Job Description

Summary

The Quality Review and Audit Lead Analyst is responsible for facilitating the analysis, research, and risk assessment of claims/system processing issues. The analyst will use an in depth understanding of technical principles, theories, and concepts in the field of quality to perform a thorough root cause and corrective action analysis. In addition to supporting department strategic initiatives, the analyst will act as a back-up for team members as needed, as well as perform other tasks or special duties as assigned.

Essential Functions

* Triage incident tickets based on a risk based approach while balancing resource availability
* Utilize the Service Reliability framework to identify error source, root cause and corrective action/preventive measures for service failures that affect client and members
* Work with cross-functional business partners to collect and record issue details, ensuring accurate data is available to drive continuous improvements
* Facilitate the resolution of complex problems
* Prioritize daily workload to meet department SLAs and internal metrics

Responsibilities

* 70 % - Using conventional problem solving techniques, ensure correct root cause is established and a solid corrective action/preventive action is in place
* 10 % - Review submitted data for quality and accuracy
* 10 % - Support projects and initiatives which drive department strategy
* 5 % - Assist in training, documentation, and other duties required to implement operating mechanisms for new or newly modified processes
* 5 % - Act as a back-up for team members as needed and perform other tasks or special duties as assigned

Qualifications

* BS/BA degree or 4 - 6 years relevant work experience
* 3-5 years relevant work experience
* Work cross-functionally to resolve complex client issues
* Adapt to a dynamic work environment, learn quickly, solve problems and make decisions with minimal oversight
* Demonstrate initiative, commitment, and ability to work under pressure and meet tight deadlines
* Possess strong focus on customer service
* Previous quality and process improvement experience strongly advised
* Working knowledge of ESI operations, systems, products and services helpful
* Strong working knowledge of MS Excel, PowerPoint, Word required

This position is not eligible to be performed in Colorado.

About Cigna

Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. We offer an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products. Together, with our 74,000 employees worldwide, 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 Cigna, youll enjoy meaningful career experiences that enrich peoples lives while working together to make the world a healthier place. What difference will you make? To see our culture in action, search TeamCigna on Instagram.

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.