[Hiring] Network Operations Senior Analyst, Provider Compliance @The Cigna Group

Role Description

Provider Compliance works to ensure the integrity of the Express Scripts networks for all Clients and Members. The Provider Compliance Senior Analyst is responsible for assisting in the daily support, and preparation, of the provider termination process. This position will work cross functionally with several different groups collecting and reporting on termination information, as well as support investigations of pharmacy noncompliance, and collaborative support Client Account Team requests that intersect with pharmacy operations and compliance.

• Ensure network providers maintain compliance with state and federal regulations, as well as ESI’s Provider Manual and Provider Agreement.
• Liaison for internal Compliance related inquiries and projects.
• Identify and align business process efficiencies between our teams and cross functional partners.
• Focus on process improvement, automation, technology, and cross-functional partnerships to drive change and deliver operational excellence.
• Thrive in a high-pressure environment with multiple competing priorities.

Qualifications

• Bachelor’s degree in related field preferred, HS Diploma required.
• At least 2 years of relevant work experience.
• Proficient with Microsoft Office suite (Word, Excel, PowerPoint and Outlook).
• Strong written and verbal communication skills.
• Exceptional follow through skills, an attention to detail and the ability to handle multiple tasks and meet daily deadlines.
• Ability to demonstrate initiative and independent thinking.
• Ability to think strategically while solving tactical challenges.
• Demonstrated ability to work with cross-functional departments to resolve issues.
• Detail oriented with strong analytical and problem-solving skills.
• Ability to adapt in a dynamic and fast-paced work environment and make independent decisions.

Requirements

• 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.

Benefits

• Annual salary of 62,200 - 103,600 USD / yearly, depending on relevant factors, including experience and geographic location.
• Eligible to participate in an annual bonus plan.
• Comprehensive range of benefits, including medical, vision, dental, and well-being and behavioral health programs.
• 401(k) and company paid life insurance.
• Tuition reimbursement.
• A minimum of 18 days of paid time off per year, paid holidays, and leaves of absence.