Remote, open to work at home, United States
Role Summary:
The Medicaid Compliance Manager is primarily responsible for managing all external audits initiated by government entities of Cignas Medicaid and Medicaid-Medicare Plan (MMP) lines of business. This position will lead a portion of the Medicaid/MMP team, and will be engaged in various compliance efforts, acting as a subject matter expert to support business partners and will need to work with a high degree of independence.
The Medicaid Compliance Manager must be highly organized with eye for detail and issue management. They will be accountable to ensure all deliverables are well understood by business owners, meet the requirements of the government entity, and are submitted timely. A successful candidate must be able to understand business processes and work cross functionally with business owners. In addition to auditing and leading a small team, the position may also have some responsibility for: (i) reviewing and informing the compliance risk assessment, (ii) communicating with regulatory oversight entities, (iii) working with Medicaid and MMP business leaders to share new or changing guidance, (iv) supporting implementation of new or changing guidance, (v) monitoring compliance with Medicaid and MMP requirements, and (vi) ensuring timely and appropriate closure of any issues.
Responsibilities:
Report to the Head of Medicaid Compliance;
Lead a small team of compliance professionals
Ensure compliance with Medicaid and MMP rules and regulations;
Manage all aspect of audits issued by government entities;
Maintain good working relationships with internal parties to ensure open lines of communications and timely responses to compliance questions;
Assist in the management of Corrective Action Plans (CAPs) and finding remediation for Medicaid and MMP related issues;
Remain aware of industry changes and/or trends.
Qualifications:
* 7+ years overall experience with healthcare regulatory and compliance matters;
* 3+ years of Medicaid experience;
* Strong knowledge of Medicaid and MMP regulations required;
* *Experience with team leadership;
* Strong attention to detail and analytic skills required;
* Strong problem solving skills required;
* Bachelors
* Strong and confident oral and written communication skills required;
* Ability to work collaboratively with others (and when appropriate influence colleagues in their decision making process) required.
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.