Cigna Quality Review and Pharmacy Audit Manager, Post Audit - Express Scripts in St. Louis, Missouri
Manager – Post Audit is responsible to oversee all post audit activity for the Retail Network Audit Department; including hiring, training and managing the post audit team. As Manager - Post Audit, you will assure direct reports are meeting established goals in accordance to the department policies, contractual obligations, and state/federal pharmacy audit regulations. This poition functions as the primary support of the Sr Manager - Audit on all escalated issues and projects.
Interact withPharma & RetailStrategy accountmanagement,chain contacts, independent pharmacy owners or associates,sales/accountmanagement,and clientsto ensure adequatecommunication and prompt resolution of client or provider issues as related to audit
Coach and develop team, oversee resolution of employee relations issues, oversee hiring and training of new associates, and manage workload assignments all aimed at ensuring the team succeeds in achieving a high-level of client satisfaction, as well as their own professional achievements
Monitor and report out to leadership, and other appropriately interested parties, on work in progress, aging, and key metrics
Supervise all audit activity and identify trends/outliers within the post audit and corporate chain audit process. Identify critical issues and manage up to Sr. Manager and/or Director while providing assistance to minimize such impact
Collaborate with internal and external partners to ensure appropriate claim submission and compliance within the Retail Pharmacy Network
Conduct all aspects of the audit lifecycle utilizing analytical skills and audit tools necessary
Oversee and manage the chain corporate audit process, scheduling, communication timelines, and delegate assignments to staff in accordance with department policy and state and or federal regulations
Ability to handle confidential and sensitive information
Conduct onsite corporate chain onsite audits – up to 25% travel
Special Projects as assigned
BA/BS degree or equivalent work experience
5-8 years of relevant businessexperienceto include a required minimum of 3 years of pharmacy experience in either retail or PBMsetting and a minimum of 3 years of pharmacy audit experience in healthcare setting; OR MA/MSdegreeand 3-5 years of experience.
Leadership /Supervisory experienceisrequired
Ability to succeed in a dynamic, high-pressure environment and develop a culture of ownership and personal accountability
Ability to motivate employees, handle difficult employee relations issues and create a culture that supports high employee morale
This position is not eligible to be performed in Colorado.
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.