Claims Data Steward (Business Analytics Senior Advisor)

Safe, accurate, and reliable data is critical to supporting The Cigna Group’s needs.  Data is its most important asset.  The Enterprise Data Governance (EDG) team assists others across the organization by providing guidance, tools, and support for data management and data quality oversight.  Effective execution of goof data governance principles and practices minimizes risk and ensures the data is available and fit for purpose.  The EDG team implements data governance and quality best practices to support operational, technological, and analytic efficiencies and enhancements across Lines of Businesses (LoBs).

The Claims Data Steward is a member of a cross-functional EDG team who partners with business, technical, and regulatory stakeholders to ensure the implementation of industry and business data standards and its documentation is accomplished.  The Data Steward leads complex, cross-organizational efforts to ensure data is fit for organizational use – including but not limited to: risk assessment, metadata management, data quality monitoring, issue management, and knowledge management.  Candidates should have a strong data management background and understanding of how data may be organized and of relationships maintained between/among data domains across multiple enterprise systems with a strong drive towards improving data quality and governance.

Responsibilities (related to Claims Data Domain):

• Serves as Data Steward dedicated to health care payer Claims data operations & initiatives
• Works collaboratively with other enterprise and business data stewards to align standards and share best practices; represents Claims data domain in enterprise workgroups and data steward communities of practice
• Leads Data Governance initiatives and collaborations with business and IT operational stakeholders to:
  • Document, define, maintain, and manage data standards and assets, e.g., Critical Data Elements (CDEs), business terms, definitions, reference data, and business rules
  • Ensure the implementation of the data governance program, tools, best practices and compliance with data standards
• Assesses and monitors data quality metrics, analyzes trends, and proactively promotes remediation and preventive action efforts
• In conjunction with the business owners:
  • Defines and communicates metrics to gauge the health and quality of data across enterprise systems
  • Identifies and presents recommendations on business process improvements and efficiencies, including business case and implementation options
• Provides consultative stewardship services to delivery and issue resolution teams, as needed, to ensure efficient and accurate flow of data.

Qualifications:

• Bachelor’s degree or higher
• 5+ years professional work experience in:
  • Data Governance, Data Management and Data Quality practices
  • Healthcare payer data products and processes
  • Claims data standards and operations, including:  
    • In depth subject matter knowledge of health care claim / encounter terminology, concepts and business processes within one or more data subdomains, e.g., medical, behavioral, vision, dental, pharmacy, etc.
    • Health care data claim / encounter transactions systems, e.g., Proclaim, Facets, EDI Gateway 837, HL7, FHIR, Arcadia or other claim / electronic medical record (EMR) data sources and data repositories
    • Claim / encounter end-to-end lifecycle processes, e.g., submission, processing, payment, reconciliation, etc.
    • Claim / encounter reference data standards, groupers and classifications, e.g., ICD-10, CPT, HCPCS, DRG, APC, ASC, SNOMED CT, EDI implementation guides, etc.
• Strong communications skills (verbal, listening, written, and presentation) with management teams and peer groups
• Strong leadership skills to motivate others to achieve goals and inspire change; ability to engage business and data stakeholders to resolve questions or issues; demonstrate ability to create professional relationships and effectively influence cross-functional teams
• Must have the ability to handle multiple and sometimes competing priorities in a fast-paced environment; ability to organize and develop project plans supporting near and long-range goals and actions; able to strategize across complex, cross-functional projects and initiatives
• Must have strong analytical and problem-solving capabilities
• Must be able to think creatively, innovate and flex where needed - quick/adaptive learner and collaborator/team player
• Self-motivated and able to function with minimal direction
• Intermediate to Advanced skills in data analysis and data governance tools (e.g., SQL, SAS, TOAD, Python, Hadoop, Teradata, Snowflake, Tableau, Collibra, Infosphere, Alation, etc.)
• Project management and Six Sigma skills are a plus
• Experience in Agile Methodology and tools (e.g., Jira, Rally, etc.)

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.

For this position, we anticipate offering an annual salary of 111,800 - 186,400 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.