Senior Provider Compliance & Risk Analyst

Cigna Healthcare; Oregon; Hybrid; USD 62,000 - 104,000; Full time

Benefits offered by this job

Health benefits

401(k)

Life insurance

Tuition reimbursement

Paid time off

Paid holidays

Leaves of absence

Job summary

The Cigna Group is seeking a compliance and operations professional to help protect Express Scripts' pharmacy networks and improve client and member experiences. You will partner across the business, research complex issues, and lead cross-functional projects to design, test, and implement solutions.

This role offers an annual salary of 62,200–103,600 USD with eligibility for an annual bonus and a comprehensive benefits package including medical, vision, dental, 401(k), life insurance, tuition

Qualifications

• 3+ years of experience in pharmacy benefit management, pharmacy networks, healthcare operations, compliance, or a related field.
• Strong analytical, critical-thinking, problem-solving, and decision-making skills; translate research into practical recommendations.
• Ability to manage multiple priorities, deadlines, and deliverables in a fast-paced environment with changing needs.
• Clear written and verbal communication skills across levels of the organization.
• Strong organization, time management, attention to detail, and independent/collaborative work judgment.
• Advanced Microsoft Excel skills, including formulas, data analysis, and pivot tables; proficiency with PowerPoint, Word, and Access.

Responsibilities

• Partner with contracted pharmacy providers and internal teams to resolve complex compliance and operational matters.
• Lead or contribute to cross-functional projects that design, test, and implement business applications, technology solutions, and process improvements.
• Analyze complex issues, identify risks and opportunities, and turn findings into clear, timely recommendations and solutions.
• Improve processes by simplifying work, automating workflows, and strengthening alignment across teams and partners.
• Monitor network provider compliance with state and federal requirements, internal policies, and procedures.
• Support client, internal, and other audits by preparing information, coordinating responses, and addressing operational needs.
• Create, review, and maintain SOPs, policies, training materials, and other process documentation.
• Share recommendations, concerns, and operational risks with stakeholders across the organization.
• Promote operational excellence through continuous improvement and effective use of technology.

Skills

PBM experience

Healthcare operations

Data analysis

Problem solving

Communication

Excel / Office tools

Education

Bachelor's degree

Tools

Excel

PowerPoint

Word

Access

Job description

The Cigna Group is seeking a compliance and operations professional to help protect Express Scripts' pharmacy networks and improve client and member experiences. You will partner across the business, research complex issues, and lead cross-functional projects to design, test, and implement solutions.

This role offers an annual salary of 62,200–103,600 USD with eligibility for an annual bonus and a comprehensive benefits package including medical, vision, dental, 401(k), life insurance, tuition