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The job profile for this position is Case Management Lead Analyst, which is a Band 3 Senior Contributor Career Track Role.
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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.
This position is a great opportunity for individuals who are passionate about supporting customers struggling with substance use disorders, integration and coaching.
Care managers offer Coaching and Support services utilizing a motivational interviewing approach that focuses on resolving ambivalence and enhancing the individual’s intrinsic motivation to change, decreasing both internal and external barriers that may be preventing the individual from initiating and/or engaging in behavioral treatment. This approach supports customers as they create goals to improve their health and well-being. This role involves integration between behavioral case management, medical and pharmacy teams within Cigna as well as treating providers. Care managers have the entire suite of Cigna services available allowing them to identify and service each individual’s unique needs.
We are specifically looking for clinicians who have additional training and experience working in the field of addiction. Ideal candidates will have familiarity with MAT, SUD levels of care, overdose prevention, harm reduction, mindfulness, recovery communities and the unique needs of not only the individual with the substance use disorder but the needs of the involved family system. The SUD team has multiple programs available for both individuals struggling with substance use, as well as support for their family members; experience working with families is a plus. We work closely with the Opioid and Pain Management team; experience in pain management as well as CBT is a plus.
Responsibilities:
• Evaluates appropriate health care services and treatment plans in conjunction with outpatient providers.
• Ensures that care management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained.
• Performs care management for specialty programs in a telephonic customer- facing environment which involves utilizing a coaching approach that provides support and resources to the customers.
• Assistance in the identification of member health education needs
• Develop SMART goals with our customers to empower them to lead and maintain a healthy lifestyle
• Assesses readiness to change and implements actions to assist members in moving through stages of change to reach their goals
• Perform research for community and educational resources to assist customers in their journey
• Consult with and assist team members in cases where a member’s behavioral health or emotional issues are impacting their ability to set and/or achieve goals
• Educate and refer members on available health resources and CIGNA Medical Management as appropriate to approach customer holistically
• Collaboration with other team members such as medical directors, pharmacist, nurse clinicians, etc.
• Provides suggestions for improvements and enhancements to outpatient coaching programs based on data/experience
• Able to manage multiple health records and systems to accurately document customer interactions and progress
• Must be able to comply with HIPAA standards and regulations in telephonic conversation and in documenting medical records.
• Flexibility to assist other teams and partners as needed.
• Comfortable with discussing substance use in a direct non-judgmental manner.
• Perform other related duties incidental to the work described herein.
Qualifications
• Requires Master’s degree mental health discipline and independent licensure to practice in the state where applicant resides (LICSW, LMFT, LPC, LPCC, Licensed Psychologist or Psych RN)
• Three to five years post-license mental health experience preferred but will also consider a new independently licensed therapist with considerable experience in the field
• Experience with direct member communication (written and verbal), experience in telephonic counseling/coaching preferred
• Working knowledge of motivational strategies, materials development, training and consultation preferred.
• Proven administrative abilities, with strong computer and software application skills.
Excellent interpersonal skills and the ability to work in a team environment
• Demonstrated ability to set priorities including, but not limited to time management and organizational skills
• A high energy level and excellent written and oral communication skills are essential.
• Passion for health improvement of members
• Strong research and analytical skills
• Ability to manage own caseload and coordinate all assigned cases
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 65,500 – 109,100 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.
