Quality Review Audit Supervisor/Senior Supervisor
The job profile for this position is Quality Review and Audit Supervisor, which is a Band 3 Management Career Track Role.
Roles and Responsibilities
The Quality Management Audit Supervisor oversees the day-to-day audit activity within the region they are aligned to. The audit department is responsible for completing business and client audits within (not an all-inclusive list): Claim, and Contact Center Operations.
- Lead the regional Audit team who are responsible for reviewing transaction to ensure they are completed according to set policies and procedures.
- Coach and develop the audit team, encourage new skill growth and support career development as the opportunity arises.
- Manages: time reporting, production, time off, employee issues and HR related matters.
- Oversee departmental personnel matters, evaluating staff performance and conducting performance appraisals for all direct reports through monthly touch points and quarterly check-ins.
- Ensure department KPIs are met through effective monitoring and reporting mechanisms.
- Assist in organizing the on-boarding and training of new hires to the team.
- Monitor capacity usage through the Quality Management Capacity Planning tool. The Capacity Planner should always be kept up to date.
- Works closely with Quality Management leadership to understand strategy and is responsible for executing departmental plans and priorities.
- Work in collaboration with Operations to ensure the effectiveness of the audit operation. Will partner on defect reduction and process improvement opportunities.
- Work with Operations leadership to ensure the audit program is meeting the requirements set forth by the business and by our clients in each client contract. Work closely with Operations on any Client at risk of not meeting a Quality metric; identify solutions for correcting the quality gaps. Support/lead Third Party Audit/joint venture reviews.
- Executes strategic initiatives, plans, and goals in alignment with the department’s KPIs and goals.
- Ensures Quality Management processes are compliant with legal, regulatory and contractual requirements.
- Instils work culture of continuous process improvement, innovation, and quality.
- Recommends changes in policy and procedures to mitigate risk and participates in projects to improve business protocols.
Skills and Requirements:
- Demonstrated strong organization skills.
- Strong attention to detail.
- Ability to quickly learn new and complex tasks and concepts.
- Competent Claim and Contact Center transaction handling
- Minimum of 2 years of health insurance or international health care provider experience.
- Minimum of 1 year of experience work in a Quality Management/Operations Claim or Contact Center function preferred.
- Data analysis and reporting skills preferred
- Inquisitive nature capable of thinking critically and challenging assumptions
- Demonstrated follow through on complex problems and tasks
- Comfortable working independently and with a team
- Flexibility to work with global teams and varying time zones effectively.
- Ability to balance multiple priorities at once and deliver on tight timelines
- Ability to stay up to date on operations workflows
- Ability to develop and effectively communicate presentations and training materials
- Strong written and verbal communication skills
- Patience and creativity amongst your strong points
- Proficiency with Microsoft Office applications (Excel, PowerPoint)
About The Cigna Group
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.
