Business Analytics Senior Manager - MidAtlantic

The Business Analytics Senior Manager position is an opportunity for an analytics professional to oversee financial analysis and reporting for Provider Contracting & Contract Underwriting functions for the Mid-Atlantic market.

This role will be responsible for understanding key drivers of medical cost results in the market, educating matrix partners, and valuing financial impact of actions to mitigate medical cost. They will partner closely with local Network team to provide analytical, financial, and business support throughout rate negotiations with Hospitals, Ancillaries, and Physician groups. Strategize with Sales, Pricing, Network, and Medical Management teams to develop competitive product offerings for various segments.

The Business Analytics Senior Manager will guide, lead and develop a team of analysts.

Responsibilities

• Responsible for executing healthcare provider-level analytics in support of contract negotiation process

• Responsible for development of, and management to, unit cost plan budgets

• Responsible for the affordability process and obtaining or maintaining best in class status

• Communicate the final performance results to the regional and national network leads on the combined fee for service and fee for value

• Engage with key partners in Sales, Pricing and Network to help develop, execute and maintain new competitive products in the changing healthcare environment

• Stewardship of data repository, renewal analysis and approvals, and accuracy of reconciliations in support of pricing functions

• Identify market trends and isolate actions to mitigate the trends – determine if the actions to mitigate trends are best suited to be taken on a market level of a value based model level

• Provide a holistic view of a provider’s relationship rather than the current status quo which is piece meal

• Communicate with and influence key matrix partners to ensure goals and targets are met

• Support the development of policies and procedures to ensure adequate controls are in place for the review and signoff of healthcare professional contracts.

• Drive change initiatives to address prospective business needs. Act as a catalyst through multiple layers to spark enthusiasm, collaboration and results

• Responsible for day to day management of an analytical team

Qualifications

• Bachelors degree in business analytics, finance, risk management or related field strongly preferred

• 6+ years' financial or business analytics experience in the Managed Care industry or Public Health Care; clinical/medical coding knowledge and experience

• Proven understanding of individual market dynamics (healthcare providers, employers, and competitors, skill/experience in quality/payment innovation programs, health plan performance, etc.)

• Knowledge of PPO and managed care environments, including product offerings, risk contracting, competitor offerings and healthcare provider value based reimbursement programs

• Demonstrated excellence in leadership ability to engage and motivate in a high performance culture

• Strategic thinker with both sound and broad business acumen

• Experience working successfully in a matrix environment

• Previous work experience applying a combination of analytical, technical and business acumen

• Demonstrated experience in challenging problems and driving outstanding results

• Proven experience in managing multiple priorities and agility in adapting to change

• Change leader who will be proactive in assisting in positive growth for the future

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.

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 need a reasonable accommodation to complete the online application process, please email [email protected] for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

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.