Healthcare Data Science Sr Manager – Value Based Care

Cigna   •  

Bloomfield, CT

Industry: Healthcare

  •  

5 - 7 years

Posted 32 days ago

The Specialty Collaborative Care and Episode of Care (SCC/EOC) Data Science Team is responsible for conducting advanced analytics and research activities in efforts to design, develop, evaluate and evolve Cigna's innovative, value-based care (VBC) programs. Team members contribute toward solution delivery under Cigna's matrixed Agile delivery model as part of a team that includes Business Leaders, Business SME's, Data Analysts, Data Scientists, and Technical Engineers. This team is also asked to consult with our program design leaders to influence the strategic direction of our VBC programs.

Role Summary:

The person in this role will lead an analytics team of 5-10 advanced analysts and data science advisors. The SCC/EOC Data Science Sr. Manager is expected to contribute to the team's success in four key areas:


  • Staff management and development including hiring, retention, and on-going development of domain expertise
  • Maintaining a strong knowledge base of Value Based Care analytic solutions; especially with respect to Specialty and Episodic Bundling centered offerings and industry trends
  • Oversee and, at times, directly contribute to discovery and outcomes research, publication, methodology design, and other analytic strategy activities
  • Partner closely with our business stakeholders and engineering team leaders

Key Activities/ Responsibilities:


  • Collaborate and work closely with stakeholders to design and evaluate Value Based Payment programs. Example areas include hospital and physician Accountable Care Organization (ACO) programs, Episodes of Care/Bundle programs, Oncology Medical Home, etc.
  • Work closely with provider and contracting leadership to help them understand opportunities and insights regarding innovative contract designs. He/she will also lead the team in interfacing with Cigna care management teams and provider groups to shape program design, evaluation requirements and support infrastructure development.
  • Apply robust and appropriate statistical and clinical rigor using advanced analytic techniques including but not limited to risk adjustment, episode analytics (ETG, Prometheus etc.), statistical modeling, power analysis, matched case control studies etc.
  • Derive actionable insights from healthcare data (claims, clinical, pharmacy, externally sourced) to engage and enable our provider/clinical partners.
  • Support IT/Engineering in their deployment of actionable insights into accessible solutions for our provider/clinical partners.
  • Present analytic findings and recommendations to non-technical business partners and leadership to drive data driven strategies.
  • Develops and documents specifications for performance and actionable reporting solutions
  • This person and his/her team will work closely with Contracting, Clinical Program Development, Product, Finance, and IT organizations to implement and support the programs.

Lead a strong analytics team by…


  • Using analytic expertise to drive and accelerate our strategic solutions
  • Supervising, coaching, and developing Data Science advisors and colleagues
  • Influencing the methodology used by our clients and consultants for the fair and equitable evaluation of programs
  • Creating meaningful analytic roles and processes within Cigna's Agile delivery framework
  • Developing process and engagement models to embed and foster use of advanced finance, contract, and value based care data science analytics
  • Hiring and developing top analytic talent
  • Monitoring and appropriately introducing innovative analytic techniques such as predictive modeling via Machine Learning (ML)

Qualifications:

This position requires healthcare and insurance content knowledge, Data Science expertise and leadership skills related to leading a team of data scientists.


  • Analytics - Advanced degree or equivalent and at least 5 years of experience in an analytics related function. Knowledge of program evaluation, pay for performance (P4P), predictive modeling, data mining, steerage, pharmacy and care management (DM / CM / medical home) best practices. Degrees in Statistics, Biostatistics, Epidemiology, Actuarial or Data Science a plus.
  • Leadership and Organization – A seasoned, respected leader with experience managing teams with over 5 staff members. Consultative leadership competencies with the ability to collaborate with others, to establish new working relationships, and to communicate effectively across the organization at different levels.
  • Subject Matter Expertise - Knowledge of healthcare data (e.g., claims, eligibility, groupers, profiling, EMR), statistical analysis aptitude, and demonstrated understanding of health care and delivery system processes. Strong acumen for developing actionable reporting using key metrics communicated in an easy to understand manner. Firsthand technical experience with SAS/R/Python and data visualization solutions such as Tableau a major plus.
  • Customer Focus - Dedicated to meeting the expectations and requirements of clients; gets first-hand customer information and uses it for improvements in products and services; acts with customers in mind. Ability to successfully navigate and contribute in a highly-matrixed environment.
  • Insight Solution Design - Translate business needs into practical applications and solutions and can easily make the connection between detailed analytic / reporting / BI outputs and implications for the business, turning insights into business actions.
  • Communication - Strong persuasion skills and effective communicator; ability to create and communicate a compelling vision internally and externally. Emerging track record of presentations / publications and thought leadership is a plus.
  • Agile - Experience working in or managing Agile teams is highly desirable.
  • Working knowledge of healthcare outcomes research, program evaluation, risk adjustment, episode groupers, pay for performance programs (ACO / bundled payment / capitation) and care management (DM / CM / medical home) best practices is highly desired.
  • This individual will be expected to have the requisite content knowledge to drive development, enhancement and evaluation of physicians and facilities (their efficiency, quality, and patient satisfaction outcomes from various program initiatives).