Evernorth Health Services, a division of The Cigna Group, is hiring a Program Management Lead Analyst/Data Analyst for a remote position. You will serve as the technical analyst for the Pre/PostPay Edit program, developing and maintaining claim editing logic to improve accuracy and operational efficiency.

What You'll Do

Act as technical analyst for Proactive Claim Intervention projects and daily tasks for all aspects of the Pre/PostPay Edit editing program.
Serve as Data Analyst for the development, installation, execution, and maintenance of the Pre/PostPay Edit editing program.
Develop and maintain editing on regular and ad-hoc basis, primarily using SAS, Microsoft SQL Server, and an internally developed ARM rule-based claim editing platform.
Responsible for data mining activities and technology integration of the Pre/PostPay Correction Program to support the Pre/PostPay Edit editing program.
Evaluate and appropriately utilize various approaches to data mining to narrow in on trends and drivers that directly impact outcomes.
Make well-thought-out decisions on complex or ambiguous IT architecture issues.
Participate in all phases of Pre/PostPay Edit program IT architecture process testing and implementation.
Ensure that system improvements are successfully implemented and monitored to increase efficiency.
Work closely with matrix business partners to define data needs, opportunities for improvement, and effectively communicate results of analysis and solutions.
Act as a resource for mentorship, training, and guidance for junior staff.

What We're Looking For

Bachelor’s degree or higher strongly preferred in Business Analytics, Data Science, Information Systems, or a related field, or equivalent work experience required.
5+ years of experience in healthcare data analytics required.
5+ years coding experience required.
5+ years of experience in healthcare data with proficient skills in medical analysis and project management.
Strong data investigation skills to mine healthcare data required.
Experience with Word, Outlook, PowerPoint, Teams, Webex, Excel (pivot tables/VLOOKUP preferred).
Strong data analysis skills with the ability to analyze large amounts of healthcare data to translate complex data into meaningful, actionable insights.
Strong project management skills and comfort in ability to create and achieve success in highly matrixed environment.
Exceptional verbal and written communication skills with demonstrated ability to research, problem solve, trouble shoot, influence and partner across the organization.
Strong presentation skills. Able to prepare, deliver, and ensure understanding of information regarding any customer-related or process improvement topic across audiences.
Demonstrated ability to work independently and drive to objectives.

Nice to Have

Proficient skills using SAS and Microsoft SQL Server highly preferred.
Experience with rule-based editing platforms desired.

Technical Stack

SAS
Microsoft SQL Server
ARM rule-based claim editing platform
Excel (pivot tables/VLOOKUP)

Team & Environment

You will work with matrix business partners and provide mentorship to junior staff.

Benefits & Compensation

Compensation: $77,500 - $129,100 USD / yearly
Comprehensive health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
401(k)
Company paid life insurance
Tuition reimbursement
Minimum of 18 days of paid time off per year
Paid holidays
Eligible to participate in an annual bonus plan

Work Mode

This is a remote position.

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.