Quality Clinical Evaluator – Analyst
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Job Description
Clinical Evaluator coordinating quality improvement for clinical personnel at The Cigna Group. Ensuring compliance and excellent customer service in a remote work environment.
Responsibilities:
- 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:
- 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:
- 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
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