The job profile for this position is Legal Compliance Senior Manager, which is a Band 4 Management Career Track Role.

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Role Summary

The Medicare Part C Compliance Senior Manager is responsible for the design, implementation, and ongoing execution of the Medicare compliance program while upholding the overall Cigna Compliance Plan. This Senior Manager will ensure operational compliance with all regulatory requirements and standards relative to Medicare Part C medical operations. This individual will lead a team of compliance professions who ensure our business partners (i) understand and implement all Medicare regulatory requirements, (ii) remediate issues timely and effectively, and (iii) understand any compliance/regulatory risks to effectuate mitigation strategies. This individual must promote strong relationships with key business and compliance leaders by endorsing an enterprise culture of compliance and serving as a trusted business advisor. Additionally, this role will assist in Medicare related external audits as well as liaise with Legal, Product, and Operational staff.

Responsibilities

• Report to the Legal Compliance Director of Medicare Business Support (MBS).
• Lead a team of compliance professionals responsible for financial, operational, and business support.
• Develop and implement a continual improvement program to enhance oversight of Medicare Part C operations and clinical and improve business performance.
• Collaborate with various members of the Compliance, Product, and Operational organizations.
• Ensure compliance of First Tier, Downstream and Related entities (FDR) with Medicare and state rules and regulations as applicable and provide oversight of the FDR program.
• Utilize subject matter expertise to ensure Medicare regulations have been implemented timely and accurately both internally and by pertinent FDRs.
• Inform both the Director of Medicare Business Support and the Medicare Compliance Officer of Part C trends, risks, or issues that should be considered for self-disclosure to regulating bodies.
• Collaborate with internal Compliance and Legal leadership to determine Cigna’s compliance policies as it relates to corresponding Medicare programs.
• Leverage an enterprise mindset while collaborating with internal Legal and Compliance leadership.
• Create and execute a development program for all staff ensuring they continue to grow their skillset and expand their knowledge enabling their career progression.
• Develop strong working relationships with internal parties to ensure open lines of communication and timely responses to compliance concerns, inquiries, or deliverables.
• Perform ongoing compliance/regulatory risk assessment of all related Medicare Part C functions.
• Leverage resources to mitigate the highest risks identified via the risk assessment.
• Perform other duties as assigned.

Qualifications 

• Previous Medicare compliance and operational industry experience required.
• Health plan experience required, involvement with Part C operations is needed to be considered.
• 5 years of Medicare program experience required; vendor management experience preferred.
• *Current managment experience is required; specifically with the ability to drive engagement and empower staff.
• Mastery of Medicare regulations required including how to research, interpret, and implement requirements.
• Strong attention to detail, analytic skills, and problem-solving required.
• Strong, confident, and tailored audience oral and written communication skills required.
• Ability to work collaboratively and influence change amongst shifting priorities required.
• Ability to thrive in a highly matrixed environment is required.

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 122,900 - 204,800 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.

We want you to be healthy, balanced, and feel secure. That’s why 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) with company match, 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, visit Life at Cigna.

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.

Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.