What are the responsibilities and job description for the Product Management Advisor - Express Scripts - Hybrid position at Express Scripts by Evernorth?
Overview
The Advisor Regulated Markets Audit Management role is responsible for coordinating the planning, execution and follow up for client and regulatory audit activities within Regulated Markets. This individual serves as a point of contact for various teams supporting audit activities. This position assists with the development and delivery of training to ensure audit readiness across the organization. Recruits and retains network of enterprise resources and collaborates with Client Audit, Compliance, Legal and other stakeholders to respond to State, Center for Medicare and Medicaid Services (CMS) and Client audit requests.
Key Accountabilities Include (but Not Limited To)
The ideal candidate will have Regulated Markets specific knowledge, experience working collaboratively across teams, strong attention to details and an ability to influence and drive work in a matrix environment.
Preferred Experience
For this position, we anticipate offering an annual salary of 92,800 - 154,600 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 Group.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.
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.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
The Advisor Regulated Markets Audit Management role is responsible for coordinating the planning, execution and follow up for client and regulatory audit activities within Regulated Markets. This individual serves as a point of contact for various teams supporting audit activities. This position assists with the development and delivery of training to ensure audit readiness across the organization. Recruits and retains network of enterprise resources and collaborates with Client Audit, Compliance, Legal and other stakeholders to respond to State, Center for Medicare and Medicaid Services (CMS) and Client audit requests.
Key Accountabilities Include (but Not Limited To)
- Reviews, evaluates and executes on new regulatory guidance. Coordinates or leads responses to Audit related Request for Proposals
- Provides day-to-day oversight of Regulated Market audit activities
- Compiles and evaluates data on the functional performance of audit related activities Utilizes in-depth professional knowledge and acumen to develop models and procedures and monitor trends
- Assist with development of audit training
- Recruits and trains audit resource network
- Coordinates audit pipeline and resource support planning with Client Audit team
- Provides audit trend/issues insight to support audit preparation
- Provides direct audit support as needed
- Ensures timely documentation of audit outcomes using established tools and processes
- Supports analysis of audit findings, coordinates responses and prepares client communications
The ideal candidate will have Regulated Markets specific knowledge, experience working collaboratively across teams, strong attention to details and an ability to influence and drive work in a matrix environment.
Preferred Experience
- 2 or more years’ experience participating in regulatory and/or performance audits in a pharmacy benefit services or managed care environment
- 2 or more years participating in cross-functional projects
- Excellent process mapping and analysis skills
- Open communicator; excellent oral and written communication skills
- Ability to work effectively in dynamic, rapidly changing, team-based environment across multiple functions and in support of diverse regulatory obligations
- Critical thinker and creative problem solver, who exercises good judgment in resolving difficult situations, prioritizes and can balance needs with enterprise objectives
- Ability to work in a fast-paced deadline-driven environment, and juggle multiple, sometimes competing, priorities and requirements
- Ability to influence direction and action; build and leverage internal relationships
- Goal oriented and personally accountable; resourceful and self-directed
- Adaptable and flexible; open minded, innovative and creative – seeks ‘out of box’ solutions
- * * This is a hybrid role that requires the ability to work in person three days per week. * * *
For this position, we anticipate offering an annual salary of 92,800 - 154,600 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 Group.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.
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.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
