26 days old

Legal Compliance Advisor-Medicare, Medicaid, and FDR Compliance Auditor- Work at home

Nashville, TN 37201
  • Job Code
Remote, work at home, United States

The Medicare, Medicaid, and FDR Compliance Auditor is 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. The Compliance Auditor will also participate in the coordination of external regulatory auditssuch as the CMS 1/3rd Financial Audit and CMS Program Audits. In addition, the Compliance Auditor will be responsible for 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 Cigna's enterprise-wide culture of compliance.

  • 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.
  • 3+ years of leadership managing projects;
  • 5+ years of Medicare (Part C and Part D) Audit, Medicaid or FDR experience;
  • Clinical designations preferred (RN, RPh, etc) or 5+ years clinical decision-making experience;
  • Experience with CMS Program Audits or CMS Financial Audits 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%);
  • Prior coordination among remote teams preferred
  • Bachelors preferred or equivalent work experience

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, you'll enjoy meaningful career experiences that enrich people's 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.

Posted: 2021-03-26 Expires: 2021-04-24
Sponsored by:
ADP Logo
Sponsored by:
Bank of America Logo

Featured Jobs[ View All ]

Featured Employers

Before you go...

Our free job seeker tools include alerts for new jobs, saving your favorites, optimized job matching, and more! Just enter your email below.

Share this job:

Legal Compliance Advisor-Medicare, Medicaid, and FDR Compliance Auditor- Work at home

Nashville, TN 37201

Join us to start saving your Favorite Jobs!

Sign In Create Account
Powered ByCareerCast