Business Analytics Senior Advisor

Summary

EviCore’s diversified portfolio of proven medical cost management solutions enables our clients to improve the quality and efficacy of care while at the same time reducing medical spend. We believe and have demonstrated that better healthcare is inherently less expensive.

We are looking for an individual with a background in medical, financial or actuarial analysis to join our Healthcare Economics team. The role will be to oversee and assist in the design, development, analysis and reporting of claims data using business intelligence tools, statistical and analytical techniques to better understand healthcare trends, report on overall program results as well as identify opportunities in support of the sales team to expand our product offering to new and existing customers. 

The Business Analytics Senior Advisor will report to the Director, Business Analytics and will work closely with our Account Management team, Finance, Informatics, Medical, Sales and Marketing staff, including direct involvement with customers in the form of written and verbal presentations to support corporate-wide strategic decision-making that impacts revenue, medical expense and product growth. The ideal candidate will come from a managed care, insurance, actuarial, or hospital background, and will be a results-oriented individual who enjoys working in a fast-paced and challenging environment.

Responsibilities:

• Work with IT and data warehousing counterparts to develop and design deliverables to support the economics team and customer reporting needs. - Conduct baseline and trend analyses for targeted medical cost categories, geographies and segments.

• Calculate baseline and trend metrics (e.g., PMPM and Utilization per 1000).

• Apply actuarial concepts and tools to enhance understanding of utilization and cost trends across networks, products and geography.

• Validate findings against established benchmarks.

• Use baseline metrics and trends to establish Savings Forecast and Pricing.

• Creating and delivering results in an accurate and timely manner to both internal and external customers.

• Effectively communicate results to key stakeholders and policy makers. Communication of results include clean and well organized presentations to reflect analytic methods used, key decision points with sufficient detail to support comprehension and replication of the analysis.

• Provide additional analyses that support New Sales and Product Development by being able to manipulate and analyze claims data to perform IBNR calculations, Provider Network Overlap, Fee Schedule Pricing, trend mitigation and population mix-shifts.

• Relate analytic findings to business questions and objectives. This includes learning to integrate information from multiple sources, discern implications for future analysis and identify opportunities for enhancing the integrity of data results.

• Perform special projects as assigned.

• Act as a SME in several business areas and mentor analysts and advisors on the team.

Qualifications:

• BA/BS degree (a Master's degree is preferred) in finance, accounting, economics, statistics or other quantitative background

• 12 years of progressive, analytical experience in a healthcare setting

• Experience working in an ACO, IPA or MCO setting and/or with bundled payments is preferred

• Knowledge of using big data and data warehouses, data extractions, manipulations, dimension, fact, and reference tables in order to obtain necessary information

• Extensive experience using data directly from a SQL or similar database, not simply through a present reporting GUI

• Strong understanding of managed care metrics (PMPM, Utilization/K and Average Cost)

• Ability to work independently as well as in a group environment

• Ability to influence internal stakeholders in order to accomplish objectives

• Strong communication and presentation skills

• Ability to present highly technical concepts to technical and non-technical audiences

• Strong organizational and time-management skills

• Demonstrated problem solving and critical thinking skills

• Strong attention to detail

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.

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessl