Program Management Lead Analyst/Data Analyst - Cigna Healthcare - Remote

Role Summary :

Data Analyst for our Pre/PostPay Edit editing program.

This position will provide the technical component of our Pre/PostPay Edit editing program in development, implementation, production monitoring and maintenance of our internal PrePay edits.

Individual will work with our matrix partners to evaluate edit ideas and use business requirements to develop the technical processes to obtain desired results and support strategic initiatives aimed at improving claim accuracy and operational efficiency.

Strong technical coding experience will be needed to be successful in this role.

Key Responsibilities:


* Act as technical analyst for Proactive Claim Intervention projects and daily tasks for all aspects of our Pre/PostPay Edit editing program.


* Data Analyst for the development, installation, execution and maintenance of our Pre/PostPay Edit editing program.


* Develop and maintain editing on regular and ad-hoc basis, primarily using SAS, Microsoft SQL Server and internally developed ARM rule-based claim editing platform



* Responsible for data mining activities and technology integration of Pre/PostPay Correction Program to support our Pre/PostPay Edit editing program.


* Evaluates and appropriately utilizes various approaches to data mining to narrow in on trends and drivers that directly impact outcomes.


* Makes well-thought-out decisions on complex or ambiguous IT architecture issues.


* Participate in all phases of Pre/PostPay Edit program IT architecture process testing and implementation


* Ensures that system improvements are successfully implemented and monitored to increase efficiency.


* Works closely with matrix business partners to define data needs, opportunities for improvement and effectively communicates results of analysis and solutions.


* Acts as a resource for mentorship, training and guidance for junior staff.

Required Qualifications:


* Bachelor's degree in Business Analytics, Data Science, Information Systems, or a related field strongly preferred or equivalent work experience required.


* 5+ years of experience in healthcare data analytics required.


* 5+ years coding experience required, with proficient skills using SAS and Microsoft SQL Server, experience with rule-based editing platforms desired.


* 5+ years' experience in healthcare data with proficient skills in medical analysis and project management.


* Strong data investigation skills to mine healthcare data required


* Strong data analysis skills with the ability to analyze large amounts of healthcare data to translate complex data into meaningful, actionable insights


* Strong project management skills and comfort in ability to create and achieve success in highly matrixed environment.


* Exceptional verbal and written communication skills with demonstrated ability to research, problem solve, trouble shoot, influence and partner across the organization to a drive toward res...