POSITION SUMMARY

The Operational Risk & Controls Senior Advisor will serve as a senior individual contributor in building and sustaining a robust control governance program within the Provider Experience and Operations (PX&O) function. This individual will be responsible for owning risk management governance over specific business process areas covering provider data management and claim operations. Specifically, this individual will ensure effective risk and control practices are embedded within these domains. The role will leverage advanced risk management, control design, and audit readiness skills to enable compliant business processes and support audit coordination across critical PX&O programs.

Candidates who reside within 50 miles of the following locations will be required to perform onsite 3 days per week: Bloomfield, CT; Chattanooga, TN; Denver, CO; St. Louis, MO; and Scottsdale, AZ.

Position Summary

• Provide subject matter expertise in operational risk and controls, supporting the development, maintenance, and monitoring of risk and control frameworks across claims and Network Operations processes.
• Document and update business process flows, control matrices, and risk assessments, establishing standards and ensuring consistency across operational areas.
• Support internal and external audit activities, including evidence collection, control remediation design and tracking, and audit readiness for SOX/SOC requirements.
• Identify and escalate emerging operational risks, advising leadership on mitigation strategies and ensuring appropriate actions are taken.
• Assess and monitor risks related to data integrity and process changes, providing expert guidance on control design and effectiveness.
• Collaborate with teams on control integration during process implementations or enhancements, ensuring new processes meet control requirements.
• Champion risk and control awareness across the organization by developing and delivering training, guidance, and communications that promote a strong control culture.

Primary Components

Control Governance: Establish and maintain a formal control governance framework to manage end-to-end process documentation. Provide expert guidance on operational risk and controls to optimize the control environment, implement proactive risk mitigation strategies, and resolve control issues efficiently.

Collaboration: Build and sustain strong partnerships across Operations, Audit, and other key business functions to drive a unified and effective approach to operational risk and control management. Facilitate open communication, knowledge sharing, and collaborative problem-solving to proactively address risks, resolve control issues, and support audit readiness.

Communication: Translate complex control concepts and audit requirements into actionable guidance for diverse audiences. Provide regular updates on control program status, risk exposures, and remediation progress to key stakeholders.

Key Qualifications

• Bachelor’s degree in Accounting, Business, Risk Management, or related field preferred.
• CIA, CISA, or CPA or related certification preferred.
• 5+ years of Big 4 audit experience preferred, or 7+ years with other relevant risk and controls experience.
• Experience in healthcare operations or payer-provider environments strongly preferred.
• Expertise in operational risk and control practices, including control documentation, risk assessments, and audit readiness.
• Experience managing SOX/SOC audit coordination and external auditor relationships.
• Deep knowledge of SOX, SOC 1, and operational risk management frameworks.
• Proven ability to embed control requirements into process design.
• Excellent communication and stakeholder management skills.
• Demonstrated ability to drive issue escalation and resolution across complex programs.

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 111,800 - 186,300 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 and paid holidays. For more details on our employee benefits programs, click here.

About The Cigna Group:

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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 require reasonable accommodation in completing the online application process, please email: See Yourself@cigna.com for support. Do not email See Yourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

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.