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Quality Review and Audit Supervisor - Enterprise Operations - Remote

Remote:

Full Remote

Contract:

Full time

Salary:

58 - 96K yearly

Experience:

Mid-level (2-5 years)

Work from:

United States

Offer summary

Qualifications:

High School Diploma required, Bachelor's Degree preferred, 3+ years people management experience, 3+ years operations experience preferred, 3+ years claim experience preferred.

Key responsabilities:

Manage a team of quality reviewers
Execute quality management strategies
Identify operational improvement opportunities
Maintain relationships with internal business owners
Support process improvement plans

The Cigna Group Health Care XLarge https://www.thecignagroup.com/

10001 Employees

See more The Cigna Group offers

Job description

Position Scope: Manage a quality team of 15-20 reviewers in a virtual environment as part of the Enterprise Operations Claim Quality Team. Manages inventory and the feedback processes associated with quality. Partners with internal business owners to ensure the appropriate quality outcome. Maintains feedback data base and tools. Supports developing process improvement plans and Manages projects that support the improvement of the customer experience. Responsible for the delivery of customer experience impact through the quality program.

Summary description of position: This position is responsible for managing a Enterprise Operations Claim Quality Team. Partner with internal business owners to improve customer experience.

Responsibilities:

Responsible for executing quality management strategies
Develop a strong relationship with internal business owners
Maintain a strong rapport with the Enterprise Operations GSP partners
Responsible for quality results for Enterprise Operations Claim Quality program
Manage a team of quality review staff members within a live and/or post pay Claim Quality Program
Participates in efforts to identify operational improvement opportunities that have a direct impact on the customer, provider, or vendor partner.
May be directly involved in complex operational audits or regulatory inquiries and provide expertise and guidance on technical or procedural issues.
Partner with Operations Managers, Quality Reviewers/Validators and Coaches to ensure negative customer experiences are assigned appropriately and feedback is shared.
Have Regular Team Meetings, Huddles, and 1/1’s to understand your teams’ needs and barriers
Utilize the eMOS Program to drive efficiencies
Build Out Weekly, Monthly, and Yearly capacity plans to understand overall staffing needs

Requirements:

High School Diploma or equivalent required
Bachelor’s Degree or equivalent work experience (preferred)
3+ years of direct people Management experience (required)
3+ years of Operations People Management experience (preferred)
3+ years of claim experience (preferred)
Highly developed decision-making and problem-solving skills (required)
Solid background in performance management and employee coaching and motivation (preferred)
Strong written and verbal communication skills (preferred)
Ability to handle multiple assignments, projects and deliverables simultaneously (required)
Ability to work under pressure and flexible hours (required)
Ability to manage in a virtual environment (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 57,600 - 96,000 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 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

Qualified applicants with criminal histories will be considered for employment in a manner
consistent with all federal, state and local ordinances.

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.