Claims Data Steward; Business Analytics Senior Advisor

Claims Data Steward (Business Analytics Senior Advisor) (Finance)

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 good 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.

• 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 work groups 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.

• 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…