Experienced Grievance Customer Service Team Lead - Cigna Healthcare Medicare/Medicaid Grievance Resolution Expert (Remote in Bloomfield, CT)

Join Cigna Healthcare as a Grievance Customer Service Associate Analyst (Team Lead) and Lead the Way in Healthcare Customer Service

Cigna Healthcare, a division of The Cigna Group, is a leader in the healthcare industry, dedicated to guiding customers through the healthcare system and empowering them to make informed decisions about their health. As a Grievance Customer Service Associate Analyst (Team Lead), you will play a critical role in managing Cigna Healthcare's Medicare/Medicaid grievances, ensuring timely and compliant resolution of issues presented by members or their representatives.

About the Role

The Grievance Team Lead is a subject matter expert responsible for overseeing the execution and performance of the Grievance team. You will provide guidance, instruction, direction, and leadership to the grievance team to achieve key results. This role involves monitoring the team's quantitative and qualitative achievements, reporting results to the management team, and enabling Grievance Coordinators to bring cases to resolution within CMS guidelines.

Key Responsibilities

• Manage a team of Grievance Coordinators, overseeing goal and productivity management, coaching, counseling, and providing feedback to the management team.
• Deliver training to employees as needed and ensure new hires have the necessary tools and training to excel in their roles.
• Ensure Grievance Coordinators expedite timely requests for information and that cases meet compliance standards.
• Utilize knowledge of Cigna's internal health plans policies and procedures to inform decision-making.
• Make critical decisions in support of the business as needed, managing all duties within CMS regulatory timeframes.
• Interpret CMS regulations and policies as needed, communicating effectively to ensure seamless hand-off and pick-up of work from colleagues.
• Ensure the team meets or exceeds production and quality goals, driving results-driven performance.

Essential Qualifications

• Bachelor's or associate degree in a related field; in lieu of a degree, a high school diploma with relevant experience.
• 2 or more years of experience in a Medicare, Medicaid managed care environment investigating and resolving grievances.
• Experience in clinical practice with a background in appeals & grievances, claims processing, utilization review, or utilization management/case management.
• Strong written and verbal communication skills, with the ability to work independently on multiple computer applications, including Microsoft Word and Excel, as well as corporate email.
• Demonstrated ability to manage large caseloads and effectively work in a fast-paced environment.

Preferred Qualifications

• Experience working in a team lead or supervisory role, with a proven track record of driving team performance and results.
• Knowledge of CMS regulations and policies, with the ability to interpret and apply them in a dynamic environment.
• Strong analytical and problem-solving skills, with the ability to make informed decisions and drive business outcomes.

Skills and Competencies

To succeed in this role, you will need to possess excellent communication and interpersonal skills, with the ability to work effectively with colleagues, customers, and stakeholders. You will also need to be highly organized, with strong analytical and problem-solving skills, and the ability to manage multiple priorities in a fast-paced environment.

Career Growth Opportunities and Learning Benefits

As a Grievance Customer Service Associate Analyst (Team Lead) at Cigna Healthcare, you will have opportunities for career growth and professional development. You will be part of a dynamic team, working on complex issues and developing your skills and expertise in grievance resolution, team leadership, and customer service. You will also have access to training and development programs, designed to help you succeed in your role and advance your career.

Work Environment and Company Culture

Cigna Healthcare is committed to creating a positive and inclusive work environment, where employees can thrive and grow. As a remote worker, you will have the flexibility to work from home, while still being connected to the team and the organization. You will be part of a culture that values diversity, equity, and inclusion, and is dedicated to making a positive impact on the lives of customers and communities.

Compensation, Perks, and Benefits

We offer a competitive compensation package, with an hourly rate of $17-$26 per hour, depending on relevant factors, including experience and geographic location. You will also be eligible to participate in an annual bonus plan, and enjoy a comprehensive range of benefits, including medical, vision, dental, and well-being and behavioral health programs. Additional benefits include 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.

Why Join Cigna Healthcare?

Cigna Healthcare is a leader in the healthcare industry, with a commitment to improving the lives of customers and communities. As a Grievance Customer Service Associate Analyst (Team Lead), you will play a critical role in driving customer satisfaction and loyalty, while developing your skills and expertise in grievance resolution and team leadership. If you are a motivated and experienced professional, looking for a challenging and rewarding role, we encourage you to apply.

Equal Employment Opportunity

Cigna Healthcare is an equal employment opportunity employer, committed to diversity, equity, and inclusion. We welcome applications from qualified candidates, regardless of race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions, 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.

Ready to Apply?

If you are a skilled and experienced Grievance Customer Service professional, looking for a challenging and rewarding role, we encourage you to apply for this exciting opportunity. Please submit your application, and our team will review it carefully.