Quality Review And Audit Senior Advisor - Express Scripts - Hybrid

Cigna

Base: $100,000 - $166,600 usd yearly; bonus: eligi...
Hybrid
Clinical and pharmacy expertise
Cms ncqa regulatory compliance
End-to-end benefit testing
Cigna is seeking a Quality Review & Audit Senior Advisor to lead quality assurance efforts focused on clinical accuracy and regulatory compliance within their pharmacy benefit management services. The ideal candidate will possess a clinical or pharmacy background, strong analytical skills, and management experience to drive continuous improvement and collaboration across various teams

Job Summary

  • The role provides enterprise-level quality assurance leadership with a strong focus on clinical accuracy, pharmacy benefit integrity, and regulatory compliance.
  • Candidates will partner with internal stakeholders to resolve complex clinical issues impacting patient safety and access to care.
  • The position offers a comprehensive benefits package including medical, vision, dental, 401(k), and paid time off starting day one.

Matching Summary

Match Score: 85

Cigna is seeking a Quality Review & Audit Senior Advisor to lead quality assurance efforts focused on clinical accuracy and regulatory compliance within their pharmacy benefit management services. The ideal candidate will possess a clinical or pharmacy background, strong analytical skills, and management experience to drive continuous improvement and collaboration across various teams.

Salary

Base: $100,000 - $166,600 USD yearly; Bonus: Eligible for annual bonus plan; Benefits: Medical, vision, dental, 401(k), life insurance, tuition reimbursement, 18 days PTO

Skills & Requirements

Must-have

  • Clinical and pharmacy expertise
  • CMS NCQA regulatory compliance
  • End-to-end benefit testing
  • Management experience required
  • Pharmacy benefit configuration validation

Nice-to-have

  • Agile methodologies experience
  • Financial acumen understanding
  • Data-driven insights capability
  • Mentoring team members skills

Key Requirements

  • Bachelor's degree in clinical or healthcare field
  • Management experience leading high-performing teams
  • Advanced proficiency with Microsoft Office Suite

Work Rights

Not specified

Tailored Resume

Cover Letter