Legal Compliance Lead Analyst (UM/Medical Management) at 091 Cigna Health & Life Ins. Co. in Memphis, Tennessee

Job Description:

Legal Compliance Lead Analyst- UM/Medical Management

Description

This position is accountable for supporting the monitoring and oversight of medical management compliance for Core Medical Operations. This individual combines clinical knowledge, regulatory compliance analysis, and operational experience to support Core Medical in developing and implementing solutions necessary to meet regulatory requirements.

Serves as a compliance subject matter expert and provides consulting support to business partners. Under the direction of the Clinical/Utilization Management Compliance Sr. Manager, will be a key contributor to streamlining and creating efficiencies in the 2nd Line of Defense Enterprise Compliance program.

• Responsible for tracking and verifying the accurate implementation of regulatory requirements


• Develops clear and accurate compliance communications, as needed


• Provides guidance and support to questions and inquiries from Health Services, Medical Management, and Clinical department and other enterprise partners regarding complex compliance issues.


• Facilitates inter-departmental activity to resolve compliance issues.


• Acts as a project manager by leading small scale initiatives to assure execution and delivery


• Assists in identifying compliance gaps within the business operations and ensures items are tracked to resolution


• Assists in the coordination of testing and monitoring plans to ensure key Core Medical business processes remain compliant


• Leads meetings with operational business partners and creates presentation materials and reports (PowerPoint)


• Monitor Corrective Action Plans that result from testing and monitoring, market conduct exams and other regulatory events


• Self-starter who takes the initiative to recommend process improvements and has the ability to create effective and clearly written processes


• Assist in training cross functional organization on the Enterprise Compliance policies (Ethics, Privacy, Mental Health Parity).

Qualifications

• Must be self-driven and willing to take the initiative in this fast paced, quickly changing environment


• Must have ability to think strategically and look at the ‘bigger picture’ and operate independently


• 3+ years related business experience ​and strong knowledge of regulatory compliance environment.


• Strong knowledge of Cigna Utilization Management systems (TruCare, CCMS, ICMS, DG\Cams).


• Strong knowledge of Core Medical clinical operation processes


• Process analysis and process improvement experience, preferred


• Excellent communication and facilitation skills.


• Strong influencing, negotiating and relationship building skills to resolve issues across matrix partner areas.


• Flexible planning/organizing skills with ability to meet changing priorities and critical deadlines.


• Ability to connect issues or individual tasks to larger compliance requirement, issue or risk


• Open to location for this role.

About Cigna

Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. We offer an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products. Together, with our 74,000 employees worldwide, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation.

When you work with Cigna, you’ll enjoy meaningful career experiences that enrich people’s lives while working together to make the world a healthier place. What difference will you make?  To see our culture in action, search #TeamCigna on Instagram.

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.