Legal Compliance Director – Medicare Compliance at Cigna

Remote
Cigna

Title: Legal Compliance Director

  • Medicare Compliance (Part C)
  • Job Type: PERMANENT
    Job Time: FULLTIME

Job Description:

  • Remote, Work at home in the United States

The Cigna Medicare Compliance Officer (Part C) will have at least five to ten years of relevant professional experience, with a successful track record in a health plan or health care provider setting. To be successful, this candidate must exhibit superior leadership, analytical, communication and collaborative skills, as well as the ability to excel in a dynamic, fast-paced environment. This highly visible compliance leader must be adept at working with internal stakeholders, will promote an enterprise-wide culture of compliance and provide first-rate support within the Compliance Department and across the business units.

As the leader of the Medicare Business Support (MBS) Team, he/she will be responsible for ensuring that the team works effectively with the business to deliver relevant regulatory compliance guidance in a concise, meaningful and actionable manner. Additionally, this individual will lead a team focused on real-time compliance monitoring and proactive compliance issue-spotting/correction. This leader will work closely with business colleagues and matrix partners (like Legal, Information Technology, et als.) across the Cigna Medicare organization to help maximize our beneficiaries experience consistent with CMS rules and guidance.

This individual will be responsible for setting an appropriate Tone at the Top of the MBS organization and helping to cultivate a culture across Cigna Medicare that: promotes open and candid discussions regarding compliance concerns; encourages employees to take responsibility for their actions; demonstrates effective compliance oversight; and evidences operational transparency with key stakeholders, including customers and government clients. To be successful, this leader must set a collegial tone and operate as a senior thought partner with business leaders and other in-house professionals, including those in Internal Audit, Legal, Human Resources and IT.

This leader must ensure that his/her team of compliance professionals understand the operational nuances and realities of the business, and that pertinent regulatory requirements and developments are communicated to the business in a timely manner. Finally, this individual must also ensure that such guidance and advice is delivered in ways that maximize its value and utility to the business.

Responsibilities Include:

  • Reports to the Managing Director, Cigna Medicare Compliance;
  • As Cigna Medicare Compliance Officer (Part C), serves as the Cigna Medicare Compliance Departments lead representative on all matters related to Part C Medicare;
  • Through a team of manager direct-reports, leads a diverse and broad team of compliance professionals in the development of ongoing Compliance Monitoring plans designed to test the regulatory compliance of a wide array of Medicare Part C business operations functions;
  • Partners with Compliance colleagues and senior business leaders to stay informed of the most pressing risks impacting the Cigna Medicare business landscape;
  • In the areas of regulatory and contractual compliance, oversees the performance of root cause analyses and the development and implementation of corrective action plans;
  • Ensures that Part C Medicare Compliance updates and reports are provided regularly to the Cigna Medicare Compliance Committee, the Chief Compliance Officer of Cigna and the Managing Director, Cigna Medicare Compliance;
  • Assists in preparing periodic reports/updates to Cignas Executive Leadership Team (ELT) and the Compliance Committee of Cignas Board of Directors;
  • Provides support in internal and external regulatory and enforcement audits;
  • Forges and maintains positive working relationships with business owners, senior management, regulators and compliance colleagues.

Qualifications:

  • A bachelors degree; graduate degree and/or certification in healthcare compliance preferred;
  • An experienced ethics and compliance leader with five plus years of experience in a Compliance leadership role. A minimum of 10 years of experience with Compliance matters and specific experience with Medicare;
  • Demonstrated executive presence with the knowledge base and stature to deliver advice in a manner that is respected and valued by business colleagues and leadership;
  • Ability to prioritize effectively and exercise sound judgment in a high-pressure environment, evaluating and balancing the needs of the business when making strategic decisions relating to compliance issues;
  • Must be effective managing and working with others in a fast paced environment with the ability to multi-task and manage a large volume of concurrent priorities;
  • Effective manager of people, through mandate as well as influence; Must have previous Management experience
  • A highly collaborative, yet decisive, compliance professional;
  • Demonstrated familiarity with regulatory requirements which govern the Medicare business;
  • Strong organizational and management skills and superior communications skills – both verbal and written;
  • Able to quickly establish credibility with stakeholders;
  • Exemplary integrity, ethics, independence and resilience; and
  • Driver of adherence to controls and good business practices.
  • Open to location

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