Cigna Case Manager Specialist in Plano, Texas
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 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 (LCSW, LMFT, LPC, LPCC, or Licensed Psychologist)
• 1 - 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
US Candidates Only : Qualified applicants will be considered for employment without regard to race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status. If you require a special accommodation, please visit our Careers website or contact us atSeeYourself@cigna.com.
Primary Location: Eden Prairie-Minnesota
Other Locations: United States-Texas-Plano, United States-Connecticut-Bloomfield, United States-Maryland-Baltimore
Work Locations: 11095 Viking Dr Eden Prairie 55344
Job: Med Mgt--Case Management
Employee Status: Individual Contributor
Job Type: Full-time
Job Level: Day Job
Job Posting: Oct 10, 2016, 1:49:22 PM