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

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

• 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.
• 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.
• About The Cigna Group
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Benefits

Additional Information

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.

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