This Case Manager Specialist role (CM) is for a dedicated account. The CM will work with the customer throughout any higher level episode of care, and will then transition the member into Case Management and continue to work on goals.
Complete Utilization Care Management throughout any Inpatient Hospitalization episode of care.
Complete any Out Patient reviews for services needing authorization.
Provide services that will assist the customer/family members in understanding their options based on their benefits.
Educate the customer/family members about treatment options, including the need for medical interventions (if appropriate).
Provide Specialty Case Management that will assist the customer in meeting their goals.
Working within a small team that will require flexibility to complete various other tasks such as Queue Management, Advisor Review follow up, Customer Service Searches, etc.
Requires Master's degree in a mental health discipline and independent licensure to practice in the state (LICSW, LMFT, LPC, LPCC, Licensed Psychologist or Psych RN).
Three to five years post-license mental health experience.
Prefer candidate with experience in either Inpatient Utilization or Outpatient Case Management/Coaching.
Works well in small team environment.
Excellent communication and interpersonal skills. Effective negotiation skills.
Ability to work independently and self-initiate tasks
Working knowledge of Microsoft Word, Excel & Access, Sharepoint, and Lync.
Knowledge of Clinical Behavioral Operations and related systems (including CAMS, DG, TruCare, etc)
Ability to switch priorities throughout the day – (utilization to case management).
Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. We offer an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products. Together, with our 74,000 employees worldwide, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation.
When you work with Cigna, you’ll enjoy meaningful career experiences that enrich people’s lives while working together to make the world a healthier place. What difference will you make? To see our culture in action, search #TeamCigna on Instagram.
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.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.