Senior Medical Cost Analytics Advisor

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The Cigna Group

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1982

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Healthcare • Healthcare Insurance • Pharmaceuticals

The Cigna Group is a global health company committed to improving the health and vitality of its clients, customers, and patients. With its two divisions, Cigna Healthcare and Evernorth Health Services, the company focuses on enhancing quality of life through healthcare services and pharmacy benefits management. The Cigna Group is dedicated to ethical practices in healthcare and artificial intelligence, and strives to create positive change in the healthcare system. It also emphasizes its Environmental, Social, and Governance (ESG) responsibilities, aiming to impact health equity and foster innovation in healthcare delivery.

📋 Description

• Support strategic medical cost analytics by identifying trends, risks, and affordability opportunities across cost containment and payment integrity programs • Translate complex findings into clear, executive-ready insights for technical, operational, and senior leadership audiences • Own financial impact assessments and business cases, including forecasts, variance analysis, and recommendations to improve performance • Support program measurement and performance monitoring for pre-payment and post-payment editing, coding audits, and recovery programs • Identify and size new opportunities by assessing billing patterns, coding and reimbursement dynamics, and drivers of wasteful or abusive practices • Partner across finance, operations, clinical, network, claims, product, vendor, and other enterprise teams to align insights to decisions and execution • Support vendor evaluation and sourcing through data-driven analysis informing negotiations, pricing structures, and performance guarantees • Improve data quality, strengthen controls, and enable scalable/self-service reporting and analytics through automation and AI-enabled tools

🎯 Requirements

• Bachelor’s degree in a quantitative field 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 • Home internet through cable broadband or fiber optic service with at least 10Mbps download and 5Mbps upload if working at home

🏖️ 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 with at least 10Mbps download/5Mbps upload for home working