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Audit Operations Lead - Evernorth - Remote

Remote / Online - Candidates ideally in
Bloomfield, Hartford County, Connecticut, 06002, USA
Listing for: The Cigna Group
Remote/Work from Home position
Listed on 2026-11-01
Job specializations:
  • Science
    Healthcare Compliance
Salary/Wage Range or Industry Benchmark: 62000 USD Yearly USD 62000.00 YEAR
Job Description & How to Apply Below
The Audit Operations Lead provides advanced support for complex client, regulatory, accreditation, and internal audits. This role is ideal for someone who can navigate ambiguity, solve problems, coordinate across teams, and take ownership of work through resolution.

** 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 escalate 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 10

Mbps download/5

Mbps upload.

For this position, we anticipate offering an annual salary of 62, 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.

For more details on our employee benefits programs,  () .

** 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,…
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