Non Par Cost Containment Compliance Initiatives hos Cigna International Health Insurances

Publicerat för 3 dagar sedan

Role Description

As part of our Global Data & Analytics Medical Economics Team (Network Analytics) you will oversee medical cost analysis relating to Cigna’s Non Par cost containment solutions as well as maximum reimbursable charge. You will be a member of a team that specializes in Non Par provider analysis; Cost containment earnings and financial projections; Client out-of-network benefit strategy and analysis; Enablement of Non Par pricing techniques; and local market Non Par reporting

Responsibilities

  • Manage staff in support of network analytics compliance activities
  • Directly enable non par operational partners with fee schedule creation and financial impact analysis pertaining to federal and state compliance measures (including PPACA, Federal surprise billing, State surprise billing, arbitration)
  • Maintain awareness of compliance regulations and design solutions/curate reference data that adhere to the particulars of the law
  • Vet, document, and defend rationale for fee schedules/reference data with legal, compliance, product, operations, contracting, and other network analytics partners
  • Guide operational partners with insights around practicality of implementing compliance requirements; assist in prioritizing compliance efforts around actions that will yield the greatest affordability for the lowest cost
  • Oversee the continued evolution of all median contract rate tables including possible expansion to product specific or local market; ensure logic is applied consistently across solutions
  • Flex to support other non par financial analysis on an ad hoc basis where load balancing may be required

Skills Necessary

  • Skilled working with data and building data sets; demonstrated experience in SQL
  • Experienced with applying common statistical measures to data; able to let the computer do the work
  • Independence: Proven ability to stand alone, apply sound decision quality, and take hard stances in a highly matrixed and sometimes nebulous environment
  • Can summarize drivers, trends, changes in calculated output in a succinct and accurate manner
  • Technical expert with strong communication skills (Bachelors in Finance, Economics, Math, Statistics or equally technical field; at least 8 years of healthcare experience)

About Cigna

Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. We offer an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products. Together, with our 74,000 employees worldwide, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation.
When you work with Cigna, you’ll enjoy meaningful career experiences that enrich people’s lives while working together to make the world a healthier place. What difference will you make? To see our culture in action, search #TeamCigna on Instagram.
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 an accommodation based on your physical or mental disability please email: SeeYourself@cigna.com. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

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