Manage operations activities for the department ensuring compliance with organization and regulatory policies.
Improve quality such that the team consistently meets or exceeds goals for accuracy, timeliness, and regulatory compliance for all department functions.
Routinely assess the talent, knowledge, and performance of the staff and administer necessary coaching, training, and performance management.
Ensure that the team meets all deliverables and milestones related to maintaining an audit readiness position at all times
Conduct performance oversight of external vendor partners to ensure successful achievement of internal metrics and compliance/regulatory standards
Enable a virtual work environment where employees have the tools, resources, and information necessary for teamwork, productivity and engagement.
Lead and drive a customer centric focus within the Medicare Grievance team
Focus on achieving team and individual accuracy, customer satisfaction and effort scores within a team of associates
Create an environment where people want to excel and are focused on delivering the best outcome for each and every customer
Partner with peer managers and individuals outside of the grievance team to create a positive work environment and lead process improvement initiatives
Manage the selection, hiring, training, coaching and development within the team
Provide direction regarding overall objectives and assignments to the team
Provide support for complex and sensitive issues concerning Customers and Healthcare Professionals
Support 24/7 operation management needs as required, including weekends
Monitor performance guarantee results as required
Identifies customer needs and responds to inquiries with knowledgeable and timely responses
Ensures timely execution of compliance with CIGNA standards for all customer types
Identifies staff education opportunities and provides proactive training on a continuous basis.
Serves as CIGNA advocate in external community
Facilitate appropriate meeting participation and follow up activities
Facilitates education and discussion on products, quality initiatives, etc. as identified
2+ years’ of previous management in operations or people leadership experience preferred
2+ years’ experience in managing vendor relationships and performance preferred but not required
Experience and passion for leading, developing and motivating employees required
Medicare experience required
Knowledge of Medicare systems and/or Medicare Grievance/Appeal functions a plus
Demonstrated excellent oral, written, interpersonal, analytical, and negotiation skills
Must be computer proficient
Ability to work in and succeed in a team oriented environment
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 53,700 – 89,500 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 .
Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you’ll enjoy meaningful career experiences that enrich people’s lives. What difference will you make?
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: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.
Cigna 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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