Legal Clinical Quality Compliance Advisor
The Cigna Group
full-time
Posted on:
Location Type: Remote
Location: Arizona • United States
Visit company websiteExplore more
Salary
💰 $96,200 - $160,400 per year
About the role
- Partner with leadership to implement and maintain a healthcare compliance program that promotes a culture of compliance and patient safety
- Oversee ongoing testing and monitoring processes to improve program effectiveness
- Collaborate across departments to route compliance issues appropriately (e.g., clinical complaints, privacy, ethics)
- Participate in prevention, detection, and correction of compliance issues (e.g., chart reviews, clinician interactions, billing audits)
- Review and help develop policies to ensure compliance with federal and state laws
- Identify compliance risks and implement corrective actions
- Provide regular reports to senior management on compliance operations and progress
Requirements
- College degree, healthcare compliance certification, or equivalent experience
- Healthcare provider licensure (RN, NP, RPh, PA) or equivalent clinical/quality experience
- 5+ years in a care delivery setting (in-person or virtual), with knowledge of medical group/specialty practices, urgent care, and employer-site clinics
- Familiarity with billing/coding standards, accreditation, and quality programs preferred
- Basic understanding of payer regulations (Medicare FFS, Medicare Advantage, Medicaid)
- Strong written and verbal communication skills
- Ability to work independently and manage multiple priorities
- Detail-oriented with analytical skills for regulatory/business data
- Self-starter with a growth mindset
- Collaborative and influential team player
Benefits
- medical, vision, dental
- well-being and behavioral health programs
- 401(k)
- company paid life insurance
- tuition reimbursement
- a minimum of 18 days of paid time off per year
- paid holidays
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
healthcare compliancebilling auditschart reviewscompliance monitoringpolicy developmentrisk identificationcorrective actionsaccreditation standardsbilling/coding standardspayer regulations
Soft Skills
written communicationverbal communicationindependent workmulti-priority managementdetail-orientedanalytical skillsself-startercollaborationinfluencegrowth mindset
Certifications
healthcare compliance certificationRNNPRPhPA