Senior Medical Cost Analytics Advisor

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The Cigna Group

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛡️ Insurance

Healthcare • Insurance

The Cigna Group is a global health services company that provides medical, dental, pharmacy, behavioral and supplemental insurance products and benefits to individuals, families, employers, brokers, providers and Medicare beneficiaries. It offers employer-sponsored group plans, individual and family plans (including Open Enrollment offerings), Medicare, international health insurance covering more than 200 countries, and digital member services through the myCigna platform (including telehealth and claims management). Its products are delivered through operating subsidiaries such as Cigna Health and Life Insurance Company and other regional affiliates.

📋 Description

• Provide strategy and analytical support for the Payment Integrity team. • Evaluate pre-payment and post-payment editing, clinical coding audits, and recovery programs. • Translate payment integrity program performance and results into actionable insights and business cases. • Identify and size new savings opportunities. • Identify trends, risks, and affordability opportunities across cost containment and payment integrity programs. • Translate complex findings into executive-ready insights and support the strategic roadmap. • Own financial impact assessments and business cases, including forecasts, variance analysis, and performance recommendations. • Support program measurement and performance monitoring through dashboards, scorecards, and executive materials. • Assess billing patterns, coding and reimbursement dynamics, and drivers of wasteful or abusive practices. • Partner across finance, operations, clinical, network, claims, product, vendor, contracting, coverage policy, compliance, reserving, and analytics teams. • Support vendor evaluation and sourcing through analysis of negotiations, pricing structures, and performance guarantees. • Improve data quality, strengthen controls, and enable scalable self-service analytics through automation and AI-enabled tools.

🎯 Requirements

• Bachelor’s degree in a quantitative field such as Economics, Finance, Data Science, Data Analytics, Actuarial Science, Business, Public Health, or Applied Mathematics, or equivalent experience. • 8+ years of progressive experience in medical cost analytics, payment integrity, financial modeling, or related fields. • Strong analytical and technical skills. • Hands-on experience with SQL, Excel, SAS, Tableau, Databricks, or similar platforms. • Knowledge of reimbursement methodologies and coding, including MS-DRG, APCs, HCPCs, and RBRVS. • Familiarity with professional and facility claim constructs. • Experience working in regulated and compliance-aware environments. • Experience modernizing analytics through automation and AI-enabled or advanced analytics methods, such as predictive modeling, NLP, and machine learning. • Ability to translate complex analyses into actionable business insights for senior and executive audiences. • Strong collaboration and influence skills in a matrixed environment. • Self-starter orientation toward continuous improvement, ownership, and impact. • For occasional or permanent home working, cable broadband or fiber optic internet with at least 10 Mbps download and 5 Mbps upload is required.

🏖️ Benefits

• Annual bonus plan eligibility • Medical benefits • Vision benefits • Dental benefits • 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 • Leaves of absence