Quality Review and Audit Senior Manager - Express Scripts - Hybrid (Finance)

The Quality Review & Audit Sr. Manager will lead the Operations Testing team for our Strategy, Testing Center of Excellence, and Vendor team.

This pivotal role will oversee the vendor relationship and testing center of excellence and play a role in the development of the testing strategy for new products and services. The ideal candidate will possess a unique blend of strategic thinking, operational expertise, and leadership skills to drive our organization's success.

In this role, you will be responsible for establishing and maintaining robust relationships with vendors, ensuring their performance aligns with our organizational goals. This includes managing vendor performance and resolving any issues that arise. You will work with other Ops Testing leaders to achieve clear performance metrics for vendors and regularly evaluate their performance, using these metrics to drive continuous improvement and ensure vendors meet or exceed expectations. Collaboration with vendors to ensure alignment with strategic goals and objectives is essential, fostering a collaborative environment that encourages innovation and mutual success.

You will oversee the Operations Testing Center of Excellence, ensuring the implementation of best practices and continuous improvement. You will provide leadership and direction to ensure high standards of quality and efficiency, developing and enforcing testing standards, methodologies, and processes to ensure high-quality outcomes. Rigorous quality assurance processes will be maintained to uphold the highest standards of product and service delivery, addressing any issues promptly and effectively to minimize impact on operations.

You will foster a culture of innovation by encouraging new ideas and approaches and creating an environment where team members feel empowered to take risks and experiment with new solutions. Accountability is paramount, holding team members accountable for their performance and ensuring that goals are met. Robust performance management processes will be implemented to track progress and ensure accountability, using data-driven insights to inform decision-making and drive improvements.

Mentorship and team building are integral to this role. You will act as a mentor to team members, providing guidance and support to help them develop their skills and advance their careers. Building bench strength by identifying and developing future leaders and individual contributors within the team is essential, creating opportunities for professional development and career advancement. Fostering a collaborative environment that encourages teamwork and mutual support, promoting open communication and a shared sense of purpose.

Analyzing data to identify trends, eliminate waste, and support decision-making processes is a critical function. You will use data-driven insights to improve operational efficiency and effectiveness, monitoring key performance indicators and other metrics to identify trends and areas for improvement. Providing data-driven insights to support decision-making processes within the operations testing organization ensures decisions are informed by accurate and relevant data.

Cross-functional collaboration is vital, working closely with other leaders within the Operations Testing organization to support strategic initiatives. Engaging with key stakeholders to ensure their needs and expectations are met, building strong relationships with internal and external partners to support strategic initiatives.

Essential Functions

• Strategic Planning and Execution:
  • Work closely with other leaders within the Operations Testing organization to support strategic initiatives.
  • Work closely with other leaders within the operations testing organization to support strategic initiatives.
  • Facilitate communication and collaboration across departments to ensure cohesive execution of strategies.
• Leadership and Management:
  • Provide leadership for the creation and delivery of processes and best practices for new client implementation and standard benefit and clinical changes to support high-quality testing services and client relationship retention and expansion.
  • Act as a mentor to team members, building bench strength and developing future leaders and individual contributors.
  • Thrive in a high-pressure environment with multiple competing priorities.
• Problem-solving and Continuous Improvement:
  • Proactively identify and solve complex problems that impact client implementations.
  • Demonstrate success in leading continuous improvement initiatives.
  • Challenge the status quo, drive change, and motivate individuals to develop and implement new ways of thinking and doing business.
• Performance Metrics and Staffing:
  • Maintain direct oversight for the timeliness of defect resolution and metrics related to performance guarantees for testing.
  • Ensure staffing levels are adequate to meet demand and address any concerns or escalations related to testing and audit activities.
• Vendor Relationship Management
  • Maintain strong relationships with vendors, ensuring alignment with organizational goals and objectives.
  • Establish performance metrics and regularly evaluate vendor performance.
• Testing Center of Excellence
  • Develop and enforce testing standards, methodologies, and processes to ensure high-quality outcomes. Continuously evaluate and improve these standards to keep pace with industry advancements.
  • Ensure processes comply with regulatory requirements, privacy standards, and organizational policies.
  • Implement quality assurance measures to maintain high standards of care.

Qualifications

High school diploma or equivalent required.

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.

For this position, we anticipate offering an annual salary of 110,400 - 184,000 USD / yearly, depending on relevant factors, including experience and geographic location.

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. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. 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. For more details on our employee benefits programs, visit Life at Cigna Group .

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.

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.

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.