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Quality Clinical Evaluator – Analyst
The Cigna Group. Assist with development, implementation and coordination of a comprehensive quality management/improvement program for clinical personnel .
About the role
Key responsibilities & impact- Assist with development, implementation and coordination of a comprehensive quality management/improvement program for clinical personnel
- Ensure compliance with internal and external requirements and ensure excellent customer service is provided
- Track and document quality assurance performance for clinical personnel of multiple specialties
- Incorporate results of call monitoring evaluations to develop training, continuing education, coaching, or other needs
- Collaborate with the Medical Management team to identify performance issues and implement quality improvement measures
Requirements
What you’ll need- Associate Degree or Bachelor Degree in Nursing
- LPN Certification
- Registered Nurse or LPN required
- Minimum 2 years relative work experience in a clinical and or clinical quality role
- Quality Assurance experience preferred
- Minimum of one year of EviCore experience strongly preferred
- Knowledge of Image One/CDP/Isaac preferred
- Proficiency in Microsoft Office and Excel applications
- Knowledge of quality assurance programs related to call centers preferred
- Ability to effectively manage one’s time and resources
- Ability to work independently
- Intermediate computer literacy skills
Benefits
Comp & perks- medical
- vision
- dental
- well-being programs
- behavioral health programs
- 401(k)
- company paid life insurance
- tuition reimbursement
- a minimum of 18 days of paid time off per year
- paid holidays
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
quality managementquality improvementquality assuranceclinical qualityEviCoreImage OneCDPIsaacMicrosoft OfficeExcel
Soft Skills
customer servicetime managementindependence
Certifications
Associate Degree in NursingBachelor Degree in NursingLPN CertificationRegistered Nurse