Legal Compliance Senior Advisor Commercial

Legal Compliance Sr. Advisor Commercial

As a senior individual contributor within EviCores Commercial Compliance department this role is pivotal in shaping and executing the organizations 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.

Key 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 EviCores regulatory and new law oversight committees

Qualifications

• Bachelors degree required. Juris Doctor (JD) masters in health-related field or paralegal certificate preferred
• 7years 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
• Knowledge of Smartsheet and Adobe (PDF) applications is preferred

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy balanced and feel secure. Thats why youll enjoy a comprehensive range of benefits with a focus on supporting your whole health. Starting on day one of your employment youll 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 Evernorth Health Services

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: for support. Do not email 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.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal state and local ordinances.