Medicare Complaints (CTM) Senior Supervisor – Cigna Healthcare – Remote Job 2024 Full Time

Job Description

• The job profile for this position is Customer Service Senior Supervisor, which is a Band 3 Management Career Track Role.

Customer Service Senior Supervisor-Medicare

The Government Business CTM (Complaint Tracking Module) Complaint Resolutions Senior Supervisor is a leadership role within the Cigna Medicare Customer & Client Service Experience (CCSE) Organization reporting to the manager of CTMs. This role will support the Medicare Advantage line of business by directly supervising the CTM team. The primary responsibilities of this role are to oversee the daily activities of the CTM team to ensure that compliance, internal operating metrics, and employee engagement standards are achieved, to drive continuous improvement within the department, and to partner with other functional areas to resolve complaints and optimize the overall customer experience. This role will require the candidate to supervise and motivate a team of people with diverse skills, responsibilities and geographic locations, and oversee reporting data to help us drive down complaints. This role will coordinate with matrix partners (e.g. vendors, compliance, Cigna operations) to ensure timely resolution of CTM complaints. This role supervises the daily activities of the CTM Analysts who are responsible for the research and resolution of complex and/or escalated member/provider issues (CTM complaints) received from The Centers for Medicare and Medicaid Services (CMS), Department of Insurance (DOI), Congressional offices, and escalated executive level inquires. This role is also responsible for supervising the CTM Review Team Analysts who are responsible for assigning work, quality monitoring, and reporting. This role provides direction and guidance regarding policies, procedures, workflows, quality, and training needs. Responsible for monitoring internal and regulatory standards.

Responsibilities

• Supervise the daily operations of the CTM department ensuring compliance with organization and CMS regulatory policies.

• Act as a liaison with CMS staff to ensure CTMs meet CMS requirements.

• Monitor the progress of pending workload and collaborate with staff to ensure cases move along at an acceptable pace and/or escalate to Cigna business partners within the necessary timeframe to ensure timely closure of complaints.

• Perform regular reviews of resource materials and make necessary updates to keep knowledge resources up to date and in compliance with CMS requirements.

• Prepare schedules and monitor team adherence to work force management (WFM) reporting and coach team to drive performance improvement.

• Monitor and improve quality such that the team consistently meets or exceeds goals for accuracy, timeliness, and regulatory compliance for all department functions.

• Routinely assess the talent, knowledge, and performance of the staff and administer necessary coaching, training, and performance management.

• Perform monthly/quarterly check-ins with staff.

• Ensure that the team meets all deliverables and milestones related to annual enrollment period plan changes and maintain an audit readiness position at all times.

• Enable a virtual work environment where employees have the tools, resources, and information necessary for teamwork, productivity and engagement.

• Lead and drive a customer centric focus within the Medicare CTM team.

• Partner with cross functional departments on projects to reduce CTM complaints.

• Analyze MHK CTM system functions and lead projects to enhance the MHK for more efficient CTM processes.

• Participate in cross functional department projects including cross function department changes needed for successful AEP activities.

• Create an environment where people want to excel and are focused on delivering the best outcome for each and every customer.

• Partner with peer managers and individuals outside of the CTM team to create a positive work environment and lead process improvement initiatives.

• Build a strong relationship/rapport with Cigna business partners and external vendor partners to ensure successful achievement of internal metrics and compliance/regulatory standards.

• Manage the selection, hiring, training, coaching and development within the team.

• Provide direction regarding overall objectives and assignments to the team.

• Support 24/7 operation management needs as required, including weekends.

• Monitor all performance requirements and guarantee results as required.

• Access MHK functionality and initiate change requests as needed to improve system performance.

• Participate in MHK new release testing and communicate changes to the CTM Team.

• Run reports as needed to monitor and track key metrics and provide reporting to executives/business partners as required.

• Ensure timely execution of compliance with CIGNA standards for all customer types.

• Identify staff education opportunities and provide proactive training on a continuous basis.

• Facilitate and participate in appropriate meetings and follow up activities.

Qualifications

• HS Diploma required

• At least 2 years of previous management in operations or people leadership experience preferred.

• At least 2 years of experience in managing vendor relationships and performance preferred but not required.

• Experience and passion for leading, developing and motivating employees required.

• Medicare experience required.

• Knowledge of Medicare systems and/or Medicare CTMs/Grievance/Appeal functions a plus.

• Demonstrated excellent oral, written, interpersonal, analytical, and negotiation skills.

• Must be computer proficient.

• Ability to work in and succeed in a team-oriented 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 annual salary of 57,800 – 96,400 USD / yearly, 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 Life at Cigna Group.

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: 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.

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.