What are the responsibilities and job description for the Fraud Advisor position at The Cigna Group?
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The Fraud Advisor supports the identification, development, and resolution of fraud, waste, and abuse (FWA) investigations across the healthcare environment. This role applies investigative judgment, data analysis, and collaboration with cross‑functional partners to assess risk, document findings, and support program integrity efforts.
Primary Responsibilities Include:
Apply advanced professional knowledge to effectively manage complex fraud, waste, and abuse concerns involving prescriber and pharmacy activity on behalf of client needs and expectations, independently and with minimal management oversight.
Identify and recommend solutions to improve SIU workflows and address operational weaknesses through process improvement initiatives.
Assist with training, case staffing, and End2End review support for new and seasoned investigators on an ongoing basis.
Work independently and collaboratively with internal and external business partners to oversee and execute projects and requests responsive to client needs.
Collaborate with fraud leadership and cross‑functional partners to identify trends, mitigate emerging risks, and enhance enterprise fraud prevention strategies.
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.
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.Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.