Medical Review Sr Specialist - CIGNA International Work...Posted: November 7, 2009
Responsible for managing the performance, productivity, and quality of the medical review staff. Oversees implementation of process improvement that incorporates information from quality audits and business initiatives. Serves as a technical resource/support for all medical review staff. Responsible for training staff. Typically is a RN or has a BSN with clinical and medical review experience. Major Duties Responsible for managing the performance, productivity, and quality of the medical review staff. Oversees implementation of process improvement that incorporates information from quality audits and business initiatives. This position is accountable for directing case management activities to control the costs of high-risk, high-cost cases. Serves as a technical resource/support for all medical review staff. Responsible for training staff. Typically is a RN or has a BSN with clinical and medical review experience Qualifications - Requires a Registered Nurse. - Previous clinical experience (3-5 years) and administrative experience in health care, quality assurance, medical review, or insurance. - Excellent oral and written communication, decision-making, and organizational skills. - Must be results-oriented and have proven ability to meet multiple deadlines while ensuring quality work. - Flexible to work in both production and project oriented environments. - Proven ability to work independently or as part of a team. - Able to set and achieve goals, and assume a high degree of responsibility. - Demonstrated positive team attitude. - Familiar with ICD-9 coding structures. - Knowledgeable in use of Microsoft Word and Excel. Pay Benefits Work Schedule CIGNA offers a competitive compensation and comprehensive benefits package including health and wellness benefits, 401k plan, and work/life balance programs, as well as opportunities for career growth and development. How To Apply We encourage you to complete all questions on the candidate profile if you wish to be considered for this opportunity. Please refer to job code 63652 when responding to this ad.
| Category: | Office Employment |
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| | Location: | Claymont, DE | | County: | New Castle County | | ZIP Code: | 19703 | | Pay Rate: | Open | | Job Terms: | full time | | Company: | CIGNA | | Phone: | email only please | | Fax: | email only please |
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