RN Quality Clinical Management Senior Advisor - Work from Home, Anywhere, USA

The Cigna Group; United States; Remote; USD 106,000 - 178,000; Full time

Job summary

A leading company in healthcare is seeking a Quality Clinical Management Senior Advisor to lead projects aimed at improving patient outcomes. This role demands strong project management skills and a solid clinical background, working collaboratively across various teams. You will handle complex projects that directly impact the quality of care for customers, leveraging your expertise in a highly matrixed environment.

Benefits

Comprehensive health benefits

401(k) with company match

Tuition reimbursement

Minimum of 18 days of paid time off per year

Qualifications

• Clinical licensure required, preferably an RN license.
• 5+ years of healthcare industry experience.
• PMP or Agile certification strongly preferred.

Responsibilities

• Lead mid-sized to large projects to improve clinical outcomes.
• Manage projects from ideation through completion, focusing on execution.
• Work collaboratively with multiple teams and stakeholders.

Skills

Analytical Skills

Project Management Skills

Creative Problem-Solving Skills

Interpersonal Skills

Education

Bachelor’s degree

Master’s degree in nursing, business, pharmacy, social work, healthcare or public health

Job description

The job profile for this position is Quality Clinical Management Senior Advisor, which is a Band 4 Senior Contributor Career Track Role.

Excited to grow your career?

We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!

Our people make all the difference in our success.

Excited to grow your career?

We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!

Our people make all the difference in our success.

Overview:

This position works collaboratively with multiple teams within quality and the broader enterprise to drive clinical outcomes and reduce gaps in care. As part of the Enterprise Quality & Accreditation team, this enterprise focused position works with a variety of matrix partners including but not limited to: IT, Interoperability Team, Office of Intelligent Automation, Innovation team, Market Medical Executives, the Health Equity Team, Sales and Network partners, Data and Analytics, and key Operations Partners to execute projects to improve the health and well-being of the customers we serve. This position is responsible for working in a highly matrixed organization in a collaborative manner and exhibiting behaviors, attitudes and actions that demonstrate a high level of teamwork to drive clear and quantifiable results.

Role Summary:

Individual will have accountability to lead major projects aimed to improve health outcomes and patient experience. Project management responsibilities for planning, overseeing, and leading projects from ideation through to completion. Requires interaction with a range of internal and external stakeholders, most often managing several projects simultaneously. This will include definition and scoping of projects, alignment with business sponsors and key stakeholders, project execution, and communication of progress and risks. The position will support various types and sizes of projects, ranging in content including, but not limited to: systemenhancements/integration/enablement,clinical care pilots, new process and technology creation/scalability and rollout, provider-focused enablement initiatives, and initiatives to improve patient experience.

Responsibilities:

