Cigna is seeking a senior analytics professional to provide advanced support for medical cost and payment integrity initiatives. You will translate complex claims and financial data into clear business cases and leadership-ready materials, guiding strategic decisions.

Responsibilities include building forecasts, performing variance analyses, and delivering dashboards and scorecards. You will collaborate across finance, clinical, and vendor teams to optimize spend and elevate data quality and

Qualifications

• Bachelor's degree or equivalent experience in a quantitative field.
• 8+ years of progressive medical cost analytics and payment integrity experience.
• Hands-on experience with SQL, Excel, SAS, Tableau, Databricks or similar.
• Knowledge of MS-DRG, APC, HCPCS, RBRVS coding and reimbursement basics.
• Experience applying advanced analytics and automation with measurable value.
• Ability to explain complex findings to senior audiences across functions.

Responsibilities

• Analyze trends, risks, and savings opportunities across cost containment and payment integrity.
• Build financial impact assessments, forecasts, and performance recommendations.
• Measure edits, coding audits, and recovery programs via dashboards and reports.
• Examine billing patterns and identify sources of waste or abuse for new opportunities.
• Collaborate with finance, clinical, claims, compliance, network, product, and vendors to drive decisions.
• Support vendor evaluation, data quality, controls, automation, and scalable analytics.

Skills

Data analytics

Stakeholder communication

Education

Bachelor's degree in a quantitative field

Tools

SQL

Excel

SAS

Tableau

Databricks

Job description

Role overview

Provide senior analytical support for medical cost and payment integrity initiatives. Evaluate program results, identify opportunities to reduce avoidable spending, and turn complex claims and financial data into clear recommendations, business cases, and materials for leaders.

Responsibilities

• Analyze trends, risks, and savings opportunities across cost containment and payment integrity programs.
• Build financial impact assessments and business cases, including forecasts, variance analysis, and performance recommendations.
• Measure pre-payment and post-payment edits, coding audits, and recovery programs through dashboards, scorecards, and leadership reporting.
• Examine billing patterns, coding, reimbursement, and potential sources of waste or abuse to identify new opportunities.
• Work with finance, clinical, claims, compliance, network, product, and vendor partners to connect findings to decisions and execution.
• Support vendor evaluation and sourcing, and improve data quality, controls, automation, and scalable self-service analytics.

Requirements

• Bachelor's degree in a quantitative or related field, or equivalent experience.
• At least eight years of progressive experience in medical cost analytics, payment integrity, financial modeling, or a related area.
• Hands-on analytical experience with tools such as SQL, Excel, SAS, Tableau, Databricks, or similar platforms.
• Knowledge of reimbursement methods and coding, including examples such as MS-DRG, APC, HCPCS, or RBRVS, and familiarity with professional and facility claims.
• Experience applying automation or advanced analytics, such as predictive modeling, natural language processing, or machine learning, where these methods deliver measurable value.
• Ability to communicate complex findings to senior audiences and collaborate across teams in regulated, compliance-aware settings.

Benefits and work setup

• Remote work requires cable broadband or fiber internet with at least 10 Mbps download and 5 Mbps upload.
• Anticipated annual salary is $112,800-$188,000, depending on experience and location, with expected eligibility for an annual bonus plan.
• Benefits include medical, dental, and vision coverage, wellbeing programs, a 401(k), paid holidays, and at least 18 days of paid time off per year.