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Quality Review Audit Supervisor at 828 Newquest LLC

Posted in Management 30+ days ago.

This job brought to you by eQuest

Type: Full-Time
Location: Bloomfield, Connecticut





Job Description:

It's fun to work in a company where people truly BELIEVE in what they are doing!

We're committed to bringing passion and customer focus to the business.

Position Description:

Manages a team of quality reviewers, in a virtual environment. Manages work inventory and is responsible for facilitating the review and feedback processes associated with their equality results. Partners with internal business owners to finalize test through the rebuttal, and remediation process.  Supports developing process improvement plans to improve the customer experience. Maintains feedback databases and tools. Manages projects that support the improvement of the customer experience.

Responsibilities:


  • Managing daily workflow and productivity of their team of employees including identification of samples according to the sample methodology, and assigning/distributing to the team.

  • Owner of the team/departments Test Plan that contains the sample methodology, frequencies, known assumptions and modifications, reporting methodology, and approvals from our business partners and Compliance.

  • Responsible for the generation of the following reports: team productivity reports, team quality (results) reports: findings, observations, rebuttals, overturns, upholds, CPE tracers, and monthly aggregates.

  • Manages capacity plans, and is able to build out weekly, monthly, and yearly capacity plans to understand overall staffing needs.

  • Establish and manage performance against monitoring goals, and metrics. Work with each staff member to expand capabilities and competencies.

  • Responsible for and acts as the primary coach and mentor for employees, including feedback in one-on-one sessions, and formal check-ins.

  • Conducts regular team meetings, huddles, one-on-ones, to understand the team’s needs and barriers, and to promote development of the team.

  • Responsible for the communication of trends, identified issues, and root causes to all levels of management; accountable for the oversight of correction action (remediation).

  • Partners with Operations Quality Coaches, Supervisors, Managers, Compliance Level 2, and 3, to ensure findings are clearly understood, appropriately documented, and remediated.

  • Creates and manages Internal Monitoring policies, procedures, job aids, process maps, and C-Kit artifacts.

  • Identifies, conducts, and/or oversees all training for the team.

  • Responsible for managing adhoc testing/reporting request from management, business partners, or compliance.

  • Oversees the day-to-day needs of the team, conducts risk mitigation, and focuses on continuous improvement opportunities.

  • Maintains timesheets, and tracking of adherence to time and attendance, conduct, and performance within OMD and manager files.

  • Monitors productivity and quality metrics, suggests new metrics to improve the team, and is responsible for reporting results on a weekly, monthly, and quarterly basis.

  • Actively participants in efforts to identify operational improvements opportunities that have a direct impact on the customer, provider, or partner.

  • Responsible for understanding, and keeping up-to-date with CMS guidelines, RMA, SOX, PwC, and other governing bodies.

Core Skills:


  • Proficient in managing day-to-day inventory and workflow. 

  • Strong analytical and problem solving skills; must be able to systematically analyze and resolve complex problems cross organizationally.

  • Strong background in productivity and quality reporting, in support of work and staff management.

  • Strong and proven background in statistical sampling.

  • Ability to meet key metrics/goals.

  • Proficient at risk mitigation.

  • Strong background with analyzing data, and identifying trends to make business decisions.

  • Proven ability to multitask, shifting effectively among multiple activities with a quick turn-around time.

  • Excellent organizational skills, including proven ability to utilize resources, prioritize task, manage and meet multiple deadlines on-time and on-budget.

  • Ability to manage medium sized projects from beginning to end, including scope, requirements, and change management.

Qualifications:


  • Bachelor’s Degree preferred

  • 3 years of direct leadership, supervisory or management experience

  • Six Sigma or PMP certification preferred

  • ProSci Change Management certification preferred

  • Strong skills with Microsoft Office (Word, Excel, PowerPoint, and Access)

  • Proficient in managing day-to-day inventory and root cause analysis

  • Strong background in a Management Operating System (MOS) environment

  • Highly developed decision-making and problem-solving skills

  • Solid background in performance management and employee coaching and motivation

  • Strong written and verbal communication skills

  • Proficient in handling multiple assignments, projects and deliverables simultaneously

  • Ability to work under pressure and flexible hours

  • Proficient in managing in a virtual environment

  • Proficient in adding, subtracting, multiplying, and dividing in all units of measure, using whole numbers, common fractions, and decimals.

  • Ability to compute rate, ratio, and percent and to draw and interpret graphs and charts.

  • Must be able to utilize a ten key calculator and must be computer literate and be able to generate reports and graphs using Excel and PowerPoint

  • Strong analytical and technical skills with high attention to detail

  • Supervisor must have good verbal and written communication skills to present findings from data analysis.

  • Supervisor must have computer skills and should have familiarity with issue tracking software programs.

  • Working knowledge of continuous improvement processes.

  • Strong analytical skills.

  • Detail oriented with a high level of accuracy.

  • Ability to maintain confidentiality with associate outcomes.

  • Excellent organizational, time management and adaptability skills.

  • Strong analytical and problem solving skills; must be able to systematically analyze and resolve complex problems cross organizationally. 

  • Excellent organizational skills including proven ability to utilize resources, prioritize, manage and meet multiple deadlines with a quick turnaround time

  • Proven ability to multi-task, shifting effectively among multiple activities with a quick turn around

Preferred Software and Program Knowledge:


  • QNXT

  • Tableau

  • Ringo

  • Microsoft Access

  • SharePoint

  • WebEx

Qualified applicants will be considered without regard to race, color, age, disability, sex (including pregnancy), childbirth 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 an accommodation based on your physical or mental disability please email: SeeYourself@cigna.com. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.