Description
Org Marketing Statement
People want to be treated like individuals. At Cigna, we get that. That''s why we embrace and encourage peoples'' uniqueness, helping to give them the strength and confidence to show the world who they really are. The coverage, expertise and services we provide are at the very core of how we help people achieve their full potential - and ultimately, improve their health, well-being and sense of security.
But before we can accomplish any of that, we have to have the right people in place. People like you.
Skills, experience, talent and creativity like yours enables us to develop the meaningful, innovative solutions our customers value and expect. That''s why we''re committed to recruiting, motivating and nurturing the best and the brightest, whether you have industry experience or not. We''re growing a workforce as unique and diverse as the millions of customers we proudly serve around the world - one individual at a time.
Role Summary
Focuses on the use of information and analytics to improve health and optimize consumer focused business processes. Responsible for the extraction and analysis of health care information regarding network utilization and cost containment and clinical quality information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings to drive the decision-making process and support business operations for internal and external customers in an effort to control medical cost and improve the quality of services provided to members. Performs research and analysis of complex healthcare and/or clinical data regarding network utilization, cost containment and quality improvement information. Responsible for research using multiple sources of data and analyzing algorithms to determine health care expenditures and utilization patterns. Combines complex IT capabilities with advanced clinical knowledge to determine trends, cost/benefit ratios, and forecasting of health care costs, medical management, and health economics. May also be responsible for designing and implementing the systems and programming to analyze and report findings. This position requires a high level of expertise in both analyzing medical data and information systems. May provide guidance or expertise to less experienced analysts. Typically requires Bachelors in Statistics, Mathematics, Epidemiology or equivalent training and mastery; minimum 4 years experience in related health care analytics; or any combination of education and experience, which would provide an equivalent background.
Major Duties
Role Summary
Seeking a motivated self-starter who can work well independently and as part of a team in a dynamic environment. The primary responsibility of this role will be to support HEDIS development and production. In this role they will work with an existing experienced business and IT staff, with matrix partners throughout the organization, and with external vendors and stakeholders. They will also be required to provide data and analytical support in collaboration with matrix partners throughout the organization in support of various internal and external clinical initiatives.
Major Duties
-Support the annual HEDIS production process by being the business owner for assigned measures/processes.
-Ensure that business specifications are complete, accurate and timely based on HEDIS requirements, NCQA updates, audit requirements and CIGNA data sources.
-Identify barriers such as data quality issues and incomplete data, and investigate, document and implement actions to meet goals. Participate/coordinate in workgroup meetings across functional areas to identify improvement opportunities that will lead to better results or improved efficiencies.
-Perform as the subject matter expert for assigned measures and processes, defining expectations with systems partners and supporting systems development, including specification and code walk-throughs and acceptance testing.
-Participate in the annual HEDIS audit process by providing documentation, analysis findings, and perform as subject matter expert to ensure a successful audit.
Qualifications
-Bachelor''s degree in business, finance, economics, healthcare administration or related field. Experience in information management, HEDIS development or in a clinical health care setting a plus.
-2 plus years work experience in health care/managed care.
-Knowledge of managed care business processes, systems and data (ICD9, CPT4, DRG, etc).
-Proven experience in interpreting and translating business needs into technical requirements.
-Strong data mining and analytical skills and experience.
-Ability to perform research and conduct root cause analysis on suspect data output.
-Proficiency in data querying/data management tools such as MS Access, SAS, SQL, etc.
-Self-directed individual who can operate effectively in an empowered team environment.
-Demonstrated ability to support multiple, complex projects in varying stages of development in a fast-paced environment.
-Capable of exercising a high degree of judgment and prioritizing work accordingly.
-Ability to communicate (orally and in writing) clearly and concisely.
Responsibilities
Seeking a motivated self-starter who can work well independently and as part of a team in a dynamic environment. The primary responsibility of this role will be to support HEDIS development and production. In this role they will work with an existing experienced business and IT staff, with matrix partners throughout the organization, and with external vendors and stakeholders. They will also be required to provide data and analytical support in collaboration with matrix partners throughout the organization in support of various internal and external clinical initiatives.
Major Duties
-Support the annual HEDIS production process by being the business owner for assigned measures/processes.
-Ensure that business specifications are complete, accurate and timely based on HEDIS requirements, NCQA updates, audit requirements and CIGNA data sources.
-Identify barriers such as data quality issues and incomplete data, and investigate, document and implement actions to meet goals. Participate/coordinate in workgroup meetings across functional areas to identify improvement opportunities that will lead to better results or improved efficiencies.
-Perform as the subject matter expert for assigned measures and processes, defining expectations with systems partners and supporting systems development, including specification and code walk-throughs and acceptance testing.
-Participate in the annual HEDIS audit process by providing documentation, analysis findings, and perform as subject matter expert to ensure a successful audit.
Qualifications
-Bachelor''s degree in business, finance, economics, healthcare administration or related field is strongly preferred.
-Experience in information management, HEDIS development or in a clinical health care setting a plus.
-Work experience in health care/managed care.
-Knowledge of managed care business processes, systems and data (ICD9, CPT4, DRG, etc).
-Proven experience in interpreting and translating business needs into technical requirements.
-Strong data mining and analytical skills and experience.
-Ability to perform research and conduct root cause analysis on suspect data output.
-Proficiency in data querying/data management tools such as MS Access, SAS, SQL, etc.
-Self-directed individual who can operate effectively in an empowered team environment.
-Demonstrated ability to support multiple, complex projects in varying stages of development in a fast-paced environment.
-Capable of exercising a high degree of judgment and prioritizing work accordingly.
-Ability to communicate (orally and in writing) clearly and concisely.
Pay Benefits Work Schedule
CIGNA offers a competitive compensation and comprehensive benefits package including health and wellness benefits, 401k plan, and work/life balance programs, as well as opportunities for career growth and development.
How To Apply
We encourage you to complete all questions on the candidate profile if you wish to be considered for this opportunity.
EEO Statement
CIGNA is an Equal Opportunity Employer
Details:
Job Id:
29305214
Posted / Updated:
5/9/2012 5:14:09 AM
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