Job Overview
Location
United States Work at Home
Job Type
Full-time
Category
Other
Date Posted
April 22, 2026
Full Job Description
đź“‹ Description
- • The Quality Clinical Evaluator (Analyst) role supports the development, implementation, and coordination of a comprehensive quality management and improvement program for clinical personnel, ensuring compliance with internal and external standards while driving excellence in customer service and experience.
- • Day-to-day responsibilities include tracking and documenting quality assurance performance across multiple clinical specialties, incorporating call monitoring evaluation results to identify training, continuing education, and coaching needs, and collaborating with the Medical Management team to address performance issues and implement quality improvement measures.
- • The role is part of Evernorth Health Services, a division of The Cigna Group, which focuses on creating pharmacy, care, and benefit solutions to improve health outcomes and increase vitality through innovation in prediction, prevention, and treatment of illness.
- • In this role, the individual will develop expertise in clinical quality assurance, gain experience with healthcare quality programs, strengthen analytical and communication skills, and contribute to improving patient care and service delivery in a remote, mission-driven environment.
🎯 Requirements
- • Associate or Bachelor’s Degree in Nursing; LPN Certification required; Registered Nurse or LPN license required in state of primary residence.
- • Minimum 2 years of relevant work experience in a clinical or clinical quality role; Quality Assurance experience preferred.
- • Minimum of one year of EviCore experience strongly preferred.
- • Proficiency in Microsoft Office and Excel applications required.
- • Knowledge of Managed Care/Medicare/Medicare Advantage preferred.
- • Ability to work independently with strong time management, verbal and written communication, and problem-solving skills.
🏖️ Benefits
- • Comprehensive health benefits including medical, vision, dental, well-being, and behavioral health programs starting on day one.
- • 401(k) retirement plan, company-paid life insurance, and tuition reimbursement.
- • Minimum of 18 days of paid time off per year plus paid holidays.
- • Eligibility to participate in an annual bonus plan.
- • Remote work opportunity with flexible hours (Monday–Friday, 8:00 AM–5:00 PM).
Skills & Technologies
About The Cigna Group
The Cigna Group is a global health services company formed in 1982 through the merger of Connecticut General and INA Corporation. It provides medical, dental, disability, life and accident insurance, pharmacy benefit management, and behavioral health services to employers, individuals and government entities. Headquartered in Bloomfield, Connecticut, the company operates in over 30 countries and jurisdictions, serving more than 180 million customer relationships worldwide through its subsidiaries and affiliates.
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