Cigna is Hiring Work from Home in Some States Now!

Cigna is hiring work from home in many states!

Cigna is a massive worldwide health services provider! Cigna makes over $100 billion dollars a year! Cigna is seeking remote Grievance Operations Lead Analysts in many states!

We are participants in the Amazon Associates program and other affiliate programs. There are referral links on this page, and I may receive a small commission, at no cost to you, if you purchase through my link. Thank you.

If you are not interested in this Cigna work at home job, you can attend a FREE work at home workshop here. Caitlin Pyle, multi-millionaire work at home mentor will show you how to work from home as a proofreader and makeup to $60/hr! HEAD HERE to begin your work-at-home career.

Make Extra $2000/Month from Home
Become a Pinterest Virtual Assistant
How to Start a Blog
Survey Junkie: Make $5-$25 from home in your spare time the EASY way: try new products, give your opinion and take part in focus groups. Join Survey Junkie Now.
SwagBucks: Shop, watch videos and earn money FAST. Join SwagBucks Now
Ibotta App: Get cash back on purchases. Shop and earn cash FAST. Join Ibotta Now
Fiverr Gigs: Earn money from simple gigs. Earn extra money TODAY. Join Fiverr Now

SUMMARY

The Operations Lead Analyst will be accountable to support oversight and monitoring of individual Prescription Drug Plan (PDP) grievance operations, compliance with CMS requirements, mock audit support and CMS plan audits. Oversight of grievance operations to identify non-adherence to established processes as well as identify improvement opportunities. Report results through ongoing audit spreadsheets, dashboards and scorecards. This role includes vendor oversight & collaboration and coordination with other internal partners and other lines of business for consistent processes across grievance operations.

RESPONSIBILITIES

Support daily oversight and monitoring of PDP grievances with the vendor, internal and external partners. Includes BPO vendor, Pharmacy Claim vendor (Express Scripts), and internal Cigna Government Business & matrix partners.
Identify grievance trends/issues within grievance operations and Center for Medicare & Medicaid Services (CMS) complaints. Support root cause analysis; engage with other operational areas and partners as needed to remediate issues.
Review Service Level Agreement (SLA) metrics on a monthly basis and work with vendor/matrix partners to address any issues impacting grievance operations.
Perform ongoing review for implemented process updates and/or technology enhancements through quality audits, calibration sessions, etc.
Conduct ongoing audits and monitoring to ensure adherence with established policies and procedures and to validate compliance with CMS requirements.
Support the annual review of grievance policies & procedures/job aids or as needed for new or updated processes or enhancements.
Support review of annual training materials and any ad-hoc or refresher training materials, as needed.
Work with internal team & vendor to identify improvement opportunities and track through implementation.
Support projects and grievance initiatives both internally and with vendor(s).
Participate in defining and reviewing business requirements documentation, user acceptance testing, checkout and signoff in of system enhancements, production fixes, and/or business process improvements.
Support AEP and 1/1 readiness activities for Grievance operations.
Participate in and actively support all CMS, external, and internal audit activities.

Make Extra $2000/Month from Home
Become a Pinterest Virtual Assistant
How to Start a Blog
Survey Junkie: Make $5-$25 from home in your spare time the EASY way: try new products, give your opinion and take part in focus groups. Join Survey Junkie Now.
SwagBucks: Shop, watch videos and earn money FAST. Join SwagBucks Now
Ibotta App: Get cash back on purchases. Shop and earn cash FAST. Join Ibotta Now
Fiverr Gigs: Earn money from simple gigs. Earn extra money TODAY. Join Fiverr Now

QUALIFICATIONS

Bachelor’s degree or equivalent experience
3-4 years of relevant Medicare (Part D and/or Part C) or other government program experience and/or Customer Service
Detailed understanding of CMS regulations and adherence to these standards relating to all aspects of Medicare business.
Strong analytical, root cause analysis, and problem solving skills
Detail-oriented with emphasis on quality/accuracy
Excellent organization skills
Ability to manage multiple competing priorities and deliverables
Excellent oral & written communication skills and the ability to communicate and interact at various levels and functions within the internal and vendor organizations
Proficiency with Microsoft Word, Excel, Outlook, PowerPoint
Self-Learner, independent strategic and creative thinker