Compliance Senior Advisor, Care Delivery & Pharmacy

The Evernorth Care Delivery & Pharmacy + Compliance Senior Advisor is a key contributor responsible for evaluating compliance with all regulatory requirements relative to the Evernorth Care Delivery, Pharmacy, Home Infusion Nursing, and Wholesale Drug Distribution. This position will also 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 Compliance Senior Advisor must be highly organized with a keen eye for detail, and issue management and problem-solving skills. They must be able to understand business processes and work cross functionally with business owners and other key stakeholders. In general, the position is responsible for: (i) carrying out assigned audit and monitoring programs, (ii) compliance data reporting and analytics, (iii) risk management programs, (iv) oversight for key risk remediation, (v) compliance program, (vi) DEA compliance, (vii) corrective action plan programs, (viii) regulatory complaint response and investigation, (ix) compliance policies, and (x) investigations for all areas of operation.

The position is hybrid role and can be part time remote work-at-home, with travel to company sites and supporting locations as needed. Ideally, the team member will be located at or near a location of The Cigna Group.

Responsibilities

• Complete an established number of audits and monitoring per quarter for Care Delivery and Pharmacy +;
• Manage the Prompt Response and Corrective Action Program;
• Lead committee meetings for various compliance elements with business stakeholders and committee members;
• Coordination and development of auditing and monitoring plans focusing on areas of Compliance risk;
• Creation of dashboards and status updates which communicate audit and monitoring results, trends, and summarize risk remediation activity;
• Deliver executive summary compliance reports and applicable findings to business stakeholders;
• Serve as subject matter expert to advise business in areas including, but not limited to care delivery, pharmacy, nursing, drug distribution, and associated regulatory requirements;
• Ensure the highest level of compliance with all Federal, State, and local rules and regulations;
• Lead, participate and facilitate accessible knowledge and guidance for business stakeholders including Compliance committees and other delivery mechanisms as needed;
• Execute training program strategy and support of business stakeholders on applicable Compliance topics;
• Research and respond to compliance questions in consultation with Legal and Compliance stakeholders;
• Collaborates with internal partners and develops good working relationships to ensure open lines of communication and timely responses to compliance questions;
• Update, revise, and maintain applicable departmental policies and procedures, and support the review of policies and documents for supported business units;
• Support business partners in issue management and resolution;
• Remain aware of industry changes and/or trends;
• Complete annual compliance program effectiveness assessments.

Qualifications

• 8+ years overall experience with healthcare regulatory and compliance matters;
• 3+ years of Care Delivery, Pharmacy, Nursing, or Drug Distribution experience preferred;
• Bachelor’s degree required;
• Pharmacist, Nurse, Licensed Healthcare Professional, or JD required.
• Demonstrated ability to interpret and apply federal, state, and local healthcare regulations
• Strong analytical, problem-solving, and issue management skills
• Proven ability to communicate clearly and confidently with business and executive stakeholders
• Self-directed, detail-oriented, and able to work independently in a fast-paced environment
• Ability to manage multiple, competing priorities while maintaining accuracy and accountability
• Strong collaborator with the ability to build effective relationships across Compliance, Legal, and business teams
• This is a flex/ WAH role

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.

For this position, we anticipate offering an annual salary of 109,600 - 182,600 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here.

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.