Product Management Senior Manager of Regulated Markets Audit - Express Scripts - Hybrid - The Cigna Group
Bloomfield, CT
About the Job
Description of Position:
+ The Product Management Senior Manager of Regulated Markets Audit is responsible for leading a team that serves as the Regulated Markets point of contact for Government Audits and the issue management of Regulated Markets book of business items. This individual will serve as a point of contact for leadership within Regulated Markets and assist in setting the strategic direction to their team, other Regulated Market capability owners, and the broader organization in support of Regulated Market Government Audits. The ideal candidate will have a broad based knowledge of Regulated Markets, experience leading people, a strategic mindset, the ability to influence and drive change, and skilled in project management. This position will ensure compliance with the Center for Medicare and Medicaid Services (CMS) guidance/regulations, work cross functionally across the organization to ensure that individuals across the organization are prepared to support CMS audits, provide subject matter expertise to internal/external stakeholders, represent Express Scripts and our Clients in CMS program audits, and ensure that issues are addressed timely.
Position Details:
+ Lead a team of Advisors and/or Senior Advisors that effectively support the management processes related to Regulated Market audits
+ Work cross functionally across the PBM in support of Regulated Market Audits and serve as the point of contact for the Government Audit team
+ Build and implement management processes in support of CMS program audits for both the Regulated Markets and the Health Plan divisions. This includes the implementation of comprehensive training program, establishing related processes to manage internal / external policies
+ Individual and team will be the capability advocate for Regulated Markets audits with all cross-functional areas of the organization
+ Work across the Regulated Markets organization to track issues and bring them to resolution and closure. This may entail working with Subject Matter Experts to create business justification for a business and/or IT project.
+ Creates project scope, project plan, tracks project deliverables, and communicates project status
+ Understand and use system tools to research and resolve issues and concerns
+ Cross-train and support other team initiatives where appropriate
Qualifications:
+ Bachelor’s degree in related field or equivalent relevant experience in lieu of degree
+ Regulated Markets experience preferred
+ Familiarity with pharmacy adjudication and other PBM operations
+ Experience in managing and implementing large scale initiatives preferred
+ Strong strategic, analytical, problem solving, and project management skills required
+ Successful track record as a people manager and/or possesses clear aptitude as a leader
+ Excellent organizational agility skills with a strong understanding of business processes and operations to facilitate execution of initiatives
_* * * This is a hybrid role that requires the ability to work in person three days per week. * * *_
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 128,500 - 214,100 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.
We want you to be healthy, balanced, and feel secure. That’s why 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) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group .
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.
_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._
_The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State._
_Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances._
+ The Product Management Senior Manager of Regulated Markets Audit is responsible for leading a team that serves as the Regulated Markets point of contact for Government Audits and the issue management of Regulated Markets book of business items. This individual will serve as a point of contact for leadership within Regulated Markets and assist in setting the strategic direction to their team, other Regulated Market capability owners, and the broader organization in support of Regulated Market Government Audits. The ideal candidate will have a broad based knowledge of Regulated Markets, experience leading people, a strategic mindset, the ability to influence and drive change, and skilled in project management. This position will ensure compliance with the Center for Medicare and Medicaid Services (CMS) guidance/regulations, work cross functionally across the organization to ensure that individuals across the organization are prepared to support CMS audits, provide subject matter expertise to internal/external stakeholders, represent Express Scripts and our Clients in CMS program audits, and ensure that issues are addressed timely.
Position Details:
+ Lead a team of Advisors and/or Senior Advisors that effectively support the management processes related to Regulated Market audits
+ Work cross functionally across the PBM in support of Regulated Market Audits and serve as the point of contact for the Government Audit team
+ Build and implement management processes in support of CMS program audits for both the Regulated Markets and the Health Plan divisions. This includes the implementation of comprehensive training program, establishing related processes to manage internal / external policies
+ Individual and team will be the capability advocate for Regulated Markets audits with all cross-functional areas of the organization
+ Work across the Regulated Markets organization to track issues and bring them to resolution and closure. This may entail working with Subject Matter Experts to create business justification for a business and/or IT project.
+ Creates project scope, project plan, tracks project deliverables, and communicates project status
+ Understand and use system tools to research and resolve issues and concerns
+ Cross-train and support other team initiatives where appropriate
Qualifications:
+ Bachelor’s degree in related field or equivalent relevant experience in lieu of degree
+ Regulated Markets experience preferred
+ Familiarity with pharmacy adjudication and other PBM operations
+ Experience in managing and implementing large scale initiatives preferred
+ Strong strategic, analytical, problem solving, and project management skills required
+ Successful track record as a people manager and/or possesses clear aptitude as a leader
+ Excellent organizational agility skills with a strong understanding of business processes and operations to facilitate execution of initiatives
_* * * This is a hybrid role that requires the ability to work in person three days per week. * * *_
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 128,500 - 214,100 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.
We want you to be healthy, balanced, and feel secure. That’s why 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) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group .
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.
_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._
_The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State._
_Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances._
Source : The Cigna Group