[Remote] Senior Business Analytics Advisor, Payment Integrity (Remote)

Note: The job is a remote job and is open to candidates in USA. Cigna Healthcare is dedicated to improving health and vitality, and they are seeking a Senior Business Analytics Advisor for their Payment Integrity team. This role involves providing strategic and analytical support, translating complex data into actionable insights, and partnering across various teams to enhance payment integrity programs.

Responsibilities

• Support strategic medical cost analytics by identifying trends, risks, and affordability opportunities across cost containment and payment integrity programs
• Tell the story behind the data, translating complex findings into clear, executive-ready insights for technical, operational, and senior leadership audiences to short the strategic roadmap
• Own financial impact assessments and business cases for initiatives, including forecasts, variance analysis, and recommendations to improve performance
• Support program measurement and performance monitoring for pre-payment and post-payment editing, coding audits, and recovery programs across dashboards, scorecards, and executive materials
• Identify and size new opportunities by assessing billing patterns, coding and reimbursement dynamics, and drivers of wasteful or abusive practices
• Partner across the enterprise (e.g., Contracting, Coverage Policy, Commercial Payment Integrity, Compliance, Network Analytics, Claims, Reserving, Product) to align insights to decisions and execution
• Support vendor evaluation and sourcing through data-driven analysis that informs negotiations, pricing structures, and performance guarantees
• Advance reporting and analytics by improving data quality, strengthening controls, and enabling scalable/self-service solutions through automation and thoughtful use of AI-enabled tools

Skills

• Bachelor's degree or in a quantitative field (e.g., Economics, Finance, Data Science, Data Analytics, Actuarial Science, Business, Public Health, Applied Mathematics) or equivalent experience
• 8+ years of progressive experience in healthcare analytics, medical cost analytics, payment integrity, financial modeling, or related fields
• Strong analytical and technical skills, with hands-on experience using tools such as SQL, Excel, SAS, Tableau, Databricks (or similar platforms)
• Knowledge of reimbursement methodologies and coding (e.g., MS-DRG, APCs, HCPCs, RBRVS) and familiarity with professional and facility claim constructs
• Proven ability to translate complex analyses into actionable business insights, with clear, confident communication for senior and executive audiences
• Comfort working in regulated and compliance-aware environments (claims operations, audit programs, policy, and related controls)
• Strong collaboration and influence skills, with the ability to balance multiple priorities in a matrixed environment
• Self-starter with a strong orientation toward continuous improvement, ownership, and impact
• 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

Benefits

• Annual bonus plan
• Medical, vision, dental, and well-being and behavioral health programs
• 401(k)
• Company paid life insurance
• Tuition reimbursement
• A minimum of 18 days of paid time off per year
• Paid holidays

Company Overview

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