Job description

JOB PURPOSE/ROLE DESCRIPTION

Reporting to Cigna's Chief Compliance Officer, the Care Delivery and Pharmacy Compliance Officer is responsible for developing, implementing and overseeing an effective compliance program for Evernorth’s Care Delivery businesses and its Pharmacy businesses and solutions. This role will partner closely with business leaders in Evernorth’s Care Delivery and Pharmacy businesses and is charged with ensuring the proactive identification and mitigation of compliance and regulatory risks that impede business goals and strategies. This role will serve as a member of Evernorth’s Care Delivery leadership team, will serve as the primary compliance point of contact for the company’s Chief Health Officer, and will lead a team of approximately 20 compliance professionals supporting Evernorth’s portfolio of Care Delivery and Pharmacy businesses. This role will partner closely with colleagues in functions that span Cigna's enterprise including Legal, Government Affairs, Enterprise Risk Management, Operations and Internal Audit.

KEY DUTIES AND RESPONSIBILITIES

Develop, implement and maintain an effective compliance program for Evernorth’s Care Delivery and Pharmacy businesses.
Serve as primary compliance contact for Evernorth’s President of Care Delivery.
Manage a team of compliance professionals dedicated to supporting Evernorth’s Care Delivery businesses (Evernorth Care Group, Evernorth Direct Health, Evernorth Home-Based Care and MDLive).
Manage a team of compliance professionals dedicated to supporting Evernorth’s Pharmacy businesses and solutions (Home Delivery Pharmacy, Specialty Pharmacy, Specialty Pharmacy Distribution and Consumer Discount Solutions).
Serves as the primary compliance contact for Cigna's Chief Health Officer,
Provide strategic leadership and direction necessary to ensure adherence to the compliance programs for in scope businesses.
Ensure the compliance programs for in scope businesses are designed to meet the expectations of an effective compliance program, in accordance with applicable regulatory requirements. Specific activities may include but are not limited to:
Establishing and maintaining appropriate governance channels through which compliance activities and issues are related to leadership.
Establishing appropriate policies and procedures to provide guidance on compliance requirements.
Partnering with Cigna's Ethics Office to respond to reports of non-compliance or ethical concerns.
Conducting a periodic risk assessment to proactively identify risks.
Overseeing the implementation of corrective action plans to ensure the closure of compliance gaps or issues.
Ensuring the appropriate disciplinary measures are taken in response to compliance violations; and
Providing training and awareness to educate employees in in-scope business areas to educate them on emerging risks, emerging issues, and policy requirements.
Prepare regular compliance updates to the Board of Directors, Cigna's and Evernorth’s leadership teams.

QUALIFICATIONS

Juris Doctor preferred.
Pharm.D preferred.
HCCA certification
Minimum of 8 years in a senior compliance role in a care delivery setting
Compliance experience supporting home delivery or specialty pharmacies.
Experience navigating through compliance issues with state and federal regulators.
Successful team management and leadership experience.
An extensive knowledge of healthcare law is necessary. The Care Delivery and Pharmacy Compliance Officer must have in depth knowledge of:
Coding
Billing
Reimbursement
Healthcare administration
Clinical activities
Risk management
Investigative activities and protocols
Healthcare agencies and regulatory standards, including those related to federal healthcare programs, virtual care, in home health care and behavioral health.

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 169,000 - 281,600 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 and long term incentive 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 The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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.

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