Legal Compliance Senior Advisor - Commercial

Legal Compliance Sr. Advisor – Commercial

As a senior individual contributor within EviCore’s Commercial Compliance department, this role is pivotal in shaping and executing the organization’s compliance strategy. The position operates cross-functionally with Compliance, Legal, Government Affairs, and business stakeholders, ensuring robust Commercial compliance programs and adherence to applicable state and federal regulations, as well as accreditation requirements.

Key Responsibilities

• Serve as the recognized Commercial Compliance subject matter expert (SME), providing advanced regulatory and reporting guidance to internal stakeholders
• Lead and support second line of defense audits, identifying and reporting areas of non-compliance and risk, and ensuring effective preventative measures are in place
• Deliver day-to-day Commercial guidance and timely notifications on updated contracts and regulations
• Identify and analyze Commercial regulatory compliance trends and risks, leveraging data and engagement to inform leadership
• Participate in client regulatory audits to observe and provide Commercial regulatory guidance
• Advise functional leaders and contribute thought leadership within Compliance, while engaging in broader projects that require a deep understanding of the business
• Key presenter in EviCore’s regulatory and new law oversight committees

Qualifications

• Bachelor’s degree required. Juris Doctor (JD), master’s in health-related field, or paralegal certificate preferred
• 7+years of experience in the healthcare industry with a focus on healthcare utilization management
• Demonstrated expertise in interpreting and implementing healthcare-related state and federal laws and regulations
• Proven ability to engage strategically with legal and business resources to ensure accurate and effective application of law and regulation
• Experience developing and leveraging processes for tracking, coordinating, and collaborating on health plan and hospital system audits, monitoring, and corrective actions
• Strong analytical, problem-solving, and communication skills, with the ability to manage multiple projects to timely completion
• Ability to work collaboratively and foster strong relationships in a large, matrixed organization
• Independent decision-making capability
• Proficiency in Microsoft Word, Outlook, PowerPoint, and Excel
• Knowledge of Smartsheet and Adobe (PDF) applications is preferred

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 108,500 - 180,900 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, mar