Summary
Medicare Advantage is a fast-growing Cigna business that depends on complete and accurate documentation for all members in our population. To that end, this role involves leading the design and development of new models to inform prospective initiatives for risk adjustment. This means leveraging a variety of claims-based and clinically-based (EHR) datasets to generate predictive models that enable a comprehensive understanding of a member’s clinically relevant information. You will join a collaborative, cross-functional team of stakeholders to meaningfully use these details to drive provider and member interventions. You will communicate modeling results and recommended process changes to MA leaders.
Key questions you would help solve include:
How can we build a machine learning algorithm to identify individuals at high risk for clinically relevant conditions, metrics of utilization, or other clinical outcomes?
How do we incorporate clinical data and insights (structured and unstructured) into meaningful insights for our business and clinical partners?
What is the potential business impact that can be driven by modeling results?
Which model best addresses the business need at hand?
What is the most effective outreach method to accurately document each customer’s risk?
You are a data and analytics expert who enjoys collaborating and creating a “meeting of the minds” between business partners and analytics. You have experience of working with large databases (particularly with claims and clinical data), and manipulating data in a cloud environment (like AWS). You enjoy digging deep into the data to surface new statistical insights, while incorporating guidance and suggestions from clinical experts. You excel at translating complex, technical analyses into simple, business-relevant findings and communicating those findings to business partners. You are self-motivated and enjoy working in a fast paced environment.
This position is with Evernorth, a new business within the Cigna Corporation.
Responsibilities
Consult independently with stakeholders across the MA business to prioritize and define key performance indicators that can be addressed with risk adjustment targeting models
Build and enhance models that prioritize outreach efforts using various analytical tools and techniques
Develop clear and thoughtful materials to communicate results/recommendations to business partners
Work effectively and efficiently on multiple tasks and deadlines, while producing high quality results.
Ensure quality and integrity of data collected and analyses performed
Qualifications
3+ years working with data in healthcare or life sciences field
Experience with SQL-based relational databases
Excellent command of data science libraries in Python
Experience working in a cloud based environment (preferably AWS)
Experience building and deploying machine learning algorithms in production preferred
Ability to independently prioritize and manage multiple responsibilities
Prior experience with ACA or MA risk adjustment program is preferred
Experience with diverse healthcare data preferred (e.g. claims, EHR, demographic, pharmacy, labs)
Bachelor’s Degree in a quantitative field (e.g. mathematics, statistics, computer science) or equivalent practical experience. Advanced degrees preferred
For this position, we anticipate offering an annual salary of $95,800 - $159,600, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
Helping our customers achieve healthier, more secure lives is at the heart of what we do. While you take care of our customers, we’ll take care of you through a comprehensive benefits program that helps you be at your best. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and best in class well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and dozens of corporate discounts on essentials you use every day. For more details on our employee benefits programs, please visit the “Life at Cigna” tab on our careersite: www.cigna.com/careers
About Evernorth
Evernorth, Cigna Corporation’s health services segment, exists to elevate health for all. We're building on our legacy and redefining health care as we know it. Unbiased in how we think, we create without limitation. We partner without constraints, deliver value differently and act in the interest of humanity. Solving across silos, closing gaps in care, and empowering clients, customers, and people everywhere to move onward and upward. When you work with us, you’ll be empowered to solve the problems others don’t, won’t or can’t. Join us. What difference will you make?
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
Cigna has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.