Position Summary: Provider Compliance works to ensure the integrity of the Express Scripts networks for all Clients and Members. The Provider Compliance Senior Analyst is responsible for assisting in the daily support, and preparation, of the provider termination process. This position will work cross functionally with several different groups collecting and reporting on termination information, as well as support investigations of pharmacy noncompliance, and collaborative support Client Account Team requests that intersect with pharmacy operations and compliance.
Essential Functions:- Ensure network providers maintain compliance with state and federal regulations, as well as ESI's Provider Manual and Provider Agreement.
- Liaison for internal Compliance related inquiries and projects
- Identify and align business process efficiencies between our teams and cross functional partners
- Focus on process improvement, automation, technology, and cross-functional partnerships to drive change and deliver operational excellence
- Thrive in a high-pressure environment with multiple competing priorities
Qualifications:
- Bachelor's degree in related field preferred, HS Diploma required
- At least 2 years of relevant work experience
- Proficient with Microsoft Office suite (Word, Excel, PowerPoint and Outlook)
- Strong written and verbal communication skills
- Exceptional follow through skills, an attention to detail and the ability to handle multiple tasks and meet daily deadlines
- Ability to demonstrate initiative and independent thinking
- Ability to think strategically while solving tactical challenges
- Demonstrated ability to work with cross-functional departments to resolve issues
- Detail oriented with strong analytical and problem-solving skills
- Ability to adapt in a dynamic and fast-paced work environment and make independent decisions
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 62,200 - 103,600 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.
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.
