Quality Review and Audit Data Measurement & Reporting Lead Analyst- Remote- Cigna Healthcare

Job Summary:

Provides advanced professional input to complex Data Measurement & Reporting assignments/projects.

Provides analytical and operational reporting, business performance measurement and management dashboards, and fulfills data and measurement requests from business partners, and assists in project management for the Risk Adjustment Quality and Audit teams.

Responsible for managing advanced data/analytics projects that are used to develop actionable insights and recommendations.

Supports and provides direction to more junior professionals.

Works autonomously, only requiring "expert" level technical support from others.

Exercises judgment in the evaluation, selection, and adaptation of both standard and complex techniques and procedures.

Utilizes in-depth professional knowledge and acumen to develop models and procedures, and monitor trends, within Data Measurement & Reporting.

Manages data projects across multiple teams throughout the risk adjustment organization.

Core Responsibilities:


* Extract and analyze large healthcare data using SAS, SQL, R, Python, Teradata, Hadoop, Excel etc.


* Identify, analyze and interpret trends or patterns in data sets through descriptive and multivariate statistics.


* Develop actionable insights and present results to non-technical business partners and stakeholders to drive the decision-making process.


* Collaborate with matrix partners to understand project developments, assess impacts to data and analytics.


* Develop methods for improving internal techniques and processes with expertise in creating highly effective, visual graphics that tell complex stories in formats that can be easily conveyed to leadership and executive clients.


* Maintain audit performance dashboards from external data sources, leveraging and improving on existing templates

Minimum Qualifications:


* 3+ years of healthcare-related data/analytics experience solving business problems through the application of analytic approaches.


* Experience with diverse healthcare data preferred, including claims, EHR, demographic, pharmacy, lab, biometrics, genomic, and text.


* Previous experience conducting program evaluation/outcomes research methods, predictive modeling and data mining is required.


* Experience with statistical software program such as SQL, SAS/SAS EG, R and/or Python is required.


* Comprehension of healthcare data (e.g., claims, utilization, provider information) and demonstrated understanding of health care and delivery system processes.


* Leadership competencies including the ability to collaborate with others and establish working relationships, communicate effectively across the organization and at different levels, think and act strategically, and influence key leaders with a strong customer focus and management of stakeholder expectations.


* Knowledge of Risk Adjustment HCC methodology is required


* HCC coding experience/exposure is preferred

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