Cigna Behavioral Case Management Lead Analyst - Initial Clinical Examiner in Fenton, Missouri
The ideal candidate for this position is a licensed professional with a background in the insurance industry as a care manager in a behavioral healthcare role, or an individual who has worked in a mental health or chemical dependency treatment facility in the area of utilization management, or in direct provision of service as a mental health or chemical dependency counselor.
As an Inpatient Care Manager at Cigna, you will use your clinical knowledge and skills to evaluate appropriate health care services and treatment plans in conjunction with inpatient providers. You will partner with facilities and families to identify and implement a holistic approach to treatment outcomes. You will be part of a virtual organization with multiple sites and must function well both independently as well as part of a larger team.
Perform precert and concurrent reviews using telephonic queue/warm transfer for inpatient levels (Detox, Inpatient, Residential, and Partial Hospitalization).
Collaborate with Facilities and Health Care Providers telephonically to obtain clinical information and ensure quality treatment outcomes in the least restrictive setting utilizing established Medical Necessity Criteria.
Coordinate with facilities to assist with discharge planning, aftercare follow-up appointments, and integration of services with Cigna Medical and Pharmacy.
Engage with customers and families to understand needs, facilitate access to Cigna coaching/case management programs and community resources.
Work in a team environment which includes contributing to team meetings, participating in clinical rounds with Cigna Medical Directors for input on utilization management, and attending all required trainings impacting utilization review and accreditation procedures.
Manage own caseload and coordinate all assigned cases.
Perform additional tasks/projects as needed, requested or assigned.
Requires Master's degree mental health discipline and independent licensure to practice in the state of employment (LCSW, LMFT, LPC, LPCC, or Licensed Psychologist)
3 - 5 years post-license mental health experience preferred
Excellent communication and interpersonal skills with a focus on customer service
Effective conflict management and negotiation skills
Ability to adapt to change and problem solve
Strong time management and organization skills with an ability to set priorities in a fast paced environment
Ability to utilize and navigate multiple technology systems
Knowledge of managed care preferred
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.