Data Management Strategy & Governance Sr Analyst - CMS Supplemental Benefits Encounter Submissions-

Cigna - Nashville, TN

Full-time

Hybrid - Nashville, TN

Insurance Carriers and Related Activities

About the position

The Data Management Strategy & Governance Sr Analyst role is part of the Encounters Risk Adjustment Submissions team at Cigna HealthSpring. This position focuses on submitting risk adjustment data to CMS, enhancing operational programs, and ensuring data integrity and quality. The analyst will leverage their expertise in medical data analysis and information systems to support business processes and improve health outcomes.

Responsibilities

• Focuses on the use of information and analytics to improve health and optimize consumer-focused business processes.
• Possess technical knowledge of all phases of applications systems and operational processes.
• Validates data, performs data analysis, loads data into appropriate systems and organizes it to get meaningful reports.
• Required to review, design, and prepare application/system specifications across multiple platforms for information systems solutions which address business needs and methods.
• Conducts testing and system validation to troubleshoot issues related to master data management and system integrity.
• Recommends ways to strengthen data integrity, quality, and availability across the organization.
• Collaborate with client management to identify and specify the complex business requirements and processes, and in the application design, testing and implementation processes.
• Broker conversations to remediate data issues while building a rapport and a positive working relationship with internal and external business partners, stakeholders, and team members.
• Give outstanding customer service to everyone you meet or work with.
• Strive to obtain the support, engagement and effort needed to successfully complete tasks as assigned.

Requirements

• Bachelor's Degree in Statistics, Mathematics, Computer Science or High School Diploma with a minimum 4 years' experience in related health care analytics or any combination of education and healthcare experience.
• Knowledge of CPT, HCPS, ICD9 and ICD10 codes.
• Knowledge of 5010, x12 EDI, Standardized Medical formats.
• Excellent oral, written presentation and communication skills.
• Strong analytical and creative problem-solving skills.
• Experience utilizing and optimizing SQL statements.
• Familiar with IT Software Development Lifecycle (SDLC)

Nice-to-haves

• Knowledge of Medicare Advantage Risk Adjustment Model (HCC model)
• Knowledge of NUCC and NUBC guidelines
• Knowledge of Medicare Regulations and Medicaid State Processing Guidelines
• Experience in working on an Agile team and understanding of Agile methodologies.