Cigna Cigna-HealthSpring Quality Improvement Sr. Specialist in Nashville, Tennessee


Senior Segment Quality Improvement

Quality Sr. Specialist (Band 4) – Cigna-HealthSpring Quality Improvement Sr. Specialist

Role Summary:

The Quality Improvement Sr. Specialist will lead a team responsible for managing the Cigna-HealthSpring Quality Improvement Depart. Within this role the Quality Improvement (QI) Sr. Specialist will be responsible for the Quality Improvement program documents, Quality Improvement activities and projects and maintain an audit ready department.

The Quality Improvement Sr. Specialist will report to the Quality manager for Medicare Quality. They will collaborate with the NCQA Accreditation and markets within the Cigna-HealthSpring Senior Segment. The ideal candidate will have a proven track record of success within Medicare Quality with a continuous quality improvement mindset and a proven track record of delivering results and executing in a matrix environment.

In addition, this role will be expected to manage both internal relationships across the segment, Cigna Quality Department, market leadership, Medical Directors, and Stars leadership teams.


•Execute on key operational outcomes to ensure Quality Improvement success.

•Motivate and develop teams through ongoing organizational and industry change – developing and aligning with strategies of the future. Includes the ability to drive effective change leadership practices to provide the proper amount of support to our teams through these transitions.

•Understand and implement business controls across functions to ensure that there is clear understanding and ownership of key scorecard measurements (QIP, CCIP, QOC and QI program documents) as well as driving continuous improvement over time.

•Understand and implement best practices as it relates to CMS and NCQA requirements.

•Develop relationships with market leadership, Health Services, Case Management, Utilization Management, Behavioral Health, Stars, HEDIS, CAHPS, HOS and market Quality teams to ensure coordination and delivery of a seamless quality program and eliminate duplication of efforts.

•Competencies: organizational agility, influence, communication, dealing with ambiguity, courage, managing vision and purpose, perspective.



•Bachelors degree required – Masters preferred

•3 years experience in a healthcare quality leadership position

•Experience with Quality regulatory requirements and agencies: CMS, QIO, NCQA, AHIP, NQF and others

•Business Acumen: thorough understanding of Medicare Advantage Quality Improvement.

•Written communications: exceptional verbal and written communication skills.

•Proven track record of relationship building and management skills within and across organizations. Able to coach direct reports to improved levels of performance. Experience managing in a virtual environment or across multiple locations

•Willing to travel 20% within the US

•Location – Nashville

Primary Location: Nashville-Tennessee

Work Locations: 530 Great Circle Road Nashville 37228

Job: Med Mgt--Clinical Qual Mgmt

Schedule: Regular

Shift: Standard

Employee Status: Manager of Managers

Job Type: Full-time

Job Level: Day Job

Travel: Yes, 25 % of the Time

Job Posting: Dec 7, 2018, 5:33:33 PM

Qualified applicants will be considered for employment without regard to age, race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status. Need an accommodation? Email: