Cms ncqa and state regulatory compliance knowledge
End-to-end clinical benefit testing leadership
The Quality Review and Audit Senior Advisor at The Cigna Group will provide enterprise-level quality assurance leadership focused on clinical accuracy and regulatory compliance in pharmacy benefits. The role requires strong analytical and clinical expertise to ensure adherence to CMS and NCQA standards, while collaborating with various internal and external stakeholders to drive continuous improvement
Job Summary
The role provides enterprise-level quality assurance leadership focusing on clinical accuracy, pharmacy benefit integrity, and regulatory compliance across Medicare, Medicaid, and Exchange lines.
Candidates will partner with cross-functional stakeholders to resolve complex clinical issues impacting patient safety and ensure alignment with CMS and NCQA standards.
The position offers a comprehensive benefits package including medical, vision, dental, 401(k), company-paid life insurance, and a minimum of 18 days of paid time off starting day one.
Matching Summary
Match Score: 85
The Quality Review and Audit Senior Advisor at The Cigna Group will provide enterprise-level quality assurance leadership focused on clinical accuracy and regulatory compliance in pharmacy benefits. The role requires strong analytical and clinical expertise to ensure adherence to CMS and NCQA standards, while collaborating with various internal and external stakeholders to drive continuous improvement.