Senior Provider Relations Analyst

Job not on LinkedIn

🔥 11 minutes ago

🇺🇸 United States – Remote

💵 $58.1k - $96.9k / year

⏰ Full Time

🟠 Senior

🧐 Analyst

👻 Ghost score 0%

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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

• Write business, functional, and non-functional business requirements • Participate in system design reviews • Review test evidence and participate in status meetings • Identify data elements required for provider data loading to PRIME (BoR) • Understand provider/practitioner demographics, contracts, contract management, and PRIME domains • Develop understanding of the PRIME BoR system and other BoR systems related to HCPM • Determine load type (update or new) based on data analysis • Collaborate with matrix partners to review outcomes and ensure accurate loading guidelines • Identify remediation needs to increase automated loading of provider data and support data integrity across provider systems • Review validated data elements to ensure data quality before BoR ingestion • Guide the team in following system process flows • Partner with IT and business stakeholders to improve provider data quality and develop automation capabilities

🎯 Requirements

• Bachelor's degree or higher strongly preferred or equivalent work experience • Knowledge and understanding of Provider Data Domains • Knowledge of PRIME contractual structure preferred • Ability to locate and analyze HCP data and perform data maintenance for accurate consumption • Ability to extract criteria through data analytics when top-down extraction is not possible • Experience in health care/managed care with direct responsibility for quality analytics and data management with relational database concepts • Expertise in relational database concepts and applications, specifically SAS EG, SQL databases and tools, and MS Office Suite • Proficiency with Structured Query Language (SQL) procedures for data retrieval • Ability to write programs to query data and retrieve data from multiple tables/sources such as Hadoop, SQL Server, and Teradata with SAS and SQL • Strong data mining skills, including research and root cause analyses • 1+ years of experience as a Business System Analyst highly preferred • Ability to work independently or with little supervision • Ability to navigate the organization, build SME relationships, and assist with internal discussions • If working from home, cable broadband or fiber optic internet service with at least 10Mbps download/5Mbps 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 • Cable broadband or fiber optic internet service requirement for home working, with at least 10Mbps download/5Mbps upload