Job Closed
This listing is no longer active.
Senior Provider Contract Analyst - CIGNA
Location
United States
Posted
70 days ago
Salary
$98.2K - $163K / year
Seniority
Senior
No structured requirement data.
Job Description
Senior Provider Contract Analyst - CIGNA
The Cigna Group
The job profile for this position is Business Analytics Advisor, which is a Band 4 Senior Contributor Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. POSITION SUMMARY Supports the medical cost position of assigned markets through analysis of healthcare provider contracts, analysis of high performing network solutions, analysis of medical expense reports, data drill downs of trend drivers, and execution of key initiatives designed to address medical expense and product pricing trends. Partners with network management and pricing units to deliver medical expense results in line with trend/cost expectations to ensure strong competitive positioning within the marketplace. ESSENTIAL FUNCTIONS - Provide analytical and strategic support of health care provider rate negotiations. - Identify opportunities for medical cost reduction, develop action plans, and drive execution. - Assess the cost and quality efficiency of health care providers. - Collaborate with local network team to develop and maintain high performing network solutions. - Assess competitiveness of standard and high performing network products. - Analyze reports and present findings to business partners at various levels of the organization. - Support business partners and team members on an ad hoc basis as needed to support various integral business needs. - Maintain strong communication with other analysts to identify new opportunities and share best practices. - Mentor/train business partners and other analysts. QUALIFICATIONS - Bachelor's degree in Statistics, Mathematics, Economics, Health Policy Analysis, Finance, or other related field of study. Master's degree preferred. - 5+ years of experience with health care data analysis required. Experience with medical cost trend analysis and health care provider contract analysis preferred. - Strong analytical and problem solving skills with a proven track record of success. - Ability to independently perform data analysis while managing multiple projects and meeting strict deadlines. - Strong ability to validate and interpret results. - Ability to influence and drive strategic planning, action plan development, and execution of plans through engagement of business partners, education on key drivers and actionable levers, and thorough understanding of market-level dynamics. - Strong communication skills to include written, oral, and group presentation. - Understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, and utilization management. - Technical sophistication with various data mining and business intelligence tools such as SAS, SQL, Microsoft Access, or similar products, advanced Microsoft Excel skills. - Knowledge of standard medical coding including CPT-IV, ICD-10, DRG, revenue codes, and HCPCS. 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 98,200 - 163,600 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. 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 and paid holidays. For more details on our employee benefits programs, click here. 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.Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
Related Guides
Related Categories
Related Job Pages
More Analyst Jobs
CUSTOMER EXPERIENCE ANALYST
Compass GroupFounded in 1941, Compass Group is a multinational corporation and the world’s largest provider of contract foodservice and support services. Headquartered in
Who is Foodbuy? We are the industry leader in procurement and supply chain solutions. We are the subsidiary to the 6th largest company in the world (Compass Group PLC), yet Foodbuy has the feel of a small entrepreneurial Company. We pride ourselves on our ability to source and provide a variety of products and services that help our customers more easily, and cost effectively, run their businesses. We work with clients in the Hospitality, Restaurant, Healthcare, Education, Entertainment, and Gaming industries, and of course we support Compass Group-- which is the world’s largest contract food and support services provider. Why Foodbuy? We care about our associates, our clients, and our community. We think big, encourage innovation and debate, and seek out game changers. Our benefits and PTO offerings are strong. Our compensation packages are competitive. And we are constantly growing, and we want our associates’ careers to grow along with us. We have an open and modern work environment, believe in flexibility, and promote a collaborative open door environment. Additionally, we follow a value system called People FIRST, which stands for Flexibility, Inclusion, Results, Sustainability and Transparency. People FIRST is the foundation for everything we do at Foodbuy. It is how we connect and interact with our clients, business partners and fellow associates. Job Summary The primary duty of this position is preparing dashboards, analytics and reviewing key metrics of customers to leverage insights into actionable outcomes for financial growth, customer satisfaction and program penetration. Responsibilities: - Supports and prepares key business analysis to assist decision making processes. - Prepare ad hoc financial analysis and special projects to support continued growth of business. - Utilize support tools to identify opportunities to increase program participation. - Facilitate cross functional activities to help ensure customer satisfaction and program growth. - Leverages a good understanding of broader company services and offerings. - Participate in internal activities and initiatives designed to improve the customer experience. - Works with external customers to resolve day-to-day issues and direct them to appropriate resources. - Uses communication skills to deliver high quality service to assigned channel customer base. - Monitors customer inquiries, resolves non-routine issues and escalates complex issues to the appropriate team member, as needed. Requirements: - Bachelor’s degree or equivalent work experience required. - 2+ years of experience in account management support or customer success; Distribution and/or Foodservice experience preferred. - Effective written & verbal communication skills. - Project Management skills / experience. - Detail-oriented and analytical problem-solving skills. - Knowledge of Microsoft Excel, PowerPivot, Word & PowerPoint required. Apply to Foodbuy today! Foodbuy is a member of Compass Group USA Click here to Learn More about the Compass Story Associates at Foodbuy are offered many fantastic benefits. - Medical - Dental - Vision - Life Insurance/ AD - Disability Insurance - Retirement Plan - Paid Time Off - Paid Parental Leave - Holiday Time Off (varies by site/state) - Personal Leave - Associate Shopping Program - Health and Wellness Programs - Discount Marketplace - Identity Theft Protection - Pet Insurance - Commuter Benefits - Employee Assistance Program - Flexible Spending Accounts (FSAs) Associates may also be eligible for paid and/or unpaid time off benefits in accordance with applicable federal, state, and local laws. For positions in Washington State, Maryland, or to be performed Remotely, click here or copy/paste the link below for paid time off benefits information. https://www.compass-usa.com/wp-content/uploads/2023/08/2023_WageTransparency_CorpAndFoodbuy.pdf Compass Group is an equal opportunity employer. At Compass, we are committed to treating all Applicants and Associates fairly based on their abilities, achievements, and experience without regard to race, national origin, sex, age, disability, veteran status, sexual orientation, gender identity, or any other classification protected by law. Qualified candidates must be able to perform the essential functions of this position satisfactorily with or without a reasonable accommodation. Disclaimer: this job post is not necessarily an exhaustive list of all essential responsibilities, skills, tasks, or requirements associated with this position. While this is intended to be an accurate reflection of the position posted, the Company reserves the right to modify or change the essential functions of the job based on business necessity. We will consider for employment all qualified applicants, including those with a criminal history (including relevant driving history), in a manner consistent with all applicable federal, state, and local laws, including the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance, the San Francisco Fair Chance Ordinance, and the New York Fair Chance Act. Certain positions may require Florida Level 2 background screening. Details: https://info.flclearinghouse.com/ Applications are accepted on an ongoing basis. Foodbuy maintains a drug-free workplace. Req ID: 1524851 Foodbuy Erin Gregory [[req_classification]]
• The Analyst, Performance Suite Analytics utilizes and develops analytic tools to solve complex business challenges as well as support decision making that can have a considerable impact on the organization and patient health. • This role will support the Medical Cost Management activities, working in a Medical Economics team that supports Business Development and new product efforts. • Support the underwriting of capitated risk proposals involving cost & use projections, trend selection/development, and estimation of Evolent’s ability to reduce cost and improve quality. • Support the design of financial arrangements that are equitable for both Evolent and our Partners. • Support the development of models and approaches aimed at quantifying and articulating our value. • Perform research and analysis of complex healthcare claims, eligibility, and pharmacy data to make recommendations based on relevant findings. • Draw actionable conclusions from analyses and effectively communicate to internal/external audiences at various levels of the enterprise. • Translate analyses into Customer-ready deliverables using available visualization tools. • Provide support and facilitate interaction with customers in a manner that fosters expertise and cooperation. • Process and validate raw unadjudicated claims data. • Use programming skills to explore, examine and interpret large volumes of data in various forms to complete deliverables with minimal assistance and oversight.
Epic Optime/Anesthesia Analyst
ERPAERPA is a leader in enterprise application managed services, cloud hosting, and consulting services.
