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On Site Locations (requires individual to work in office, must live in/or near one of these locations):Scottsdale, AZBloomfield, CTPhiladelphia, PANashville, TNAustin, TXHouston, TXSUMMARYDelivers specific delegated tasks assigned by a supervisor in the Quality Assurance/Audit job family. Completes day-to-day Quality Review and Audit tasks without immediate supervision, but has ready access to advice from more experienced team members. May assist in more complex audits where experience and wider business acumen is required. Contributes to the development of audit policies and procedures. Tasks involve a degree of forward planning and anticipation of needs/issues. Resolves non-routine issues escalated from more junior team members.RESPONSIBILITIES
Performs monitoring of internal partners, external partners (70+ FDRs with 1,400 down-lines and 20,000 agents)
Provides feedback to agents and managers as well as external partners regarding agent/agency performance and compliance.
Maintains a strong rapport with telephonic internal and external partners
Provides support locating calls recordings to departments within Medicare Growth organization
Performs additional audit assignments as directed by Quality Review/Audit Manager
May be directly involved in complex operational audits and monitoring or regulatory inquiries to provide expertise and guidance on technical or procedural issues
Performs annual audit of CMS’ Foreign Language-TTY study to ensure that agents adhere to guidelines enforced by CMS
Provides periodic training to agents regarding telephonic evaluations
Performs ad hoc review of data to improve processes and develop remediation as necessary
Ensures CMS and Cigna audit readiness
Ensures that internal and external partners adhere to filed telephonic scripts
Collaborates with peers to ensure consistency in processes
Serves as SME for multiple audit types and procedures
Support segment level initiatives in a subject matter expert capacity, providing process and system application expertise
Drives process efficiencies through active change leadership and robust project management discipline.
Creates or revises procedures to correct gaps on process details or corrects process data requirement
Drives strong quality audit results; resolves sources of audit issues and translates to effective training, coaching, mentoring and process improvement.
QUALIFICATIONS
High School Diploma and 5 or more years work related experience required, Bachelor’s degree highly preferred
Bilingual Spanish required
Experience working in a Telesales environment preferred
Knowledge of CMS and Cigna compliance policies and procedures preferred
High attention to detail, quality and accuracy required
Strong coordination and organizational skills required
Ability to communicate effectively and follow-up where needed
Fast-learner and multi-tasking skills
Ability to work independently and within a team environment in a matrixed environment required
Strong interpersonal and prioritization skills preferred
Sales and/or training experience recommended
Ability to handle multiple assignments, projects and deliverables simultaneously required
Strong computer skills required (Microsoft Office Suite products preferred)
Excellent listening, written and verbal communication skills required
Adaptability, flexibility, and ability to manage through change in a fast-paced environment required
Goal oriented, resourceful, personally accountable and self-directed
Ability to effectively collaborate across the organization
Process-oriented with organization and planning skills among competing responsibilities and tasks
Proactively seek opportunities for improvement
Ability to speak to different audiences
Familiarity and expertise in Cigna systems including/ but not limited to - Microsoft Office, Salesforce, and SharePoint
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.About Cigna HealthcareCigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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.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.
