Data Scientist - Grouper and Risk Model Team - Evernorth (Work from home) at Cigna in Raleigh, North Carolina

Posted in General Business 8 days ago.

Type: Full-Time

Job Description:

The Data Scientist will apply statistical analysis and clinical data know-how to test and fine tune Episode Grouper and Risk Adjustment performance for existing models. They will also research, develop and test new Episode Grouper and Risk Adjustment models (open source, homegrown and new vendor alternatives). The team member will be a key advisor to other Cigna teams on methodologically appropriate model use and output consumption. Finally, they will collaborate with team leadership to monitor evolving industry Grouper and Risk Adjustment trends to propose solutions that will influence Cigna's strategic application of these models.

This position is with Evernorth, a new business within the Cigna Corporation.

Key Responsibilities

  • Statistical analysis and fine tuning of current Episode Grouper and Risk prediction model parameters, inputs and outputs.

  • Innovate by testing and developing (ML and Deep Learning) alternative models for superior performance in various Episode Grouper, Risk Adjustment and Cost Prediction use cases.

  • Serve as methodological SME on all statistical aspects of Grouper Episodes and adjoining Risk Prediction model use and on appropriate consumption by sister teams for Risk Adjustment, Cost Prediction and Cohort Matching for Evaluations.

  • Present findings/recommendations to technical and non-technical leaders to drive Evernorth's Episode Grouper and Risk Adjustment strategy.


This position requires demonstrated acumen and experience applying rigorous statistical methodology and Supervised Learning models to claims and clinical data prediction:

  • Post-Graduate degree in Statistics, Biostatistics, Actuarial or Data Science (Masters or PhD preferred), with significant modelling experience (4+ years preferred) using Python or R/SAS to build Supervised Learning models for predictive purposes.

  • Keen eye for data and modelling detail, appetite for methodological nuances (required).

  • Proven experience querying (SQL, Hadoop) and statistically analyzing (Python, R, SAS) large claims and clinical data as key step prior to modeling. (required)

  • Prior experience applying Supervised Learning models (Lasso Regression, Classification, other ML and DL) to for cost, risk score or other outcome predictions (required).

  • Knowledge of Health Claims data, Episode Groupers and Risk Adjustment models (preferred).

  • Solid verbal communication and consultative skills. Ability to collaborate with technical and non- technical teams/leadership, establish working relationships, and drive business decisions based on sound methodologic points.

  • Prior experience contributing to research/development/thought leadership on Data Science applications for strategy, innovation and practical solutions.

  • A sense of humor.

  • Experience working in an Agile environment.

For this position in Colorado, we anticipate offering an annual salary of 93,700.00, +/- 20%, depending on experience.

This role is also anticipated to be eligible to participate in an annual bonus plan.

Helping our customers achieve healthier, more secure lives is at the heart of what we do. While you take care of our customers, we'll take care of you through a comprehensive benefits program that helps you be at your best. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and best in class 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 dozens of corporate discounts on essentials you use every day. For more details on our employee benefits programs, please visit the "Life at Cigna" tab on our careersite:

About Evernorth

Evernorth, Cigna Corporation's health services segment, exists to elevate health for all. We're building on our legacy and redefining health care as we know it. Unbiased in how we think, we create without limitation. We partner without constraints, deliver value differently and act in the interest of humanity. Solving across silos, closing gaps in care, and empowering clients, customers, and people everywhere to move onward and upward. When you work with us, you'll be empowered to solve the problems others don't, won't or can't. Join us. What difference will you make?

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 require reasonable accommodation in completing the online application process, please email: for support. Do not email for an update on your application or to provide your resume as you will not receive a response.