Business Analytics Senior Advisor Payment Integrity - Risk & Affordability ENCORE

Cigna Healthcare is dedicated to improving the health and vitality of those they serve. They are seeking a Senior Business Analytics Advisor to provide strategy and analytical support for the Payment Integrity team, focusing on evaluating payment integrity programs and translating performance into actionable insights.

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

Requirements:

• Bachelor's degree in a quantitative field (e.g., Economics, Finance, Data Science, Data Analytics, Actuarial Science, Business, Public Health, Applied Mathematics) or equivalent experience
• Must be a Cigna retiree
• 20+ 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)
• Proven ability to translate complex analyses into actionable business insights, with clear, confident communication for senior and executive audiences
• Knowledge of reimbursement methodologies and coding (e.g., MS-DRG, APCs, HCPCs, RBRVS) and familiarity with professional and facility claim constructs
• 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
• Master's degree preferred