• Develop new complex mobile applications from top to bottom • Implement new features in existing mobile applications • Maintain existing mobile software systems by identifying and correcting software defects • Act as a technical reference / subject matter expert in all areas of mobile application development
Analista de Qualidade De Software II
ExperianWe're unlocking the power of data to help create a better tomorrow.
Company Description A Serasa Experian é a primeira e a maior Datatech do Brasil. Líder em soluções de inteligência para análise de riscos e oportunidades, com foco nas jornadas de crédito, autenticação e prevenção à fraude. Com tecnologia de ponta, inovação e os melhores talentos, transforma a incerteza do risco na melhor decisão, ajudando pessoas a realizarem seus sonhos e empresas de todos os portes e segmentos a prosperarem. Temos 22.000 pessoas operando em 32 países e a cada dia estamos investindo em novas tecnologias, profissionais talentosos e inovação para ajudar todos os clientes a maximizarem cada oportunidade. Com sede corporativa em Dublin, Irlanda, a Experian está listada na Bolsa de Valores de Londres (EXPN) e compõe o índice FTSE 100. Job Description Job description Responsabilidades Criação e manutenção de projetos de automação de testes de API com foco em performance, resiliência e observabilidade da qualidade. Execução de testes manuais em APIs, serviços e aplicações distribuídas. Projetar, implementar e validar testes de integração, regressão, contrato e carga para sistemas baseados em microserviços. Garantir boas práticas de qualidade, documentação, padronização e rastreabilidade dos testes. Colaborar com times multidisciplinares (negócios, SRE, desenvolvimento) em ambientes ágeis. Participar ativamente de revisões técnicas, validações de requisitos, identificação de riscos e proposição de melhorias de qualidade. Requisitos obrigatórios Experiência sólida em QA atuando com testes de APIs e serviços backend. Conhecimentos sólidos em testes funcionais e não funcionais. Conhecimento de padrões de projetos e arquitetura limpa. Experiência com testes envolvendo bancos de dados relacionais (PostgreSQL, SQL Server, etc.). Experiência com testes envolvendo bancos de dados não relacionais (DynamoDB, MongoDB, Redis, etc.). Experiência com ferramentas de testes de API como Bruno e Postman. Familiaridade com metodologias ágeis (Scrum/Kanban). Diferenciais Experiência na indústria de antifraude. Certificação CTFL. Soft Skills esperadas Capacidade de trabalhar de forma colaborativa e orientada a resultados. Boa comunicação verbal e escrita, especialmente para detalhamento de cenários, defeitos e riscos. Pensamento crítico e foco em resolução de problemas. Capacidade de pensar estrategicamente, visualizar o todo e compreender os impactos que uma iniciativa pode gerar sob diferentes perspectivas. Proatividade e autonomia no dia a dia. Qualifications Qualifications - Automação - Teste de Software - microserviços - SQL - Engenharia de Software - Documentação Additional Information A Serasa Experian é muito mais do que você imagina. Com o propósito de criar um futuro melhor, ampliando oportunidades para pessoas e empresas, no Brasil somos mais de 4 mil pessoas que atuam em diversos times e especialidades. Aqui, cada conhecimento e diversidade se complementa e você pode trabalhar no que mais ama, estamos comprometidos a construir uma cultura inclusiva e um ambiente no qual pessoas possam equilibrar a carreira com seus compromissos e interesses pessoais, prezando pelo bem-estar. A gente se dedica muito em ser uma das melhores e mais inovadoras empresas para se trabalhar do país, possibilitando experiências e carreiras incríveis para nossas pessoas. Nossa forte abordagem de pessoas em primeiro lugar é reconhecida externamente por meio de diversas certificações de mercado: fomos premiados pelo Great Place To Work™ em 24 países e pela certificação internacional Top Employers, além de sermos reconhecidos como uma das melhores empresas para jovens profissionais e contarmos com uma avaliação de 4,6 no Glassdoor. Cada reconhecimento nos indica que estamos no caminho certo, proporcionando um ambiente de trabalho cada vez melhor para nossos talentos. Experian Careers - Creating a better tomorrow together Find out what its like to work for Experian by clicking here - Employee Status: Regular - Role Type: Home - Department: Technology - Schedule: Full Time


