Senior Business Analyst - Out of Network Analytics - Evernorth

Senior Business Analyst - Out of Network Analytics - Evernorth

Are you passionate about using data to drive meaningful change in healthcare? Join our Out of Network Analytics team and help shape the future of medical cost analysis and protection programs.

This team is responsible for performing valuable medical cost analysis on Cigna's out of network (OON) protection programs as well as maximum reimbursable charge.

As a Senior Business Analyst, you'll turn complex data into actionable insights, collaborate with talented colleagues, and make a real impact on our organization's success.

Responsibilities


* Lead the creation and maintenance of median in-network schedules to ensure compliance with the No Surprises Act, supporting positive outcomes for our clients and members.


* Guide and coordinate the offshore Out of Network analytics team to deliver high-quality analytical projects and solutions.


* Enhance and maintain OON data assets using SAS and SQL Server Management Studio; drive migration to scalable platforms like Databricks and Alteryx.


* Monitor data quality and conduct regular audits to ensure accuracy and consistency in our foundational data repository.


* Perform advanced financial analysis and generate insights that support the OON Protection Program, with a focus on regulatory compliance.


* Maintain clear documentation on policies and procedures related to the No Surprises Act and OON analytics.


* Support audits and legal projects, ensuring our analytics meet the highest standards.


* Enable OON analysis and reporting using Medicare rates as a common currency, driving strategic decision-making.

Qualifications

Required:


* 5+ years of experience in the healthcare domain, with expertise in healthcare claims data.


* Advanced proficiency in data querying tools such as SAS and SQL.


* Strong analytical and problem-solving skills, with attention to detail.


* Ability to collaborate and communicate effectively with internal stakeholders.


* Flexible and able to work with global partners across time zones.

Preferred:


* Hands-on experience with Databricks and Alteryx.


* Experience leading or mentoring analytics teams.


* Bachelor's degree in a related field.


* Experience with migration to scalable reporting platforms.


* Located in Eastern or Central time zones.

Candidates who reside within 50 miles of Bloomfield, CT or Plano, TX may be asked to work a hybrid, in office/work from home, flexible arrangement

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 96,000 - 160,000 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in...