Business Analytics Advisor, Payment Integrity - Cigna Healthcare - Remote
South Carolina Work at Home, United States
R
USD 98K-163K Mid-level Full Time
Tasks
- Analyze edit performance to reduce false positives
- Apply machine learning for fraud waste and abuse detection
- Automate manual processes and improve decision support
- Build statistical models and predictive analytics
- Create dashboards and executive reporting
- Design model validation performance monitoring and outcome measurement
- Develop editing logic and proof of concept models
- Develop reusable data assets for scalable analytics
- Document claim editing enhancement needs
- Evaluate emerging AI and healthcare analytics technologies
- Interpret query languages using data dictionaries
- Lead payment integrity analytics initiatives
- Migrate SAS based edits to ARM claim editing platform
- Operationalize AI enabled analytics solutions
- Perform exploratory data analysis
- Promote responsible AI governance and compliance
- Research and update unified claim record data streams
- Standardize and format claim editing data
Perks/Benefits
Skills/Tech-stack
AWS | Altair | Automation | Azure | Claim Editing | Data Analysis | Data Governance | Data Mapping | Data Quality | Data Visualization | Databases | Databricks | Exploratory Data Analysis | Feature Engineering | Fraud Detection | Fraud Waste Abuse | Language Processing | Machine Learning | Model Evaluation | Model Validation | Natural Language | Natural Language Processing | Performance Monitoring | Power BI | Predictive Analytics | Python | R | SAS | SQL | Snowflake | Statistical modeling | TOAD | Tableau
Education
Bachelor of Engineering | Bachelor of Science | Master of Science
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