Audit Operations Lead

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🔥 2 minutes ago

🦌 Connecticut – Remote

🦌 Connecticut – Remote

💵 $62.6k - $104.3k / year

⏰ Full Time

🟠 Senior

⚙️ Operations

👻 Ghost score 0%

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The Cigna Group

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛡️ Insurance

Healthcare • Insurance

The Cigna Group is a global health services company that provides medical, dental, pharmacy, behavioral and supplemental insurance products and benefits to individuals, families, employers, brokers, providers and Medicare beneficiaries. It offers employer-sponsored group plans, individual and family plans (including Open Enrollment offerings), Medicare, international health insurance covering more than 200 countries, and digital member services through the myCigna platform (including telehealth and claims management). Its products are delivered through operating subsidiaries such as Cigna Health and Life Insurance Company and other regional affiliates.

📋 Description

• Provide advanced support for complex client, regulatory, accreditation, and internal audits • Manage audit activities from intake through execution, remediation, validation, and closure • Support CMS program and mock audits, delegation and data validation audits, NCQA and URAC audits, internal audit findings and remediation, and other compliance, regulatory, or operational initiatives • Clarify requirements, timelines, dependencies, and deliverables • Translate complex or incomplete requests into actionable next steps • Research unfamiliar issues and engage subject matter experts as needed • Coordinate activities across multiple teams and stakeholders • Facilitate audit preparation, meetings, requirements discussions, and follow-up • Maintain documentation and communicate status, risks, and next steps • Identify and escalate risks while recommending solutions • Improve SOPs, workflows, tools, and audit processes

🎯 Requirements

• High school diploma required; bachelor’s degree preferred • 5+ years of experience in client/customer support, healthcare operations, audit, compliance, project coordination, or a related area • Experience coordinating complex, time-sensitive work across multiple teams • Strong communication, organization, problem-solving, adaptability, and time-management skills • Healthcare, regulatory, accreditation, client, or internal audit experience preferred • Experience developing or improving SOPs, workflows, or process documentation preferred • Knowledge of prior authorization, post-service processes, reporting, or relevant eviCore systems preferred • If working from home, cable broadband or fiber optic internet service with at least 10 Mbps download and 5 Mbps upload

🏖️ Benefits

• Annual bonus plan eligibility • Medical benefits • Vision benefits • Dental benefits • Well-being and behavioral health programs • 401(k) • Company-paid life insurance • Tuition reimbursement • Minimum of 18 days of paid time off per year • Paid holidays • Leaves of absence

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