Quality Review and Audit Analyst, Medicare (Bilingual) - Remote - Cigna Healthcare at Cigna in Bloomfield, Connecticut

Job Description:

Work Location - Remote, United States
Bilingual Required - English/Spanish

Summary

General Purpose: To perform standardized telephonic evaluations of both internal and external agents in order to ensure compliance to CMS and Cigna rules and regulations

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


• 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


• 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

Qualifications

• 
  High School Diploma and 3 or more years work related experience required, Bachelor's degree preferred


• Bilingual - Englis/ 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


• Strong coordination and organizational skills


• 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

Competencies

• Informing, Organizing, Priority Setting, Perseverance, Problem solving, Customer Focus, Organizational Agility, Interpersonal Savvy

Ensure familiarity and expertise in Cigna systems including but not limited to Microsoft Office, CRM, 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.

For this position, we anticipate offering an hourly rate of 24 - 37 USD / hourly, 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 Cigna Healthcare

Cigna 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.