Medicare Complaints (CTM) Senior Supervisor - Cigna Healthcare - Remote

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.

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