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Plano

    Business Analytics Lead Analyst - Plano, United States - The Cigna Group

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    Full time
    Description

    Business Analytics Associate – (Provider Contract Analytics)

    Summary:

    We are seeking a highly motivated and innovative team member to join our growing and dynamic Network Analytics team as a Business Analytics Associate (Provider Contract Analytics) for the South Texas Market. In this role, you will support the medical cost position of assigned markets through analysis of healthcare provider contracts, data drill downs of contract trend drivers, and execution of key initiatives designed to address unit cost and competitive discount. You will partner with contracting, network management, medical management, and pricing business units to deliver contract analysis results in line with trend/cost expectations to ensure strong competitive positioning within the marketplace.

    Responsibilities:

    • Analyze impact to trends for professional, facility and ancillary contract negotiations.
    • Effectively influence contracting in a strategic fashion and offer meaningful options during negotiations with a healthcare provider.
    • Proactively identify opportunities for unit cost improvement and engage contracting to build these into negotiations and plan where appropriate.
    • Provide ad-hoc analysis and deep dives into data as appropriate to support negotiations and provide value to our contracting partners.
    • Leverage Hospital and Payer Transparency competitor data/insights in contract negotiation modeling.
    • Analyze reports and present findings to business partners at various levels of the organization.
    • Assist Senior Manager on planning processes and ad-hoc report requests.
    • Keep management informed as to the progress of financial planning and proactively identify risk and opportunities for meeting the plan results.
    • Maintain strong communication with other analysts to identify new opportunities and share best practices.

    Qualifications:

    • Bachelor's degree in Statistics, Mathematics, Economics, Health Policy Analysis, Finance, or other related field of study.
    • Knowledge of standard medical coding including CPT-IV, ICD-10, DRG, revenue codes, and HCPCS.
    • 2+ years of experience with health care data analysis required. Experience with trend analysis and health care provider contract analysis preferred.
    • Familiarity with various data mining and reporting tools such as Microsoft Excel, Microsoft Access, or SAS/SQL language.
    • Strong analytical and problem-solving skills with a proven track record of success.
    • Ability to independently perform data analysis while managing multiple projects and meeting strict deadlines.
    • Strong ability to validate and interpret results.
    • Ability to influence and drive strategic planning, action plan development, and execution of plans through engagement of business partners, education on key drivers and actionable levers, and thorough understanding of market-level dynamics.
    • Strong communication skills to include written, oral, and group presentation.
    • Understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, and utilization management.


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