Job Information
The Cigna Group Informatics Specialist - Hybrid in Bloomfield, Connecticut
Summary
Cigna is seeking a highly motivated and innovative team member to join our growing and dynamic Global Data & Analytics team as a Provider Management Tool Analyst. In this role, you will maintain and manage the Provider Management Tool (PMT), Rate Sheet History (RSH), the Chargemaster Input Tool (CMI), and the Profee Projection Tool (PPT). You will ensure compliance of PMY policies and procedures and lead monthly review sessions with the Contracting team.
Responsibilities
Maintain and manage, for assigned markets, all Healthcare Professional (HCP) contracted rates and demographic data.
Ensure compliance the Provider Management Tool (PMT), Rate Sheet History (RSH), Chargemaster Input Tool (CMI) and Profee Projection Tool (PPT) policies and procedures for Healthcare Professional (HCP) demographic and contracted rates data management.
Lead monthly review sessions with the contracting team to ensure most accurate and best line of sight is being reflected on each active or projected rate schedule maintained in PMT, RSH, CMI & PPT.
Review projections with contracting team to ensure monthly accuracy of results.
Lead and perform claim match process for assigned markets.
Coordinate and perform rating area review process for assigned markets.
Participating on project teams to help develop and test new PMT features, enhancements or fixes.
Suggest and recommend new tools or processes to enhance PMT.
Responsible for updates to Pro fee projection tool, provider moves, etc.
Qualifications
Minimum of 3 years of related health care/managed care work experience
Strong analytical and problem-solving skills
Strong communication skills to include written, oral and group presentation
Understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, and utilization management
Familiarity various data mining and reporting tools, such as Microsoft Excel & Access
Ability to work independently while managing multiple tasks and meeting deadlines
Experience working with claim data and familiarity with standard medical coding: CPT, ICD9, HCPC preferred
Bachelor's degree in Finance, Economics, Business, Health Policy Analysis, Healthcare Administration, Mathematics or Statistics.
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 76,700 - 127,800 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.
We want you to be healthy, balanced, and feel secure. That’s why 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) with company match, 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, visit Life at Cigna Group .
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 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.
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.