Quality Review and Audit Advisor

🔥 0 minutes ago

🏰 Missouri – Remote

🏰 Missouri – Remote

💵 $78.8k - $131.3k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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The Cigna Group

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1982

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Healthcare • Healthcare Insurance • Pharmaceuticals

The Cigna Group is a global health company committed to improving the health and vitality of its clients, customers, and patients. With its two divisions, Cigna Healthcare and Evernorth Health Services, the company focuses on enhancing quality of life through healthcare services and pharmacy benefits management. The Cigna Group is dedicated to ethical practices in healthcare and artificial intelligence, and strives to create positive change in the healthcare system. It also emphasizes its Environmental, Social, and Governance (ESG) responsibilities, aiming to impact health equity and foster innovation in healthcare delivery.

📋 Description

• Lead resolution of issues identified during pharmaceutical audits or Pharma Web Portal reviews • Track status of data deliverables and monitor contract terms to ensure appropriate data requests • Troubleshoot issues and questions arising from pharma audits and the Pharma Web Portal • Work cross-functionally with Express Scripts subject matter experts and internal departments • Build data analytics and obtain, validate, and organize electronic files and data • Discuss pertinent issues with pharmaceutical manufacturers or their auditors and manage expectations • Serve as technical lead for the Pharma Web Portal and lead routine pharma audits • Field information requests and provide ongoing support to Client Audit and other subject matter experts • Identify process improvement opportunities • Perform systems analysis, SQL, and macro functions to improve departmental efficiency • Assist with department workload needs and special projects as assigned

🎯 Requirements

• Bachelor's degree in Finance, Business, Accounting, Economics, or related field • Experience supporting pharmaceutical manufacturer audits, compliance reviews, or client audit activities • Experience reviewing and interpreting contract language and validating data requests against contractual requirements • Strong data analysis experience, including gathering, validating, and reconciling large datasets • Advanced Microsoft Excel skills • Healthcare, PBM, pharmaceutical manufacturer, pharmacy, or managed care industry experience • Knowledge of Express Scripts systems and operations preferred • Previous experience working with cross-functional departments to research and resolve issues using innovative solutions • Demonstrated ability to meet multiple deadlines and manage a dynamic workload • Well organized • Demonstrated analytical and problem-solving skills • Detail oriented • Excellent verbal, written, and presentation skills • If working at home, cable broadband or fiber optic internet service with speeds of at least 10Mbps download/5Mbps upload

🏖️ Benefits

• Annual bonus plan eligibility • Medical, vision, and 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 • Remote work arrangement • Cable broadband or fiber optic internet service with minimum 10Mbps download/5Mbps upload for home working