Senior Provider Compliance & Process Excellence Analyst

UnitedHealth Group; United States; Remote; USD 62,000 - 104,000; Full time

Job summary

The Cigna Group (Evernorth Health Services) invites a Compliance and Operations Specialist to partner with pharmacy networks, research complex matters, and implement improved processes. You will analyze risks, coordinate cross-functional projects, and help audits and training efforts.

This role emphasizes data-driven decision making, strong communication, and the ability to drive operational excellence in a regulated healthcare environment.

Qualifications

• 3 years of experience in pharmacy benefit management, pharmacy networks, healthcare operations, compliance, or related field.
• Strong analytical, critical-thinking, and decision-making skills with ability to translate research into practical recommendations.
• Clear written and verbal communication across organizational levels.

Responsibilities

• Partner with contracted pharmacy providers and internal teams to research and resolve complex compliance and operational matters.
• Lead or contribute to cross-functional projects that design, test, and implement business applications and process improvements.
• Analyze complex issues, identify risks, and turn findings into timely recommendations and solutions.
• Monitor network provider compliance with state and federal requirements and internal policies.
• Support audits by preparing information and coordinating responses.

Skills

Analytical skills

Communication

Project coordination

Microsoft Excel

Education

Bachelor's degree

Tools

PowerPoint

Word

Access

Job description

The Cigna Group (Evernorth Health Services) invites a Compliance and Operations Specialist to partner with pharmacy networks, research complex matters, and implement improved processes. You will analyze risks, coordinate cross-functional projects, and help audits and training efforts.

This role emphasizes data-driven decision making, strong communication, and the ability to drive operational excellence in a regulated healthcare environment.