4.1 Business Analytics Manager
Posted Updated
Description
Position Summary
The International Health Medical Economics team is looking for a Medical
Economics Analytics Manager to help identify the drivers of medical cost
and utilization trends and translate them into actions that improve
affordability and health outcomes. This role combines healthcare claims
expertise, advanced analytics, data visualization, and stakeholder
leadership. The successful candidate will lead a team responsible for
analysing complex claims and eligibility data, identifying actionable
opportunities, and partnering with Network, Clinical, and Fraud, Waste
and Abuse teams to develop targeted interventions. The role is suited to
an analytics leader who can move from data exploration and root-cause
analysis to executive communication, recommended interventions, and
measurable business action. It offers the opportunity to build scalable
analytics capabilities supporting Cigna’s international health insurance
business across multiple markets.
Responsibilities
Claims analytics and insight generation
- Lead analysis of medical cost and utilization trends to identify
underlying drivers across markets, clients, providers, populations,
and clinical categories.
- Apply healthcare claims knowledge to distinguish the effects of
utilization, unit cost, provider mix, service mix, disease burden,
benefit design, and member behaviour.
- Develop analytics covering provider performance, population risk,
claims leakage, clinical variation, and potential fraud, waste and
abuse.
- Convert analytical findings into clearly defined opportunities,
supported by evidence, expected impact, and recommended next
actions.
Business action and stakeholder partnership
- Partner with Network teams to support provider benchmarking,
contracting strategies, and provider negotiations.
- Partner with Clinical teams to identify opportunities related to
care pathways, disease management, utilization management, and
site-of-care optimization.
- Partner with FWA teams to identify abnormal billing, utilization,
and provider behaviour patterns requiring further investigation.
- Present complex analytical findings to senior stakeholders in a
concise, decision-oriented format.
- Track whether implemented actions deliver the expected impact and
use the results to improve future analyses.
Analytics products and dashboards
- Define and develop self-service dashboards that enable users to
identify and investigate medical cost and utilization drivers more
quickly.
- Translate business questions into analytical requirements, measures,
drill-down pathways, and intuitive dashboard designs.
- Work with Data and Technology teams to ensure analytics products are
scalable, reliable, and supported by appropriate data controls.
Team and capability leadership
- Lead, coach, and develop a team of analysts and data specialists.
- Set analytical priorities based on business value, feasibility, and
stakeholder needs.
- Review analytical approaches and outputs to ensure accuracy,
consistency, and actionability.
- Collaborate with actuarial, finance, data, and analytics teams to
reuse existing capabilities and avoid duplication.
Qualifications
- 10+ years of experience in health insurance claims analytics,
medical economics, actuarial analytics, or health insurance
consulting, including experience leading analytical projects or
teams
- Strong understanding of healthcare claims data, including diagnosis,
procedure, provider, place-of-service, utilization, unit-cost, and
member-level information
- Experience using a visualization platform such as Qlik Sense, Power
BI, or Tableau
- Hands-on proficiency in SQL and experience working with large,
complex claims datasets
- Strong written, verbal, presentation, and stakeholder-management
skills
The International Health Medical Economics team is looking for a Medical
Economics Analytics Manager to help identify the drivers of medical cost
and utilization trends and translate them into actions that improve
affordability and health outcomes. This role combines healthcare claims
expertise, advanced analytics, data visualization, and stakeholder
leadership. The successful candidate will lead a team responsible for
analysing complex claims and eligibility data, identifying actionable
opportunities, and partnering with Network, Clinical, and Fraud, Waste
and Abuse teams to develop targeted interventions. The role is suited to
an analytics leader who can move from data exploration and root-cause
analysis to executive communication, recommended interventions, and
measurable business action. It offers the opportunity to build scalable
analytics capabilities supporting Cigna’s international health insurance
business across multiple markets.
Responsibilities
Claims analytics and insight generation
- Lead analysis of medical cost and utilization trends to identify
underlying drivers across markets, clients, providers, populations,
and clinical categories.
- Apply healthcare claims knowledge to distinguish the effects of
utilization, unit cost, provider mix, service mix, disease burden,
benefit design, and member behaviour.
- Develop analytics covering provider performance, population risk,
claims leakage, clinical variation, and potential fraud, waste and
abuse.
- Convert analytical findings into clearly defined opportunities,
supported by evidence, expected impact, and recommended next
actions.
Business action and stakeholder partnership
- Partner with Network teams to support provider benchmarking,
contracting strategies, and provider negotiations.
- Partner with Clinical teams to identify opportunities related to
care pathways, disease management, utilization management, and
site-of-care optimization.
- Partner with FWA teams to identify abnormal billing, utilization,
and provider behaviour patterns requiring further investigation.
- Present complex analytical findings to senior stakeholders in a
concise, decision-oriented format.
- Track whether implemented actions deliver the expected impact and
use the results to improve future analyses.
Analytics products and dashboards
- Define and develop self-service dashboards that enable users to
identify and investigate medical cost and utilization drivers more
quickly.
- Translate business questions into analytical requirements, measures,
drill-down pathways, and intuitive dashboard designs.
- Work with Data and Technology teams to ensure analytics products are
scalable, reliable, and supported by appropriate data controls.
Team and capability leadership
- Lead, coach, and develop a team of analysts and data specialists.
- Set analytical priorities based on business value, feasibility, and
stakeholder needs.
- Review analytical approaches and outputs to ensure accuracy,
consistency, and actionability.
- Collaborate with actuarial, finance, data, and analytics teams to
reuse existing capabilities and avoid duplication.
Qualifications
- 10+ years of experience in health insurance claims analytics,
medical economics, actuarial analytics, or health insurance
consulting, including experience leading analytical projects or
teams
- Strong understanding of healthcare claims data, including diagnosis,
procedure, provider, place-of-service, utilization, unit-cost, and
member-level information
- Experience using a visualization platform such as Qlik Sense, Power
BI, or Tableau
- Hands-on proficiency in SQL and experience working with large,
complex claims datasets
- Strong written, verbal, presentation, and stakeholder-management
skills