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Operational Risk Sr. Advisor-Healthcare Policy-Work from Home at Cigna in Houston, Texas

Posted in General Business 30+ days ago.

Type: Full-Time





Job Description:

Job Location: remote, work from home, United States

Reporting into the CareAllies President, the Operational Risk team identifies and works to mitigate the prospect of loss from potentially inadequate procedures, systems, and policies.

In this role, you will serve as part of the Operational Risk Team responsible for federal and state risk assessment and management for Cigna's CareAllies functions. You will work closely with CareAllies business areas to support risk assessment and risk mitigation. Promote a culture of compliance through the continued implementation of a robust Operational Risk Program and associated governance and oversight, policies and procedures, programs, and risk tracking and reporting.

RESPONSIBILITIES:


  • Support the CareAllies multi-year risk model and mitigation process grounded in the four legs of the balanced scorecard methodology (risk documentation, issue and mitigation identification and tracking, and creation of risk score factors based on likelihood, speed of onset, and business affected).


  • Assess processes and business controls to identify operational and quality gaps informing multi-year strategy and business goal development.


  • Investigate origin of identified operational risks and support or coordinate mitigation efforts as appropriate.


  • Update and track key risk indicator data to help inform risk levels and business strategy decisions.


  • Support management of regulatory risk; advising internal staff and external clients on regulatory and legislative changes affecting our business or the business of our provider clients.


  • Coordinate with legal and compliance teams to support the development of policies, procedures (includes support of licensure and accreditation to minimize audit penalties).


  • Report operational risk issues and decisions to manager on a regular basis.


  • Present on complex regulatory information, business implications, and risk.


QUALIFICATIONS:


  • Bachelor's Degree preferred or equivalent work experience



  • 7+ years managed care related or health plan business experience required


  • Previous risk management experience highly preferred


  • Knowledge of Medicare programs, including Center for Medicare and Medicaid Innovation Center models and Medicare Advantage highly preferred



  • Ability to interpret regulatory and policy changes and translate them into business solution opportunities


  • Excellent Presentation skills expeirence to executive leadership


  • Ability to ask probing questions and identify potential exposure areas within business units


  • Strong analytic and negotiation skills


  • Skilled in fostering strong relationships with key business leaders and initiating action


  • Ability to deliver complex information to all levels of the organization (fluid communicator)


  • Ability to resolve conflict (striving for win-win outcomes)


This position is not eligible to be performed in Colorado.

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.