Business Analytics Senior Advisor (Nurse Informaticist) - Evernorth Health Services - Remote

Summary:

The Nurse Informaticist applies advanced clinical expertise and informatics knowledge to drive quality improvement initiatives through data-driven strategies. This role is responsible for optimizing clinical workflows, enhancing patient care, and ensuring regulatory compliance by utilizing evidence-based data analysis and digital data acquisition methods.

Within Cigna, this position contributes to clinical quality efforts by leading projects that leverage data to inform improvements in both clinical and operational practices. The role is essential in maintaining compliance with external accreditation and regulatory requirements via sophisticated data analysis and comprehensive reporting. As Cigna shifts from traditional HEDIS measurement to digital quality assessment, the Nurse Informaticist will be pivotal in modifying methodologies, implementing new tools, and updating strategies to meet changing industry standards and technological advancements.

Key Responsibilities:

HEDIS & Clinical Data Analysis

• Oversee HEDIS data collection, reporting, and analysis for assigned regions and projects.
• Evaluate clinical initiative outcomes to identify improvement opportunities across diverse populations, including clients, CACs, commercial markets, and IFP programs.
• Conduct both statistical and qualitative analyses utilizing claims, pharmacy, laboratory, and demographic data sources.
• Facilitate the transition to digital quality measurement by adapting data workflows, analytical tools, and reporting methodologies.

Clinical Integration

• Connect clinical practice with data analytics to inform evidence-based care enhancements.
• Partner with nursing and clinical teams to transform data-driven insights into practical protocols.

Clinical Systems Leadership

• Lead the design, implementation, and optimization of clinical information systems, such as EHRs and digital quality measurement platforms.
• Act as a subject matter expert in clinical data standards, interoperability, and digital health initiatives.

Advanced Quality Measurement

• Direct the shift from traditional to digital quality measurement methods, ensuring alignment with best clinical practices.
• Develop and validate clinical quality metrics that accurately represent real-world patient outcomes.

Measurement & Reporting

• Establish measurement strategies and create scorecards and reports to support:
• External accreditation
• Population health advancement
• Regulatory compliance
• Performance monitoring

Project Leadership & Technical Guidance

• Manage time-sensitive projects and deliverables within larger strategic initiatives.
• Provide technical leadership and guidance to quality teams regarding system requirements and data solutions.

Process Improvement & Efficiency

• Identify and implement opportunities to optimize analytic processes and reduce operational costs.
• Design and maintain tools for tracking and forecasting HEDIS performance metrics.

Stakeholder Engagement

• Collaborate with internal cross-functional teams and external partners to advance personalization and localization objectives.
• Coordinate with state immunization registries and other external organizations for data submissions.

Experience:

• Minimum of 8–10 years of clinical nursing experience, with at least 3–5 years in informatics or clinical data analytics roles.
• Proven leadership in clinical informatics initiatives, such as EHR implementation, digital quality measurement, and workflow redesign.
• Previous experience with HEDIS and digital quality programs is preferred.

Technical Skills:

• Advanced proficiency with EHR systems, clinical data standards (HL7, FHIR), and analytics tools.
• Experience utilizing SQL, Tableau, PowerBI, and healthcare interoperability solutions.
• Proficiency in MS Access and MS Excel.

Certifications:

• Nursing Informatics Certification is preferred.

Education

• A valid Registered Nurse (RN) license is required.
• A Master’s degree in Nursing Informatics, Health Informatics, or a closely related discipline is strongly preferred.

Other Qualifications:

• Strong project management, communication, and change leadership skills.
• Excellent analytical, problem-solving, and presentation capabilities.
• Demonstrated customer-centric approach with the ability to collaborate effectively within a matrixed environment.

If you will be working at home