The Audit Operations Lead provides advanced support for complex client, regulatory, accreditation, and internal audits. This role is ideal for someone who can navigate ambiguity, solve problems, coordinate across teams, and take ownership of work through resolution.
Key Responsibilities- Audit responsibilities may include:
- CMS Program and Mock Audits
- Delegation and Data Validation Audits
- NCQA and URAC Audits
- Internal audit findings and remediation
- Other compliance, regulatory, or operational initiatives
- Manage audit activities from intake through execution, remediation, validation, and closure.
- Clarify requirements, timelines, dependencies, and deliverables.
- Translate complex or incomplete requests into actionable next steps.
- Research unfamiliar issues and engage subject matter experts as needed.
- Coordinate activities across multiple teams and stakeholders.
- Facilitate audit preparation, meetings, requirements discussions, and follow-up.
- Maintain documentation and communicate status, risks, and next steps.
- Identify and escalate risks while recommending solutions.
- Improve SOPs, workflows, tools, and audit processes.
Minimum Requirements- High school diploma required; bachelor's degree preferred.
- 5+ years of experience in client/customer support, healthcare operations, audit, compliance, project coordination, or a related area.
- Experience coordinating complex, time-sensitive work across multiple teams.
- Strong communication, organization, problem-solving, adaptability, and time-management skills.
Preferred Qualifications- Healthcare, regulatory, accreditation, client, or internal audit experience.
- Experience developing or improving SOPs, workflows, or process documentation.
- Knowledge of prior authorization, post-service processes, reporting, or relevant eviCore systems.
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 62,600 - 104,300 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.
At The Cigna Group, 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), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.
