Senior Provider Relations Analyst

🔥 12 hours 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

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

• Write business, functional, and non-functional business requirements • Participate in system design reviews, test evidence reviews, and 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 existing BoR system (PRIME) and other BoR 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 provider-data loading 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 • Work with business partners and IT 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 and retrieve data from multiple tables/sources, including Hadoop, SQL Server, and Teradata, using SAS and SQL • Strong data mining skills, including research and root cause analysis • Ability to navigate the organization, build SME relationships, and assist with internal discussions • 1+ years of experience as a Business System Analyst highly preferred • If working at home, cable broadband or fiber optic internet service with at least 10 Mbps download and 5 Mbps upload is required

🏖️ Benefits

• Annual bonus plan eligibility • Medical, vision, and dental benefits from day one • 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 • Tobacco-free policy • Reasonable accommodation support for the application process