Quality Review and Audit Advisor - Express Scripts - Remote

The Cigna Group
$78,800 - $131,300Remote

About The Position

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. This Advisor level Analyst will serve as a project lead and tracks status on data deliverables, monitors contract terms to ensure pharma is requesting appropriate data, and assists with troubleshooting issues and questions arising from pharma audits and/or the PWP. As a Quality Review and Audit Advisor, you will work 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.

Requirements

  • Bachelor's degree in Finance, Business, Accounting, Economics, or related field.
  • Experience supporting pharmaceutical manufacturer audits, compliance reviews, or client audit activities.
  • Experience reviewing and interpreting contract language and validating data requests against contractual requirements.
  • Strong data analysis experience, including gathering, validating, and reconciling large datasets.
  • Advanced Microsoft Excel skills
  • Healthcare, PBM, pharmaceutical manufacturer, pharmacy, or managed care industry experience
  • Previous experience working with cross functional departments to research and resolve issues using innovative solutions.
  • 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.

Nice To Haves

  • Knowledge of Express Scripts systems and operations preferred.

Responsibilities

  • 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.
  • 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.

Benefits

  • medical
  • vision
  • dental
  • well-being and behavioral health programs
  • 401(k)
  • company paid life insurance
  • tuition reimbursement
  • 18 days of paid time off per year
  • paid holidays
  • leaves of absence
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