Business Analytics Advisor, Payment Integrity – Risk & Affordability (Remote)

The Cigna Group is dedicated to improving health and vitality through its services. As a Business Analytics Advisor, you will lead complex analytical workstreams to support medical cost containment initiatives, translating large datasets into actionable insights and partnering with various teams to define methodologies for decision-making.

Responsibilities:

• 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

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
• 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
• 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
• 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
• Familiarity with provider contracting terms, clinical operations and reimbursement methodologies