Formulates and defines systems scope and objectives based on both user needs and a good understanding of applicable business systems and industry requirements. Devises or modifies procedures to solve complex problems considering computer equipment capacity and limitations, operating time, and form of desired results. Includes analysis of business and user needs, documentation of requirements, and translation into proper system requirement specifications. Guides and advises less experienced Business Analysts..
- Responsible for data mining activities and technology integration of Pre- pay Correction Program.
- Develop queries on regular and ad-hoc basis (primarily using SAS and Microsoft SQL Server).
- Assist with the execution and maintenance of edits and related technical tasks.
- Primary technical support for Proactive Claim Intervention projects and daily tasks.
- Evaluates and appropriately utilizes various approaches to data mining to narrow in on trends and drivers that directly impact outcomes.
- Makes well-thought-out decisions on complex or ambiguous data architecture issues.
- Ensures that system improvements are successfully implemented and monitored to increase efficiency.
- Works closely with matrix business partners to define data needs, opportunities for improvement and effectively communicates results of analysis and solutions.
- Acts as a resource for direction, training and guidance for less experienced staff.
- Performs technical duties as assigned for Proactive Intervention team.. Requirements
- Ability to write, read and code using SQL, with SAS required and Microsoft SQL Server preferred.
- Bachelors degree or equivalent strongly preferred and at least 2 years of related experience required
- Ability to work extensively in Microsoft Access to manipulate and analyze data.
- Demonstrated ability to work independently and drive to objectives
- Exceptional verbal and written communication skills with demonstrated ability to research, problem solve, trouble shoot, influence and partner across the organization to a "win-win" solution for the client (or provider) and CIGNA.
- Strong presentation skills. Able to prepare, deliver, and ensure understanding of information regarding any customer-related or process improvement topic across audiences .
- Experience with Healthcare Claim Data is preferred.
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