"Alerted.org

Summary

Supports the medical cost position of assigned markets through analysis and tracking of health care provider contracts, analysis of medical expense reports, data drill downs of trend drivers, and execution of identified key initiatives designed to mitigate medical cost trends. Partners with the network management unit to deliver medical expense results in line with trend/cost expectations to ensure strong competitive positioning within the marketplace.

Responsibilities

+ Provide analytical and strategic support of health care provider rate negotiations

+ Summarize and communicate analytical findings and recommendations to business partners

+ Effectively influence contractors by offering meaningful solutions during negotiations

+ Provide ad hoc analysis and drill down reports as necessary to support negotiations and other initiatives contributing to medical cost improvement

+ Assess the cost and quality efficiency of health care providers

+ Assess the competitiveness of health care provider rate exhibits

+ Contribute to the provider unit cost planning process. Influence contractors to establish targets that meet or exceed corporate objectives and ensure strong competitive positioning

+ Identify risks and opportunities for meeting targets and inform management about potential and actual plan variances

+ Collaborate with other analysts and contractors to maintain accuracy of forecasting tools

+ Update health care provider rate schedules, trends, and other details in tracking databases

+ Lead data validation efforts

+ Collaborate with tool developers on tool enhancements

+ Mentor and train business partners and other analysts

Qualifications

+ 3+ years' of experience with health care analysis

+ Experience with health care provider contract analysis

+ Strong analytical and problem-solving skills with the ability to validate and interpret results

+ Strong communication skills including written, oral, and group presentation

+ Ability to work independently while managing multiple tasks and meeting strict deadlines

+ Exposure to various data mining and business intelligence tools such as Tableau, Microsoft Excel and Access preferred

+ Knowledge of standard medical coding including CPT-IV, ICD-10, DRG, revenue codes and HCPCS preferred

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.

We want you to be healthy, balanced, and feel secure. That’s why 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) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group .

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

_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:_ [email protected]_ _for support. Do not email_ [email protected]_ _for an update on your application or to provide your resume as you will not receive a response._

_The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State._

_Qualified applicants with criminal histories will be considered for employment in a manner_ _consistent with all federal, state and local ordinances._