Job description
POSITION SUMMARYThe Quality Review and Audit Analyst is responsible for supporting the organization’s goal of delivering high quality service, addressing member needs and client intent. This is primarily accomplished by completing phone, fax and email audits, attending calibration sessions, presenting quality expectations in new hire training and providing detailed documentation to the supervisors and OPS leadership for coaching purposes. In addition, the Quality Analyst will collaborate with leadership to assist with operations development concerning quality. The standard set of criteria used by the Quality Representative is designed to measure quality performance at the Agent/Site/Global level. The quality scores have direct impact on some of our high-profile client Performance Guarantees. Through quality observations, the QA Representative is responsible for driving strategic imperatives. They also provide status updates and trend data during client/project implementations.
ESSENTIAL FUNCTIONS
Review inbound, outbound or written communication or processes and evaluate Advocate performance based on criteria and impact patient experience, to determine scorecard ratings.
Monitor and assess compliance within assigned area
Ensure consistent measurement across sites by participating in site and global calibration sessions
Provide additional support to ensure our Performance Guarantees and deadlines are met
Additional duties include but are not limited to reporting on trends, scorecard creation and testing, Agent coaching, client listening session participation and identifying root cause of service failures and solutions to enable the ability to address service or process opportunities.
Proactively identify and remediate service opportunities
Partner with Supervisors to develop, communicate, achieve and reinforce quality objectives to drive business results, and work on performance improvements with Agents
Provide recommendations for process improvement based on data analysis and investigation
QUALIFICATIONS
High School diploma or G.E.D. required
Coverage Review Department, (CRD) experience preferred
Quality monitoring experience preferred
PC skills including proficiency in Microsoft Office (Excel, Outlook, PowerPoint)
Excellent verbal and written communication skills
Strong attention to detail
Ability to identify issues and work cross functionally to drive improvement
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 23 - 36 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 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.
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.
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