Remote, Work from Home, United States
This role supports the Network Quality & Innovation department of the Total Health and Network organization.
This position contributes directly to the development and enhancement of customized tools and capabilities to support activities that measure and analyze the quality and consumption of healthcare provider data. This role will maintain a strong focus on facts and data to understand and improve the quality of our provider network, contract, and demographics data.
May work as an individual contributor or lead a team to work on complex systems analysis and development activities across multiple functional areas using judgment, fact, and discretion. Actions have a significant impact on key department objectives.
- Execute management strategies for Network Quality & Innovation project portfolio, identifying areas of improvement, gathering data, conducting analysis and recommending controls or other actions to ensure accuracy of Provider data for consumption.
- Participate in and possibly lead multiple complex, time-sensitive projects designed to deliver targeted outcomes.
- Support audit activities, including manual and semi-automated inspections of specific transactions, utilizing data mining and intelligence tools
- Work independently and collaboratively with Cigna business partners to verify and document provider quality defects and opportunities for improvement.
- Organize efforts to identify, prioritize, and assess the impacts of business process problems and consumption defects.
- New application development
- Translate business needs into practical applications and solutions.
- Evaluate technical solution options taking into consideration both upstream inputs into business and system process and downstream consumers of data.
- Technical design, programming, unit & system test.
- Identify defects, root cause analysis, and developing recommended solutions.
- Manage source code version control.
- Document new functionality.
- Production support, maintenance, and enhancement to existing applications
- Run production processing and verify the results.
- Troubleshoot unexpected results.
- Technical design, programming, unit & system test of application changes.
- Identify opportunities for technical and process improvements.
- End user support.
- Coach and develop colleagues
- Train users on new and changed applications.
- Share technical expertise.
- Bachelor's Degree or higher strongly preferred or equivalent work experience.
- 5+ years’ experience in data processing and IT within a healthcare setting, including technical design, programming, testing, and production support.
- Advanced or expert developer skills in SQL Server required and SSIS.
- Advanced or expert developer skills in MS Access and Excel using VBA required.
- Database programming experience: SQL Server, PL-SQL, and/or T-SQL
- Experience in Visual Studio / vb.net programming.
- SAS programming experience.
- Experience with reporting and analytical tools such as Hyperion/Brio, Business Objects, or COGNOS desired.
- Source code version management experience, especially using Microsoft Git.
- Experience in healthcare operations claim processing with emphasis on healthcare provider demographics, contracting, and networks as well as provider services.
- Experience with or exposure to audits or quality assurance activities, including conducting sample audits, designing and maintaining audit procedures, implementing quality inspections, assisting in the development and enhancement of quality tools, and analyzing results to improve quality outcomes..
- Healthcare data statistical analysis experience and demonstrated understanding of healthcare delivery systems processes.
- Strong organization skills.
- Strong critical thinking skills with the ability to identify the root cause of a problem as well as potential peripheral impacts.
- Leadership competencies, including strong communication skills, ability to collaborate with others and establish working relationships across teams, ability to navigate and contribute within a highly matrixed environment, and strategic thinking.
- Ability to lead and train others.
This position is not eligible to be performed in Colorado.
About CignaCigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, 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 us, or one of our subsidiaries, you’ll enjoy meaningful career experiences that enrich people’s lives. What difference will you make?
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.