Medical Economics Analytics Manager

Medical Economics Analytics Manager

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 behavior. 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

About The Cigna Group

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.