Job Description

Overview

The Advisor Regulated Markets Audit Management role is responsible for coordinating the planning, execution and follow up for client and regulator driven audits for a specific market within the Regulated Markets book of business. This individual serves as a SME and point of contact for SMEs and other functions supporting audit activities. This position develops market specific education and delivers training to ensure resource preparedness for audit support. Recruits and retains network of enterprise resources and collaborates with Cient Audit, Compliance, Legal and other stakeholders to respond to State and Center for Medicare and Medicaid Services (CMS) and Client audit requests. Represents Express Scripts and our Clients in audits. Ensures documentation and data entry aligned with function processes. Drives timely resolution of findings and/or deliverables.

Key accountabilities include (but not limited to):

- Provides day-to-day oversight of market specific audit activities
- Develops and maintains market specific audit training
- Recruits and trains market specific audit resource network
- Coordinates market audit pipeline and resource support planning with Client Audit team
- Provides audit trend/issues insight to support audit prep
- Provides direct audit support as needed
- Ensures timely documentation of audit outcomes using team tools and processes
- Supports development of audit finding/CAP responses, client communications
- Drives completion of activities to address audit findings and/or deliverables\xe2\x80\x8b

Additional skills and experience

The ideal candidate will have Regulated Markets specific knowledge, experience leading cross-functional teams, attention to details and an ability to influence and drive work in a matrix environment. Preferred experience:

- 2 or more years experience participating or leading regulatory and/or performance audits in a managed care environment
- 2 or more years leading cross-functional projects
- understanding of training methodologies

This is a hybrid role and will require the ability to work in-person.

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.

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.

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.

The Cigna Group 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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