Quality Review and Audit Lead Analyst

November 7, 2024

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The Cigna Group

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The Cigna Group is a global health company committed to improving the health and vitality of its clients, customers, and patients. With its two divisions, Cigna Healthcare and Evernorth Health Services, the company focuses on enhancing quality of life through healthcare services and pharmacy benefits management. The Cigna Group is dedicated to ethical practices in healthcare and artificial intelligence, and strives to create positive change in the healthcare system. It also emphasizes its Environmental, Social, and Governance (ESG) responsibilities, aiming to impact health equity and foster innovation in healthcare delivery.

10,000+ employees

Founded 1982

⚕️ Healthcare Insurance

💊 Pharmaceuticals

📋 Description

• Provides advanced professional input to complex Quality Assurance/Audit assignments/projects to identify pharmacy audit risks. • Works autonomously, requiring only expert level technical support from others. • Exercises judgment in the evaluation, selection, and adaptation of techniques and procedures. • Utilizes in-depth professional knowledge to monitor trends within Quality Review and Audit. • May recommend changes in processing procedures based on independent judgement. • Responsible for using analytical skills and audit tools to identify pharmacy audit risks and develop/execute audit plans. • Performs complex on-site network pharmacy audits to correct risks identified. • Adheres to department policies, state and federal requirements and client contractual requirements. • Develops and produces reports as required to meet the needs of various stakeholders. • Mentors less experienced team members and trains new associate auditors on departmental processes.

🎯 Requirements

• Bachelor’s degree or equivalent experience. • Valid driver’s license. • Travel up to 25%. • 2+ years of pharmacy technician experience in a retail, long term care, specialty, mail order or similar pharmacy setting. • Certified Pharmacy Technician (CPhT) Preferred. • Proficient in database and spreadsheet applications, including Microsoft Excel, Access, Word. • Excellent organizational, interpersonal, and communication skills. • Ability to work well with all levels of internal and external contacts. • Ability to handle sensitive or confidential information is critical. • Ability to work with minimum management oversight while performing on-site audits. • Ability to work a flexible schedule to accommodate project deadlines. • Willingness to travel.

🏖️ Benefits

• Comprehensive health-related benefits including medical, vision, dental, and well-being programs. • 401(k) with company match. • Company-paid life insurance. • Tuition reimbursement. • Minimum of 18 days of paid time off per year. • Paid holidays.