Provider Data Management Specialist - Hybrid

Provider Data Management Analyst

Are you ready to make a difference in healthcare analytics? Join our Market Analytics, Pricing & Solutions team as a Provider Data Management Analyst and help drive innovation, accuracy, and compliance in provider data management.

If you thrive on solving complex challenges and collaborating with talented colleagues, this is your opportunity to grow and make an impact.

Responsibilities


* Manage and maintain Healthcare Professional (HCP) contracted rates and demographic data for assigned markets, ensuring accuracy and compliance.


* Lead monthly review sessions with the contracting team to ensure the best line of sight on rate schedules and projections.


* Oversee the claim match and rating area review processes, driving improvements in data quality and operational efficiency.


* Collaborate with project teams to develop and test new PMT features, enhancements, or fixes.


* Recommend new tools or processes to enhance the Provider Management Tool and related systems.


* Ensure compliance with PMT, Rate Sheet History (RSH), and Chargemaster Input Tool (CMI) policies and procedures.


* Support continuous improvement by identifying opportunities to streamline data management and reporting.

Qualifications

Required


* Strong analytical and problem-solving skills.


* Excellent written, oral, and group presentation communication skills.


* Understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, and utilization management.


* Familiarity with data mining and reporting tools, such as Microsoft Excel & Access.


* Ability to work independently while managing multiple tasks and meeting deadlines.


* Experience working with claim data and familiarity with standard medical coding (CPT, ICD9, HCPC preferred).


* Minimum 2 years of relevant experience.

Preferred


* Bachelor's degree in Finance, Economics, Business, Health Policy Analysis, Healthcare Administration, Mathematics, or Statistics.


* Experience collaborating with cross-functional teams and leading process improvements.

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 77,300 - 128,800 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.

At The Cigna Group, 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), company paid life insurance, tuit...