Director of Operations
NJM Insurance Group
Lead Quality Review and Audit Analyst
The Cigna Group
full-time
Posted on:
Origin: • 🇺🇸 United States • Alabama
Visit company websiteSalary
💰 $69,600 - $116,000 per year
Job Level
Senior
About the role
- Lead and manage multiple audit projects, including client-initiated and government audits (e.g., State Readiness, Market Conduct, Pre-delegation). Perform quality reviews of signature control items to validate and ensure alignment with audit requirements. Analyze large datasets using Excel to identify discrepancies and ensure data integrity. Develop and maintain standard operating procedures (SOPs) for audit and quality review processes. Collaborate with cross-functional teams (e.g., Internal Audit, Regulated Markets, Client Audit, Sales & Account Management, IT) to resolve issues and implement improvements. Prepare formal written responses to audit findings and ensure timely and accurate documentation. Monitor AuditBoard and other systems to ensure compliance in audit deliverables. Identify and implement process improvements to enhance audit efficiency and effectiveness.
Requirements
- High School Diploma or GED required. Bachelor’s degree in Business, Finance, Healthcare Administration, or related field preferred. 2+ years of experience in auditing, quality assurance, or pharmacy benefit management (PBM). Advanced proficiency in Microsoft Excel (pivot tables, VLOOKUP, formulas), Word, PowerPoint, and Smartsheet. Strong analytical, problem-solving, and organizational skills. Excellent verbal and written communication skills. Ability to manage multiple priorities and meet tight deadlines. Experience working independently and collaboratively in dynamic environments. Knowledge of CMS regulations and PBM operations preferred. 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.
