Cigna Hiring for Customer Service/Grievances Associate Analyst2 – Work from home at Hartford, CT Full Time

The Grievance team manages Cigna 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 Process Improvement Analyst is responsible for reviewing operational processes for Intake, Research and Resolution to ensure compliance with policies, procedures and quality standards. The Grievance Process Improvement Analyst has accountabilities for the monitoring, implementation and evaluation of process and programs to meet regulatory, accreditation and standards of practice. The individual at this level will embody Cigna’s Culture Drivers through his/her workplace behavior and will work under minimal supervision.

Duties and Responsibilities:

• Ensures that there are processes in place to monitor and measure all activities related to performance and process improvement.
• Record/track quality assessment scores and provide feedback to reduce errors and improve processes and performance to ensure quality.
• Review and update all Grievance workflows, process, procedures and Knowledge assets.
• Present results of investigations to senior staff and prepare written reports concerning investigation activities.
• Subsequent auditing and handling of grievance requests including processing where applicable, tracking, documenting, reporting and dispersal of findings and recommendations.
• Identify defects and improve departmental performance by supporting quality, operational efficiency and production goals.
• Assist in the development of departmental policies and procedures; reviews the efficiency of existing training.
• Meet established time frames and rates of performance for the quality and quantity of work for the position.
• Participate in regulatory and mock audit activities including universe review, universe scrubbing, risk analysis, timeliness assessment, and case walkthrough activities.
• Additional duties as assigned

Candidate Qualifications

• 2+ years in a Medicare, Medicaid managed care environment investigating and resolving Grievances.
• Experience in an Auditing capacity conducting root cause analysis
• Experience with experience in appeals & grievances, claims processing
• Experience handling confidential information.
• Compliance & Regulatory Responsibilities: Knowledge of state and federal appeal and grievance regulatory requirements
• 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.

For this position, we anticipate offering an hourly rate of $18 – $27, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

Helping our customers achieve healthier, more secure lives is at the heart of what we do. While you take care of our customers, we’ll take care of you through a comprehensive benefits program that helps you be at your best. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and best in class 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 dozens of corporate discounts on essentials you use every day. For more details on our employee benefits programs, please visit the “Life at Cigna” tab on our careersite: www.cigna.com/careers

About 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.