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Cigna Quality Review and Audit Director - Express Scripts in St. Louis, Missouri

Job Description:

This position will own the manufacturer rebate contract audits and the rebate audits of ESI’s clients. The Director will serve as the primary point of contact regarding the manufacturers’ invoicing and clients’ rebate share arrangement to manufacturers and third party auditors for manufacturers and clients in the audit process. The Director- Rebate Audits will provide additional support to supervising the audit staff; and collaborate with Legal to review and interpret the contract with respect to invoicing and receipting of rebate contract payment and the subsequent share of rebate dollars with clients. The position will need to develop expertise in Company’s systems and department functions to ensure knowledge of entire rebate process from claim to invoice payment, and develop a good understanding of audit contract language. In addition, this position will act as an internal subject matter expert / consultant on rebate audit process improvement / enhancements, manufacturer reporting enhancements as well as technological / automation improvements in collaboration with his / her internal partners.

ESSENTIAL FUNCTIONS

  • Hires and trains the team to understand manufacturer rebate contracts. Specifically regarding invoicing and payment terms, and contractual audit language to manage manufacturer’s audit rights while taking care to affirm it is required by contract or law.

  • Hires and trains the team to have a full understanding of Express Scripts’ client contracts, specifically regarding rebate sharing arrangements and contractual audit language to manage client’s audit rights.

  • Analyzes results from manufacturer audits and works with Health Services management and internal departments to develop corrective actions when necessary.

  • Review and revise internal policy and procedure best practices for efficient audit process.

  • Participate in post-audit discussions with manufacturers, management, and Legal to resolve outstanding issues.

QUALIFICATIONS

  • 12+ years relative experience, Master’s Degree with 8+ years, RPh (not required) with 7+ years

  • 10+ years PBM, healthcare, financial analysis, contract rebate, auditing experience preferred.

  • Leadership experience or possesses character and skills to become a successful leader.

  • Analytical and problem solving skills, research and conceptual understanding required.

  • Ability to work with complex contracts.

  • Ability to handle sensitive and confidential information.

About Cigna

Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. We offer an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products. Together, with our 74,000 employees worldwide, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation.

When you work with Cigna, you’ll enjoy meaningful career experiences that enrich people’s lives while working together to make the world a healthier place. What difference will you make? To see our culture in action, search #TeamCigna on Instagram.

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.

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