Senior Advisor - Compliance & Regulatory Excellence (Care Delivery & Pharmacy)

Evernorth Care Delivery & Pharmacy + Compliance Senior Advisor

Role Summary

The Evernorth Care Delivery & Pharmacy + Compliance Senior Advisor is a key contributor responsible for evaluating compliance with all regulatory requirements relative to the Evernorth Care Delivery, Pharmacy, Home Infusion Nursing, and Wholesale Drug Distribution.

This position will also be engaged in various compliance efforts, acting as a subject matter expert to support business partners and will need to work with a high degree of independence.

The Compliance Senior Advisor must be highly organized with a keen eye for detail, and issue management and problem-solving skills.

They must be able to understand business processes and work cross functionally with business owners and other key stakeholders.

In general, the position is responsible for: (i) carrying out assigned audit and monitoring programs, (ii) compliance data reporting and analytics, (iii) risk management programs, (iv) oversight for key risk remediation, (v) compliance program, (vi) DEA compliance, (vii) compliance policies, and (viii) investigations for all areas of operation.

The position is hybrid role and can be part time remote work-at-home, with travel to company sites and supporting locations as needed.

Ideally, the team member will be located at or near a location of The Cigna Group.

Responsibilities


* Complete an established number of audits and monitoring per quarter for Care Delivery and Pharmacy +;


* Manage the Prompt Response and Corrective Action Program;


* Lead committee meetings for various compliance elements with business stakeholders and committee members;


* Coordination and development of auditing and monitoring plans focusing on areas of Compliance risk;


* Creation of dashboards and status updates which communicate audit and monitoring results, trends, and summarize risk remediation activity;


* Deliver executive summary compliance reports and applicable findings to business stakeholders;


* Serve as subject matter expert to advise business in areas including, but not limited to care delivery, pharmacy, nursing, drug distribution, and associated regulatory requirements;


* Ensure the highest level of compliance with all Federal, State, and local rules and regulations;


* Lead, participate and facilitate accessible knowledge and guidance for business stakeholders including Compliance committees and other delivery mechanisms as needed;


* Execute training program strategy and support of business stakeholders on applicable Compliance topics;


* Research and respond to compliance questions in consultation with Legal and Compliance stakeholders;


* Collaborates with internal partners and develops good working relationships to ensure open lines of communication and timely responses to compliance questions;


* Update, revise, and maintain applicable departmental policies and procedures, and support the review of policies and doc...