Quality Review and Audit Advisor - Express Scripts - Hybrid at Cigna in St. Louis, Missouri

Job Description:

POSITION SUMMARY

The Quality Review and Audit Advisor works with our pharmaceutical manufacturers (and/or their auditors) and management as well as other Express Scripts (ES) subject matter experts as a lead to resolve issues noted during the Pharma Audit process or during Pharma Web Portal (PWP) review. Serves as project lead and tracks status on data deliverables. Monitors contract terms to ensure pharma is requesting appropriate data. Assists with troubleshooting issues and questions arising from pharma audits and/or the PWP. Works cross functionally with other ES subject matter experts to build out data analytics, obtain applicable electronic files/data when necessary, ensuring all information is included and readable. Assist other members of the team with performing their job duties as needed. Provides data and ongoing support to both Pharma Audit and PWP subject matter experts as needed.

ESSENTIAL FUNCTIONS

• Works with Pharma Audit and PWP as lead to ensure issues are resolved and deadlines are met by working independently as well as cross functionally with internal departments.


• Assists with troubleshooting issues and questions arising from audits.


• Discusses any pertinent issues with Pharma (and/or their auditor), understanding and managing their expectations and working through any limitations that may be experienced due to confidentiality of information, etc.


• This position requires the analyst to be able to anticipate pharma's needs as it relates to audit or the PWP.


• It also requires the ability to deal with sensitive situations.


• Tracks status and serves as technical lead for PWP, and acts as lead for pharma audit during routine audits and monitors contracts to ensure clients are requesting appropriate data.


• Fields various requests for information and provides ongoing support for Client Audit as well as other subject matter experts as needed.


• Steps in when necessary to assist with department workload needs.


• Look for opportunities to initiate process improvement and perform all necessary systems analysis and SQL, Macro functions to ensure that the department is moving towards more efficient processes.


• Special projects as assigned.

Qualified candidates will possess a combination of the following:

• Bachelor's degree preferably with focus in Finance or other business related field.


• Microsoft Office including Excel, Access, Word, and Outlook; Knowledge of Express Scripts systems and operations preferred.


• Previous experience working with cross functional departments to research and resolve issues using innovative solutions.


• Focus on quality and service.


• Demonstrated ability to meet multiple deadlines and manage a dynamic workload, well organized.


• Demonstrated analytical and problem solving skills.


• Detail oriented; Excellent verbal and written communication skills along with presentation skills.


• Ability to handle sensitive or confidential information is critical.


• Ability to work a flexible schedule to accommodate project deadlines.

* * * This is a hybrid role which requires the ability to work 3 days per week on site in Morris Plains or St. Louis. * * *

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.

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.