The Cigna Group
Strategic Analysis Senior Advisor – ACA HHS Risk Adjustment Analytics
The Cigna Group, Denver, Colorado, United States, 80285
Profile Summary:
Individual & Family Plans (IFP) is a fast-paced Cigna Healthcare business unit serving the Affordable Care Act (ACA) market. In this role within Evernorth, you will join the IFP Analytics team responsible for identifying and sizing new risk adjustment opportunities that not only create better health outcomes for patients but also enable Cigna Healthcare to remain compliant and competitive in the dynamic federally regulated Risk Adjustment space.
There’s no shortage of deep dives and insights to be uncovered, and in this role, you’ll have the agency to drive real, measurable change within the healthcare ecosystem. If you’re continually curious, eager to try new things, and passionate about making a difference for your peers, the organization, and the real people Cigna Healthcare has the privilege to serve, then this role is for you!
Data is at the backbone of everything that this team does, and you will be viewed as a data and analytics expert with an eye for applying statistical techniques to your analysis. Therefore, you have experience working with large databases and combining different healthcare data domains together using SQL. You enjoy digging deep into healthcare conditions, claim patterns, and market dynamics to surface new insights, while seeking out and incorporating guidance from clinical experts. You excel at translating complex, technical analyses into simple actionable recommendations that you’ll communicate to leaders and change makers at all levels of the organizations including the senior leadership team.
Key Responsibilities:
Consult independently with stakeholders across the IFP business to prioritize, define, and conduct key strategic analyses
Monitor and identify member cohorts in need of healthcare intervention to drive engagement
Evaluate and recommend improvements to the risk adjustment suspecting and targeting models
Pilot cutting edge technology applications and models inclusive of GenAI (LLM backed techniques)
Develop clear and thoughtful materials to communicate results/recommendations to varying levels of individuals and teams within the organization
Navigate and lead initiatives effectively in a cross functional organization
Qualifications
MS/MPH in public health, statistics, economics, or related fields; or FSA
Healthcare Actuarial Modeling or financial modeling background preferred
6+ years of work experience in healthcare analytics
Strong familiarity with medical claims data
Experience with HHS ACA (or Medicare) risk adjustment model
Strong database manipulation and SQL scripting skills
Ability to work with business partners in consultative manner
Strong communication skills (e.g. experience translating complex analyses into easy-to-follow slides/materials)
Ability to independently prioritize and manage multiple responsibilities
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 126,900 - 211,500 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.
We want you to be healthy, balanced, and feel secure. That’s why 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) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
About The Cigna Group
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.
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.
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Individual & Family Plans (IFP) is a fast-paced Cigna Healthcare business unit serving the Affordable Care Act (ACA) market. In this role within Evernorth, you will join the IFP Analytics team responsible for identifying and sizing new risk adjustment opportunities that not only create better health outcomes for patients but also enable Cigna Healthcare to remain compliant and competitive in the dynamic federally regulated Risk Adjustment space.
There’s no shortage of deep dives and insights to be uncovered, and in this role, you’ll have the agency to drive real, measurable change within the healthcare ecosystem. If you’re continually curious, eager to try new things, and passionate about making a difference for your peers, the organization, and the real people Cigna Healthcare has the privilege to serve, then this role is for you!
Data is at the backbone of everything that this team does, and you will be viewed as a data and analytics expert with an eye for applying statistical techniques to your analysis. Therefore, you have experience working with large databases and combining different healthcare data domains together using SQL. You enjoy digging deep into healthcare conditions, claim patterns, and market dynamics to surface new insights, while seeking out and incorporating guidance from clinical experts. You excel at translating complex, technical analyses into simple actionable recommendations that you’ll communicate to leaders and change makers at all levels of the organizations including the senior leadership team.
Key Responsibilities:
Consult independently with stakeholders across the IFP business to prioritize, define, and conduct key strategic analyses
Monitor and identify member cohorts in need of healthcare intervention to drive engagement
Evaluate and recommend improvements to the risk adjustment suspecting and targeting models
Pilot cutting edge technology applications and models inclusive of GenAI (LLM backed techniques)
Develop clear and thoughtful materials to communicate results/recommendations to varying levels of individuals and teams within the organization
Navigate and lead initiatives effectively in a cross functional organization
Qualifications
MS/MPH in public health, statistics, economics, or related fields; or FSA
Healthcare Actuarial Modeling or financial modeling background preferred
6+ years of work experience in healthcare analytics
Strong familiarity with medical claims data
Experience with HHS ACA (or Medicare) risk adjustment model
Strong database manipulation and SQL scripting skills
Ability to work with business partners in consultative manner
Strong communication skills (e.g. experience translating complex analyses into easy-to-follow slides/materials)
Ability to independently prioritize and manage multiple responsibilities
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 126,900 - 211,500 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.
We want you to be healthy, balanced, and feel secure. That’s why 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) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
About The Cigna Group
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.
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.
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