After Hours Case Management Lead Analyst - 12% Shift Differential- Evernorth

Company: Cigna Health and Life Insurance Company
Location: Eden Prairie
Posted on: September 18, 2022

Job Description:

Provide crisis triage support and utilization management for CIGNA Behavioral Health customers.Shift: Thur- Sun 2:30pm-12:30am CST.This position qualifies for a 12% shift differential.RESPONSIBILITES:Assists customers or their family members struggling with mental health or chemical health issues by assessing for their immediate needs and risks and assisting the customers to get access to the care they need. This includes the assessment of the bio-psycho-social needs of the member and connecting them to the appropriate community resources.Obtains clinical assessment data from providers and recommends initial treatment authorizations (inpatient or outpatient) based on parameters from CIGNA LEVEL OF CARE GUIDELINES FOR MENTAL HEALTH AND SUBSTANCE ABUSE.Provides information resources to clients, family members, and providers on an as-needed basis. To assist with problem solving or clarifying aspects of their mental health system (e.g. benefits, claims, procedures).Provides Employee Assistance services to customers and client employers in the form of telephonic consultations, management consultations, and coordination of critical incident debriefings.Reviews clinical status and therapeutic progress of clients with providers periodically to determine the need for continuing treatment; recommends authorization for continuing treatment as appropriate. Negotiates alternative session frequency or intervention strategy with providers when provider's plan exceeds outpatient parameters of CIGNA LEVEL OF CARE GUIDELINES FOR MENTAL HEALTH AND SUBSTANCE ABUSE.Creates and maintains computerized authorization and clinical records on each client by entering crisis notes, complete assessment, clinical update and authorization data for each customer and provider contact. Generates additional external correspondence (e.g. denial letters, uncooperative provider letters, etc.), as appropriate.Contributes to team meetings in a manner which improves communications and proceduresrelevant to team functioning. Also communicates with E.D., National Service Center personnel and external resources in a manner which facilitates effective system functioning and problem resolution.Performs additional tasks as needed, requested or assigned.Masters or PhD level clinical/counseling license in state of employment (LMHC, LCSW, LMFT, LPCC, LPC, RN, or LP).At least five (5) years of outpatient/inpatient experience as a mental health clinician involving knowledge in both mental health and substance abuse diagnosis and treatment preferredKnowledge/experience in coordinating alternative care treatments and community resources.Position requires significant skill levels in both clinical judgment and interpersonal communication.Considerable diplomacy/tact is often required as customers and providers are not always receptive to the process.Clinical creativity is central to the process of developing alternative intervention strategies.
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 60,400 - 100,600 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 .About CignaCigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, 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 us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives. What difference will you make?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.Cigna has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

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