Remote, open to work at home, United States
Medicare, Medicaid, and FDR Compliance Auditor
The Medicare, Medicaid, and FDR Compliance Auditor is responsible for the facilitation and project management of external regulatory audits such as the CMS 1/3rd Financial Audit and CMS Program Audits. In addition, the Compliance Auditor will be responsible for auditing the compliance with all regulatory requirements and standards relative to the Medicare Parts C and D and the Medicaid Program at Cigna. This individual is responsible for conducting audits in such a way that ensure (i) that all Medicare and Medicaid regulatory requirements and standards are understood, (ii) business processes required to address those regulations and standards are implemented and (iii) any compliance risks are communicated to the Compliance Officer. The Compliance Auditor must be able to effectively communicate with all levels of management (including senior leadership) as well as external regulatory auditors. This role requires an assertive, flexible individual with the ability to create structure in potentially ambiguous situations. This individual must maintain open lines of communications with the business and must promote Cignas enterprise-wide culture of compliance.
Responsibilities
* Report to the Medicare, Medicaid, and FDR Compliance Audit Leader;
* Facilitate and manage external CMS regulatory audits of Cigna;
* Conduct internal mock CMS Program Audits;
* Ensure Cigna compliance with Medicare rules and regulations;
* Validate that Medicare regulations have been implemented correctly by Cigna;
* Conduct high quality compliance audits;
* Maintain good working relationships with internal parties to ensure open lines of communications and timely responses to compliance questions;
* Create a sense of urgency with internal business partners to achieve objectives; and
* Remain aware of industry compliance changes and/or trends.
Qualifications
* 3+ years of leadership managing projects;
* 5+ years of Medicare (Part C and Part D) Audit, Medicaid or FDR experience;
* Experience with CMS Program Audits or CMS Financial Audits; is needed.
* Strong knowledge of Medicare and Medicaid regulations preferred;
* Experience with Project Management or Process Improvement methodologies preferred (Six Sigma Black Belt and/or Project Management Professional certifications preferred);
* Strong attention to detail and analytic skills required;
* Strong problem solving skills required;
* Strong and confident oral and written communication skills required;
* Ability to work collaboratively with others required (and influence colleagues, when appropriate, in their decision-making process);
* Travel is required (typically 10-25%); as needed in the future
* Prior coordination among remote teams preferred
* Bachelors degree
This position is not eligible to be performed in Colorado.
About Cigna
Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. We offer an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products. Together, with our 74,000 employees worldwide, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation.
When you work with Cigna, youll enjoy meaningful career experiences that enrich peoples lives while working together to make the world a healthier place. What difference will you make? To see our culture in action, search TeamCigna on Instagram.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
Bloomfield, CT
Cigna Corporation, a health service organization, provides insurance and related products and services in the United States and internationally. It operates through Integrated Medical, Health Services, International Markets, and Group Disability and Other segments. The Integrated Medical segment offers medical, pharmacy, dental, behavioral health and vision, health advocacy programs, and other products and services to insured and self-insured clients; Medicare Advantage, Medicare Supplement, and Medicare Part D plans to Medicare-eligible beneficiaries, as well as Medicaid plans; and health insurance coverage to individual customers on and off the public exchanges.
The Health Services segment provides clinical solutions, specialized pharmacy care, home delivery pharmacy, retail network pharmacy administration, benefit design consultation, drug utilization review, drug formulary management drug claim adjudication, digital consumer health and drug information, provider, and medical benefit management services. The International Markets segment offers supplemental health, life and accident insurance products, and health care coverage, as well as health care benefits to mobile employees of multinational organizations.
This segment offers health coverage, hospitalization, dental, critical illness, personal accident, term life, and variable universal life products. The Group Disability and Other segment provides group long-term and short-term disability, group life, accident, and voluntary and specialty insurance products and related services; and permanent insurance contracts to corporations to provide coverage on the lives of certain employees for the purpose of financing employer-paid future benefit obligations. The company distributes its products and services through insurance brokers and insurance consultants; and directly to employers, unions and other groups, or individuals. Cigna Corporation was founded in 1792 and is headquartered in Bloomfield, Connecticut.