• Leads mid-sized to large, time-limited projects or components of a larger project and directs one or more teams of business subject matter experts involved in the evaluation of systems requirements and/or the development of newprocedures/processes/orpolicy solutions to address highly complex business needs.
• Provides counsel and advice to top management on significant Business Project Management matters, often requiring coordination between organizations.
• Assesses impact and implications from a cost, efficiency, contractual, privacy, legal and/or regulatory standpoint.
• Determines requirements, plans projects, establishes priorities and monitors progress.
• Identifies and facilitates process design changes related to on-going projects.
• May coordinate with other project owners on enterprise projects with large scope
• Actions have significant impact on key department and enterprise objectives.
• Focuses on providing thought leadership and technical and clinical expertise across multiple disciplines.
• Recognized internally as “the go-to person” for the most complex clinical improvement assignments.
• Exercises considerable creativity, foresight, and judgment in conceiving, planning, and delivering initiatives.
• Uses deep professional knowledge and acumen to advise functional leaders.
• Leads project planning sessions and leverages established project methodology to define and develop project plans
• Develops and maintains project plans that consider the business objectives, key milestones, timelines, resource impacts and task sequencing required to deliver the desired value of each project.
• Identifies and develops relationships with internal and external stakeholders to achieve project objectives.
• Coordinates with cross discipline team members to make sure that all parties are on track with project requirements, deadlines, and schedules.
• Monitors progress against project goals and objectives and implements communication and reporting mechanisms to manage issues, risks and timely delivery of initiative results.
• Ensures the timely and quality development of all deliverables for the project.
• Coordinates project steering committee meetings and communicates status to the leadership team.
• Ensures appropriate use of tools to track and monitor the alignment of goals, progress against goals, and the financial performance of assigned projects.
• Identifies opportunities to optimize and improve processes where applicable.
• Conducts post project evaluations and identifies successful and unsuccessful project elements.
• Leads, directs, and oversees the development and implementation of clinical initiatives, special projects and process improvement initiatives.
• Influences and leads projects and functions such as: clinical initiatives development, pilot studies, health disparities activities, patient experience improvements, communication and reporting or activities, results and recommendations. Develops, reviews, and revises associated standard operating procedures to improve efficiency and policies and procedures as necessary to support functions.
• May manage multiple projects and studies simultaneously and at any given time, with responsibility from conception to implementation, evaluation and dissemination of findings or outcomes.
• Collaborates with matrix partners and individuals assigned to projects/work teams to develop/implement clinical initiatives.
• Trains and coaches others on departmental processes such as study design.
• Collaborates with leaders in other business units to develop new initiatives and/or improve existing processes.
• May have contact with CIGNA customers, clients, healthcare professionals, external business partners and industry coalitions.
• Participates in strategic planning and budget management for assigned functions.
• Participates on and supports, as required, quality committees and management and staff meetings.
• Supports broader Clinical Measurement and Improvement team in delivering necessary program documents/operations/improvements for community-collaborative, transparency,
• May support HEDIS and clinical initiatives reporting requirements.

Qualifications:

• Clinical licensure and bachelor’s degree required. Master’s degree in nursing, business, pharmacy, social work, healthcare or public health is a plus.
• Prefer Active unrestricted RN license in state of residency
• Strong clinical background with 5+ year’s experience in diverse settings; 3-5 years in managed care.
• 5+ years of healthcare industry experience required.
• PMP or Agile certification strongly preferred. Six sigma belts highly desirable.
• Self-starter with excellent analytical, technical, and project management skills.
• Ability to analyze and interpret qualitative and quantitative clinical data. Statistics acumen preferred.
• Skilled in basic concepts of statistical sampling and testing using Excel or Minitab.
• Ability to display complex information using data visualization tools to facilitate business decisions and allow matrix partners to readily share with external partners.
• Excellent interpersonal and relationship management skills, with demonstrated ability to influence internal and external resources.
• Excellent written and oral communication skills, presentation skills and experience working in a highly matrixed and empowered team environment.
• Works productively in an environment that requires constant development of technical data skill sets, and experience with Word, Excel, PPT and other relevant software applications.
• Industry knowledge of HEDIS, Evidence Based Medicine measures (EBM), accreditation, health equity topics and trends.
• Strong written and verbal communication skills
• Capacity to manage high stress situations
• Ability to multi-task and manage various projects simultaneously
• Big picture thinking and vision
• Attention to detail
• Ability to work in a highly matrixed environment
• Ability to meet tight deadlines
• Proactive, driven, and positive leadership skills
• If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Key competencies of this role:

• Positive Attitude and drive for results
• Problem Solving
• Priority Setting
• Dealing with Ambiguity
• Project Management Skills
• Analytical Skills
• Creative Problem-Solving Skills
• Partnering with key matrix partners
• Organizing
• Informing
• Written / Verbal Communication skills
• Conflict Management
• Customer Focus
• Managing Vision and Purpose

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an annual salary of INSERT / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visitLife at Cigna.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at thislink.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an annual salary of 106,600 - 177,600 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.