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

Cigna Healthcare•Tennessee Work at Home, TN

4d•$98,200 - $163,600•Remote

About The Position

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.

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

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.