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The Cigna Group logo
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.

Quality Review and Audit Advisor

AdvisorGeneralFull TimeRemoteSeniorTeam 10,001+Since 1982H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

9 days ago

Salary

$78.8K - $131.3K / year

Seniority

Senior

Bachelor Degree3 yrs expEnglish

Job Description

Quality Review and Audit Advisor

The Cigna Group

• Provide expert execution for complex, high impact Quality Assurance and Audit initiatives • Plan, lead, and deliver largescale and cross-functional testing efforts • Ensure accurate benefit, clinical, and pricing configuration • Support successful client implementations and operational changes • Partner closely with implementation, account management, operations, product, and regulatory teams • Ensure thorough test planning, execution, validation, and clear communication of results • Support regulatory and operational audits • Contribute to procedural and control enhancements

Job Requirements

  • Bachelor’s degree required and 3+ years of experience in operations, benefits/clinical, claims processing, testing, quality assurance, audit, or a related role required – or – 6+ years of related experience
  • Experience supporting HealthPlan, Medicare, Medicaid, Exchange, Commercial, DoD, and/or Cigna Lines of Business
  • Clinical, pharmacy, or healthcare-related background preferred
  • Project Management Certification or skillset is preferred
  • Strong business acumen with the ability to quickly learn new business domains and processes
  • Proven ability to work autonomously, manage competing priorities, and meet critical deadlines
  • Proficiency in Microsoft tools including Excel, PowerPoint, Word, Outlook, and SharePoint

Benefits

  • medical, vision, dental, and well-being and behavioral health programs
  • 401(k)
  • company paid life insurance
  • tuition reimbursement
  • a minimum of 18 days of paid time off per year
  • paid holidays
  • leaves of absence

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