This job listing has expired and the position may no longer be open for hire.

Business Analytics Senior Manager - Head of Medical Economics (International Markets) at Cigna in Wilmington, Delaware

Posted in Science 30+ days ago.

Type: Full-Time





Job Description:

Summary

The Head of Medical Economics for the International Markets is responsible for oversight and leadership of all activities related to the Medical Economics Team. This team drives affordability strategies and outcome measurement of our affordability solutions and uses analytics to provide insights, counsel and advice to global and regional Total Health & Network (TH&N) leaders and cross-functional organization stakeholders. The primary goal of this team is to provide accurate and relevant data, analytics, and reporting for utilization, unit cost, and TH&N program performance aligned with Network, Clinical, and Payment Integrity strategies.

This leader will collaborate with Clinical, Network, and Payment Integrity teams, to provide strategic partnership in analytics which includes: identifying and prioritizing opportunities for impact, developing analytic solutions leveraging data science and technology capabilities, embedding analytics-driven processes in operations and measuring impact over time. They will also support decision making and execution based on data, facts and analytical findings across different parts of the organization and manage the process and output of TH&N Monthly Operating Report (MOR) for P&L regions, including automation of MOR data, performance tracking of medical cost savings initiatives against plan, and quarterly financial forecasting and/or adjustments based on TH&N performance.

The successful candidate will also serve as a 'hands on' analyst for a key region, performing complex outlier analysis and utilizing predictive modelling to identify provider billing and medical cost trends across large amounts of medical claims data. Their analysis will support TH&N business operations including: creating data mining architectures/models/trackers/monitors/protocols, statistical reporting, dashboards, and data analysis methodologies to identify trends in large data sets. May conduct more in-depth research with goal of breaking new ground in business data analytics. This leader will provide thought leadership and technical expertise across multiple disciplines.

This role reports into the International Markets Data & Analytics (D&A) team with a dotted line to SVP Global Delivery Systems.

Responsibilities


  • Partner with regional and local market stakeholders to understanding business needs, strategies, and performance targets


  • Provide expert consultation to improve data collection, quality and availability with operational efficiency


  • Lead monthly Medical Economics Insights Meetings with TH&N business leaders, and present recommendations and actions based on data-driven insight


  • Manages a team of international analysts with diverse culture and skills background


  • Participate and lead in workgroup meetings across regions and TH&N functional areas to identify quality improvement opportunities that will lead to better ways to profile providers and utilization patterns


  • Work closely with the regional TH&N leads on global and regional affordability programs to identify and design analytical tool assets


  • Prioritize and support ad-hoc analytics needed by regional TH&N teams


  • Provide advanced analytic outputs utilizing predictive modelling and outlier identification


  • Develop ad hoc analytic tools such as cost monitors, trackers, and interactive modeling tools to enable the organizational objectives of affordability, predictability, and simplicity


  • Communicate analytical findings/gaps/solutions to management and offer solutions to meet gaps


  • Streamline and optimize MOR source data and process to ensure timely MOR reports production and communicate monthly results highlights and drivers


  • Manage the aggregate financial impact of contracts and TH&N programs to support financial planning and management decisions


  • Coordinate and leverage IM D&A capabilities in ensuring TH&N analytical needs and dependencies are communicated and being addressed in D&A roadmap. Ensure the status of data sources, data elements, data quality, data governance and processes are transparent to the Med Econ team for proper data consumption and document if many manual manipulation needed before using


  • Participate in research-related activities including industry and/or global best practices and experience studies


  • Effective management and flexibility with multiple international time zones and ways of working to ensure timely and quality deliverables


Qualifications

This position requires healthcare and insurance content knowledge, analytics/data science expertise, value based program expertise, contract underwriting, and provider reimbursement knowledge.


  • Experience with managing teams of medical economics analysts


  • 7+ years' Expert-level Medical Economics experience with direct responsibility with health plans analytics and medical cost management. International product/data experience a plus


  • Deep understanding of medical cost drivers, categorization of healthcare claims structure, provider contract reimbursement methodologies, clinical programs, payment integrity/FWA opportunities, and other cost management programs


  • Comprehensive healthcare data experience and demonstrated understanding of the health delivery systems, analytic concepts and models and database management


  • Demonstrated experience in informatics & data exchange, particularly using healthcare and clinical data


  • Demonstrated knowledge and/or experience with analytics tools such as Tableau (preferred), SQL, SAS, Python Jupyter or other modern business intelligence tools


  • 5+ years' Advanced knowledge and proven experience working with databases (SQL)


  • 3+ years' Advanced knowledge and proven experience with outlier and/or predictive modelling for medical claims data with a focus on provider medical cost trends


  • 5+ years' Advanced knowledge and hands-on experience with data mining needed to research, explore, analyze (including root cause analysis), and report on healthcare data; skilled in end-to-end delivery within a reporting environment


  • Proven financial acumen in cost savings reporting, forecasting, and actuarial analysis of medical cost analysis and reserves


  • Ability to navigate organization, build subject matter expert (SME) relationships and assist with internal discussions and effectively represent subject matter expertise


  • Highly skilled with navigating and creating professional presentation documents


  • Skills and comfort in ability to create and achieve success by negotiating and problem-solving in complex/highly-matrixed organizations


This position is not eligible to be performed in Colorado.

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.





More jobs in Wilmington, Delaware

Other
about 4 hours ago

AstraZeneca
Other
about 4 hours ago

AstraZeneca
Other
about 4 hours ago

AstraZeneca
More jobs in Science

Science
about 7 hours ago

Environmental Resources Management Inc
Science
about 7 hours ago

Environmental Resources Management Inc
Science
about 9 hours ago

Signature Health, Inc.