Quality Review and Audit Advisor

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The Cigna Group

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1982

⚕️ Healthcare Insurance

💊 Pharmaceuticals

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

• Provide expert execution for complex, high impact Quality Assurance and Audit initiatives • Plan, lead, and deliver largescale and cross-functional testing efforts • Ensure accurate benefit, clinical, and pricing configuration • Support successful client implementations and operational changes • Partner closely with implementation, account management, operations, product, and regulatory teams • Ensure thorough test planning, execution, validation, and clear communication of results • Support regulatory and operational audits • Contribute to procedural and control enhancements

🎯 Requirements

• Bachelor’s degree required and 3+ years of experience in operations, benefits/clinical, claims processing, testing, quality assurance, audit, or a related role required – or – 6+ years of related experience • Experience supporting HealthPlan, Medicare, Medicaid, Exchange, Commercial, DoD, and/or Cigna Lines of Business • Clinical, pharmacy, or healthcare-related background preferred • Project Management Certification or skillset is preferred • Strong business acumen with the ability to quickly learn new business domains and processes • Proven ability to work autonomously, manage competing priorities, and meet critical deadlines • Proficiency in Microsoft tools including Excel, PowerPoint, Word, Outlook, and SharePoint

🏖️ Benefits

• medical, vision, dental, and well-being and behavioral health programs • 401(k) • company paid life insurance • tuition reimbursement • a minimum of 18 days of paid time off per year • paid holidays • leaves of absence