Legal Compliance Senior Advisor - Commercial

Cigna Group • Franklin, TN

24d

About The Position

Legal Compliance Sr. Advisor – Commercial As a senior individual contributor within EviCore’s Commercial Compliance department, this role is pivotal in shaping and executing the organization’s compliance strategy. The position operates cross-functionally with Compliance, Legal, Government Affairs, and business stakeholders, ensuring robust Commercial compliance programs and adherence to applicable state and federal regulations, as well as accreditation requirements.

Requirements

• Bachelor’s degree required. Juris Doctor (JD), master’s in health-related field, or paralegal certificate preferred
• 7+years of experience in the healthcare industry with a focus on healthcare utilization management
• Demonstrated expertise in interpreting and implementing healthcare-related state and federal laws and regulations
• Proven ability to engage strategically with legal and business resources to ensure accurate and effective application of law and regulation
• Experience developing and leveraging processes for tracking, coordinating, and collaborating on health plan and hospital system audits, monitoring, and corrective actions
• Strong analytical, problem-solving, and communication skills, with the ability to manage multiple projects to timely completion
• Ability to work collaboratively and foster strong relationships in a large, matrixed organization
• Independent decision-making capability
• Proficiency in Microsoft Word, Outlook, PowerPoint, and Excel
• 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

Nice To Haves

• Juris Doctor (JD), master’s in health-related field, or paralegal certificate preferred
• Knowledge of Smartsheet and Adobe (PDF) applications is preferred

Responsibilities

• Serve as the recognized Commercial Compliance subject matter expert (SME), providing advanced regulatory and reporting guidance to internal stakeholders
• Lead and support second line of defense audits, identifying and reporting areas of non-compliance and risk, and ensuring effective preventative measures are in place
• Deliver day-to-day Commercial guidance and timely notifications on updated contracts and regulations
• Identify and analyze Commercial regulatory compliance trends and risks, leveraging data and engagement to inform leadership
• Participate in client regulatory audits to observe and provide Commercial regulatory guidance
• Advise functional leaders and contribute thought leadership within Compliance, while engaging in broader projects that require a deep understanding of the business
• Key presenter in EviCore’s regulatory and new law oversight committees

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Number of Employees: 5,001-10,000 employees