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Case Management Lead Representative

Company: Cigna
Location: Eden Prairie
Posted on: January 9, 2021

Job Description:

Work Schedule: Mon-Fri 10:30am - 7:00pm CSTPlease Note: Work-at-Home is only offered to internals who are already set up as Work-at-HomeJob Summary:The Personal Advocate position is responsible for representing Cigna Behavioral Health (CBH) to all inbound callers within a call center environment and assuring caller's contact with CBH is positive. Advocates are many times the first encounter customers have with Cigna and thus are responsible for giving a positive first impression. The Advocacy tasks of this position are varied and often complex in nature requiring flexibility and multi-tasking capabilities. Responsibilities may include but are not limited to: educating customers on benefits, eligibility, referrals, non-clinical resources and assessing for potential risk of harm or substance abuse concerns.This position services calls in a warm and empathetic manner as many of the calls are sensitive in nature. Independent problem solving skills are critical to success within the role along with intelligent judgment of assessing the caller's needs. Based upon the call type and requests advocates should be able to use customer service skills, knowledge of the mental health/substance abuse field and Cigna training to effectively address callers needs in an educational manner. This position is an entry level role with opportunity for growth within the company. Incumbents will utilize telephonic communication the majority of the time with some web, and internal CBH materials to achieve first time resolution for callers.Responsibilities:The primary responsibility of the Advocate role is answering calls from customers. The majority of the day will be answering inbound calls from customers looking to access, understand, or utilize services.Within a call an advocate may:Register participants in the intake system and opens case filesEducate participants on their benefits based upon individual plan design and other clinical or non-clinical resources availableConduct an intake as needed to assess for presenting concern and risk of harm or substance abuse concernsProvide participants with names and phone numbers of nearest providersMulti-task by maneuvering through various computer programs and screensAs needed an advocate may also:Write authorizations to ensure claims are paid correctly.Provide follow-up calls to participants to ensure correct information is givenSend eligibility requests to determine effective coverage dates or to verify correct benefits are loadedSend complaints to initiate grievance process for customersOn all calls an advocate is responsible for:Providing high quality customer service as identified by Advocacy department quality standardsUsing independent problem solving skills to make sound decisions in assessing the needs of the callers by giving accurate information and providing first call resolutionUnderstanding the business needs of the role, while balancing the needs of the customerTaking an educational approach to ensure callers are able to understand the complexities of accessing careDemonstrating a complete awareness and understanding of the responsibilities and workflows of the various departments within CignaQUALIFICATIONS:Bachelor's degree in mental health field or psychology/social work related field (can also include: family communications, health coaching, community/public health or other related major). NOTE: This is a non-clinical role and does not require a licensePrevious customer service experience or related positionSuperb interpersonal communicationEffective listening and organizational skillsAbility to manage multiple tasks, setting priorities where neededIndependently problem solve, with ability to function without constant supervisionA demonstrated ability to type effectively; with strong PC skills/word processing experience and ability to learn new computer software systemsAbility to learn new workflows and tasks quicklyAbility to work independently and be a team playerPrevious call center environment experience preferredQualified applicants will be considered without regard to race, color, age, disability, sex (including pregnancy), childbirth 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 an accommodation based on your physical or mental disability please email: SeeYourself@cigna.com. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.About CignaCigna 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.

Keywords: Cigna, Eden Prairie , Case Management Lead Representative, Executive , Eden Prairie, Minnesota

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