Provider Data Lead Analyst - Directory Accuracy Quality Program - Remote

This role supports the provider data management organization within the Network Operations Quality Enablement Team. This position will support and conduct quality audit activities that measure and analyze the quality and consumption of provider data along with partnering in process improvement initiatives. Activities will include web research, outbound calls to providers’ offices, ancillaries and facilities validating provider demographic and relational data and data remediation. Along with these duties, this role improves the quality of the data, the process, and improvements in data consumption. This will require the ability to think critically and utilize judgment, fact and discretion in helping to drive quality improvements.

The Provider Data Lead Analyst should be proficient in understanding and interpreting provider data in source systems. Excellent customer service and communication skills are also a requirement of the role.  This role uses various tools that assist with data validation and requires a proficiency working with data and basic data analysis.  This role requires a solid understanding of the importance of data accuracy, data analytics, and external provider group relationships.  A strategic mindset and ability to adapt to changing requirements and priorities is vital. 

Duties Include:

• Engage with external provider partners by conducting outreach calls in a meaningful manner to improve and enhance the provider experience
• Track outgoing and incoming communication including documentation of outcome, key relational and field element changes
• Validate the demographic information and metadata of providers across the following data elements: Provider Status, Name, Gender, Date of Birth (DOB), State License, DEA, Address and Hospital Affiliation by web research and outbound calls to providers’ offices.
• Validate the relational information of providers across the following data elements: Service Locations, Group Affiliation and Provider Practicing Status by making outbound calls to providers’ offices.
• Assess the accuracy, completeness, and currency of Networks, Contracts, Demographic and Reimbursement data within Cigna systems.
• Implement and support business activities utilizing data mining, reporting, and other intelligence methods and tools.
• Submit provider updates to Provider Data Management (PDM) following existing outlined processes.
• Perform provider updates by automated processes and manual remediation.
• Excellent relationship building skills with internal and external partners.
• Accountable for supporting business readiness activities for project implementation.
• Assist with any special projects.

Qualifications:

Required

• Bachelor’s Degree required or a minimum of 3 years of work experience in provider services, provider contracting, network operations or analytics
• Strong knowledge and exposure/experience in the healthcare operations with emphasis on healthcare providers, contracting, and provider services
• Strong knowledge of Network, Contract and Demographic data elements.
• Strong knowledge of Provider structures and relationships
• Strong knowledge of Cigna systems - CPF and HCPM
• Microsoft Excel proficiency required (pivot tables, conditional formatting, VLOOKUP, etc.)
• Strong drive to learn new concepts/technology with the ability to embrace a rapidly changing environment
• Strong documentation and organizational skills with the ability to thrive in a fast-paced environment while supporting multiple concurrent efforts.
• Solid communication skills with the ability to discuss data analysis results
• Ability to manage large data sets
• Adept critical thinking skills with the ability to determine causes with consistency in results

Preferred:

• Previous telephonic customer service experience

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 62,500 - 104,100 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.