Grievance Customer Service Associate Analyst (Team Lead) – Cigna Healthcare – Remote in USA

Grievance Customer Service Associate Analyst (Team Lead) - Cigna Healthcare - Remote - Cigna - USA - work from home job Company: Cigna Job description: Remote - work from home, United States Summary: The Grievance team manages Cigna Healthcare - Medicare/Medicaid grievances that are presented by our member’s or their representatives pertaining to the authorization of or delivery of clinical and non-clinical services. Grievance works in collaboration with divisions within and outside the organization to resolve issues in a timely and compliant manner. The Grievance Team Leader is the subject matter expert responsible for overseeing the execution and performance of the Grievance team. The Team Lead will provide guidance, instruction, direction and leadership to the grievance team, for the purpose of achieving key results. The Team Lead monitors the quantitative and qualitative achievements of the team and reports results to a management team. The Team Lead will enable Grievance Coordinator to bring cases to resolution within CMS guidelines. Responsibilities: • Manages a team of Grievance Coordinators with responsibility for goal and productivity management, coaching and counseling, provide feedback to management team and other leadership responsibilities as assigned. • Delivers training to employees as needed and ensures new hires have proper work tools and are trained accordingly. • Ensures Grievance Coordinators expedite timely requests for information and that cases meet compliance. • Understands Cigna’s internal health plans policies and procedures to frame decisions. • Makes critical decisions in support of the business as needed. • Manage all duties within CMS regulatory timeframes and Interpret CMS regulations and policies as needed. • Communicate effectively to hand-off and pick-up work from colleagues. • Responsible for ensuring that the team meets/exceeds production and quality goals. Qualifications: • Bachelor's or associate degree in related field; in lieu of a degree, a high school diploma • 2 or more years in a Medicare, Medicaid managed care environment investigating and resolving Grievances required. • Experience in clinical practice with experience in appeals & grievances, claims processing, utilization review or utilization management/case management. • Strong written and verbal communication skills, ability to work independently on several computer applications such as Microsoft Word and Excel, as well as corporate email • Demonstrated ability to manage large caseloads and effectively work in a fast-paced 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 hourly rate of 17 - 26 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 . 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: [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. 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. Expected salary: Location: USA Job date: Sun, 03 Sep 2023 01:56:04 GMT Apply for the job now! Apply tot his job