25 days old

Risk Adjustment Data Scientist - Evernorth

Bloomfield, CT 06002
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The Data Science Advisor is a hands-on data role that will be relied on to further advance Cigna and Evernorth's risk adjustment accuracy in the Individual and Family Plans (IFP) market. The advisor will need to use data science to answer business critical risk adjustment questions and provide expert content/professional leadership on complex data science assignments and projects. Our goal is to leverage data science, with the lens of risk adjustment, to drive business decisions that will help make healthcare affordable, predictable, and simple for the members that we serve.

The right candidate will possess a strong degree of innovation, a core healthcare data and analytics skillset, and a proficiency in applying advanced analytic methods to healthcare data. They will also demonstrate a talent for translating between technical and non-technical audiences, as well as a desire to champion a data-driven culture with our business partners.

This role involves leading the design and development of new advanced analytical models utilizing healthcare data and clinical records for each member. This means developing new tools and techniques, using a variety of internal and external data sources, to enable a comprehensive understanding of a member's clinically relevant information.

Key questions you would help solve include:

  • How can we use clinically relevant data to create a comprehensive and accurate prediction for what health conditions members may have?
  • How do we incorporate clinical data and insights (structured and unstructured) into meaningful risk adjustment insights for our business and clinical partners?
  • What is the potential business impact that can be driven by modeling results?
  • Which model best addresses the business need at hand?
  • What else should we as a collective team be looking at to advance our risk adjustment capabilities?

This position is with Evernorth, a new business within the Cigna Corporation.

Key Responsibilities:

  • Initiate and collaborate with stakeholders across the IFP business to prioritize and define key performance indicators that can be addressed with risk adjustment targeting models
  • Enhance and create new advanced analytical models that prioritize outreach efforts
  • Maintain and enhance existing advanced analytical models that predict member's condition profile
  • Develop clear and thoughtful materials to communicate results/recommendations to business partners
  • Work effectively and efficiently on multiple tasks and deadlines, while producing high quality results.
  • Use data science and advanced analytic methods (machine learning, cluster analysis, predictive modeling) to identify areas of opportunity and inform risk adjustment business strategy


  • Bachelor's Degree or higher in a quantitative field (e.g. mathematics, statistics, data science, business, MIS, actuarial science, finance, etc.) preferred
  • Strong experience with large SQL-based relational databases required
  • Excellent command of data science libraries in Python strongly preferred
  • Experience with ACA or MA risk adjustment scoring algorithms and targeting models preferred
  • 3+ years of experience building, deploying, scaling machine learning algorithms in production
  • Experience working in a cloud based environment (preferably AWS) preferred
  • Deep healthcare data (e.g., ICD-9/ICD-10, claims, profiling) and demonstrated understanding of health care and delivery system processes preferred
  • Ability to work with business partners in consultative manner
  • Ability to independently prioritize and manage multiple responsibilities
  • Proficiency with syntactic and semantic interoperability of health information exchange using data standards such as SNOMED CT, RxNorm, LOINC, and variations of HL7 (e.g. 2, FHIR, etc.) a plus.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an annual salary of 95,800 - 159,600 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna .

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives. What difference will you make?

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

Cigna has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

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Posted: 2022-11-11 Expires: 2022-12-10
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Risk Adjustment Data Scientist - Evernorth

Bloomfield, CT 06002

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