Business Analytics Advisor, Payment Integrity – Risk & Affordability (Remote)
As a Business Analytics Advisor, you’ll lead complex strategy and analytical workstreams supporting enterprise medical cost containment initiatives. You’ll translate large, complex claims and medical expense datasets into clear, actionable insights; quantify financial impact for proposed and implemented programs; and partner across clinical, contracting, product, operations and business teams to define assumptions, methodologies, and measurement strategies that enable sound decisions and sustained medical cost trend management.
What You’ll Do:
Lead end-to-end analytics to evaluate medical cost savings initiatives, including medical policy changes and other cost containment programs.
Own savings estimates by developing accurate, auditable financial impact assessments grounded in historical and current medical expense patterns.
Partner cross-functionally with Clinical Operations, Network, Coverage Policy, project managers, and medical directors to align assumptions, methodologies, and measurement strategies.
Identify trends and cost drivers through exploratory, longitudinal, and ad hoc analysis to surface emerging patterns and anomalous utilization.
Design and maintain analytical routines (tools, algorithms, monitoring) to track medical forecasts and savings performance over time.
Apply advanced analytics (statistical techniques and scalable methods) to generate insights that support medical cost trend reduction and assess the impact to providers, clients and customers .
Tell the story behind the data by translating complex findings into concise, executive-ready summaries and recommendations for stakeholders at multiple organizational levels.
What You’ll Bring:
Demonstrated ability to independently execute complex analyses while managing multiple priorities and deadlines.
Strong analytical and problem-solving skills, including experience developing algorithms and methodologies to quantify cost savings opportunities.
Strong business acumen and working knowledge of healthcare data, claims payment processes, eligibility, benefit design, and clinical data.
Familiarity with provider contracting terms, clinical operations and reimbursement methodologies preferred.
Experience modernizing analytics through automation and thoughtful use of AI-enabled and advanced analytics methods (e.g., predictive modeling, NLP, machine learning) where they add measurable value.
Self-starter with a strong orientation toward continuous improvement, ownership, and impact.
Requirements:
Bachelor’s degree in quantitative field (e.g., Statistics, Mathematics, Economics, Health Policy Analysis, Finance, Actuarial, Public Health, Business ) or equivalent practical experience.
5+ years of experience in healthcare or finance cost analysis
Knowledge of standard medical coding systems (e.g., DRG, ICD-10, HCPCS) and the ability to translate analytical results into actionable business insights for senior and executive stakeholders.
Technical proficiency with data and BI and AI tools such as SQL, SAS, Tableau, Databricks, Calude and Excel
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an annual salary of 98,200 - 163,600 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here.
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.
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 need a reasonable accommodation to complete the online application process, please email [email protected] for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.
The Cigna Group 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.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
What You’ll Do:
Lead end-to-end analytics to evaluate medical cost savings initiatives, including medical policy changes and other cost containment programs.
Own savings estimates by developing accurate, auditable financial impact assessments grounded in historical and current medical expense patterns.
Partner cross-functionally with Clinical Operations, Network, Coverage Policy, project managers, and medical directors to align assumptions, methodologies, and measurement strategies.
Identify trends and cost drivers through exploratory, longitudinal, and ad hoc analysis to surface emerging patterns and anomalous utilization.
Design and maintain analytical routines (tools, algorithms, monitoring) to track medical forecasts and savings performance over time.
Apply advanced analytics (statistical techniques and scalable methods) to generate insights that support medical cost trend reduction and assess the impact to providers, clients and customers .
Tell the story behind the data by translating complex findings into concise, executive-ready summaries and recommendations for stakeholders at multiple organizational levels.
What You’ll Bring:
Demonstrated ability to independently execute complex analyses while managing multiple priorities and deadlines.
Strong analytical and problem-solving skills, including experience developing algorithms and methodologies to quantify cost savings opportunities.
Strong business acumen and working knowledge of healthcare data, claims payment processes, eligibility, benefit design, and clinical data.
Familiarity with provider contracting terms, clinical operations and reimbursement methodologies preferred.
Experience modernizing analytics through automation and thoughtful use of AI-enabled and advanced analytics methods (e.g., predictive modeling, NLP, machine learning) where they add measurable value.
Self-starter with a strong orientation toward continuous improvement, ownership, and impact.
Requirements:
Bachelor’s degree in quantitative field (e.g., Statistics, Mathematics, Economics, Health Policy Analysis, Finance, Actuarial, Public Health, Business ) or equivalent practical experience.
5+ years of experience in healthcare or finance cost analysis
Knowledge of standard medical coding systems (e.g., DRG, ICD-10, HCPCS) and the ability to translate analytical results into actionable business insights for senior and executive stakeholders.
Technical proficiency with data and BI and AI tools such as SQL, SAS, Tableau, Databricks, Calude and Excel
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an annual salary of 98,200 - 163,600 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here.
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.
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 need a reasonable accommodation to complete the online application process, please email [email protected] for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.
The Cigna Group 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.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.