Senior Provider Compliance Analyst

Job not on LinkedIn

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $62.2k - $103.6k / year

⏰ Full Time

🟠 Senior

🚔 Compliance

👻 Ghost score 0%

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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

• Partner with contracted pharmacy providers and internal teams to research and resolve complex compliance and operational matters • Lead or contribute to cross-functional projects involving business applications, technology solutions, and process improvements • Analyze complex issues, identify risks and opportunities, and develop timely recommendations and solutions • Simplify work, automate workflows, and strengthen alignment across teams and partners • Monitor network provider compliance with state and federal requirements, internal policies, and procedures • Support client, internal, and other applicable audits by preparing information, coordinating responses, and addressing operational needs • Create, review, and maintain standard operating procedures, policies, training materials, and process documentation • Share recommendations, concerns, and operational risks with stakeholders • Promote operational excellence through continuous improvement, effective technology use, and consistent execution

🎯 Requirements

• 3+ years of experience in pharmacy benefit management, pharmacy networks, healthcare operations, compliance, or a related field • Strong analytical, critical-thinking, problem-solving, and decision-making skills • Ability to translate complex research into practical recommendations • Ability to independently manage multiple priorities, deadlines, and deliverables in a fast-paced environment • Clear written and verbal communication skills • Strong organization, time management, attention to detail, and sound judgment • Advanced Microsoft Excel skills, including formulas, data analysis, and pivot tables • Proficiency with PowerPoint, Word, Access, and related business applications • Experience with regulatory requirements and industry standards related to accreditation, credentialing, delegation, or oversight • Experience improving processes, supporting audits, developing procedures or training, or implementing technology solutions in a regulated environment • If working at home, internet connection through cable broadband or fiber optic service with at least 10Mbps download/5Mbps upload • Bachelor’s degree is listed as preferred, not required

🏖️ 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