Audit Operations Lead – Evernorth – Remote

Evernorth Health Services; Connecticut; Remote; USD 63,000 - 104,000; Full time

Benefits offered by this job

Health benefits

401(k) plan

Life insurance

Tuition reimbursement

Paid time off

Job summary

Evernorth Health Services, a division of The Cigna Group, seeks an audit/compliance professional to manage end-to-end audit activities across healthcare operations. You will coordinate requirements, timelines, and deliverables with multiple teams while driving remediation and process improvements.

The role offers an annual salary range and eligibility for bonus benefits, with some remote work options. The company emphasizes comprehensive health and wellbeing programs from day one.

Qualifications

• Strong communication, organization, problem-solving, adaptability, and time-management skills.
• Experience coordinating complex, time-sensitive work across multiple teams.

Responsibilities

• Audit activities from intake through execution, remediation, validation, and closure.
• Clarify requirements, timelines, dependencies, and deliverables.
• Translate complex requests into actionable steps.
• Coordinate with multiple teams and stakeholders to ensure audits.
• Maintain documentation and communicate status, risks, and next steps.
• Identify risks and suggest solutions to improve processes.

Skills

Strong communication

Organization

Problem solving

Adaptability

Time management

Education

Bachelor’s degree preferred

Job description

Key Responsibilities

• Audit responsibilities may include:
  • CMS Program and Mock Audits
  • Delegation and Data Validation Audits
  • NCQA and URAC Audits
  • Internal audit findings and remediation
  • Other compliance, regulatory, or operational initiatives
• Manage audit activities from intake through execution, remediation, validation, and closure.
• Clarify requirements, timelines, dependencies, and deliverables.
• Translate complex or incomplete requests into actionable next steps.
• Research unfamiliar issues and engage subject matter experts as needed.
• Coordinate activities across multiple teams and stakeholders.
• Facilitate audit preparation, meetings, requirements discussions, and follow-up.
• Maintain documentation and communicate status, risks, and next steps.
• Identify and escalation risks while recommending solutions.
• Improve SOPs, workflows, tools, and audit processes.

Minimum Requirements

• High school diploma required; bachelor’s degree preferred.
• 5+ years of experience in client/customer support, healthcare operations, audit, compliance, project coordination, or a related area.
• Experience coordinating complex, time-sensitive work across multiple teams.
• Strong communication, organization, problem-solving, adaptability, and time-management skills.

Preferred Qualifications

• Healthcare, regulatory, accreditation, client, or internal audit experience.
• Experience developing or improving SOPs, workflows, or process documentation.
• Knowledge of prior authorization, post-service processes, reporting, or relevant eviCore systems.

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 62,600 - 104,300 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.

At The Cigna Group, 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), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence.

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 need a reasonable accommodation to complete the online application process, please email [e-mail] for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

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.