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Summary
Responsible for design and buildout of trend prediction capabilities across key clinical and affordability metrics, this individual will build expert-level clinical metrics into the broader CHC Risk Ecosystem. Candidates should be very familiar with the intersection of clinical data with predictive techniques including authorization data, service category, and diagnosis drivers. Key stakeholder groups include clinical and affordability teams, analytics, and finance.
Responsibilities
Buildout key clinical risk indicators and projection insights into the CHC Risk Ecosystem
Partner with clinical & financial stakeholders to design and implement effective clinical analysis capabilities and key performance indicators into trend analysis & claim insights
Unpack relationships between key clinical drivers, including authorizations, claims, diagnostic categories, and episodes of care in the CHC Risk Ecosystem
Own end-to-end development of innovative clinical insights and affordability opportunities, seeking continuous improvement
Influence the cost of care through enhancement of predictive capabilities to deliver data-driven insights
Utilize external data to drive deeper connections between internal clinical data and marketplace trends
Leverage large datasets in analysis, partnering with technical and visualization teams as applicable
Serve as a strategic business partner with multiple cross-functional areas including clinical, financial, and technical stakeholders to improve operational efficiency, accuracy, and depth of data-driven clinical insights
Qualifications
5+ years' of experience in medical economics/health-plan data analytics, affordability or clinical analysis
Advanced experience with SQL, Python and/or other similar data tools
Familiar with key clinical coding (CPT/ICD10) concepts and data
Proven core clinical knowledge including provider data, clinical information, claims data and health plan performance including cost and quality objectives
Experience in working successfully in a matrix environment with demonstrated ability to collaborate
Effective storytelling skills and business acumen are key competencies
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, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here.
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.Please note that you must meet our posting guidelines to be eligible for consideration. Â Policy can be reviewed at this link.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
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