The Quality Support Team's mission is to ensure a Customer Strong experience through facilitating the compliance and standards of the medical necessity process for peer reviews through Me to We collaboration with internal matrix partners and facilities. The Case Coordinator role is a fast-paced position that is inclusive of all of the Cigna cultural beliefs and comprises numerous tasks including:

• Complete scheduling of peer reviews for all lines of business (Cigna East, TruCare, CareAllies, Cigna West, QANI, and QANI Legacy) which includes building and verifying template information, making outbound/receiving inbound calls from facility to schedule, coordinating MD calendars, documenting in the case, assigning for follow-up, updating a peer review tracker, and notifying Case Managers


• Provide verbal determination to facility on results of peer reviews


• Complete follow-up on cases after peer review including assisting with alternative level of care authorizations, discharge planning, and making referrals to behavioral specialty case management programs ( Listen to Advocate )


• Utilize workflows efficiently to ensure accurate documentation and adhere to compliance guidelines ( Think it Through )


• Responsible for management of MD Scheduling mailbox


• Work closely with internal matrix partners to ensure legal, Federal, and State Mandates are in compliance, and NCQA and URAC accreditation guidelines are met ( Own It! )


• Proficiently communicate with matrix partners including appeals coordinators, Case Managers, Medical Directors, individual HCP's, and facilities ( Be Bold )


• Provide exceptional customer service ( Customer Strong ), collaborating closely with matrix partners, to ensure each case is completed and effectively communicated to the customer and facility in a timely manner ( Me to We )


• End of month reporting for various data that includes all lines of business


• Additional tasks as assigned

Qualifications:

• Bachelor's degree required


• At least 2 years of experience in behavioral health services setting


• Strong verbal, written, and interpersonal communication skills


• Effective listening and analytical skills


• Extremely detail oriented and proficient organizational skills


• Strong ability to multi-task and exhibit excellent prioritization skills


• Experience working on multiple projects simultaneously under tight deadlines


• Technical knowledge of automated databases, tracking systems, spreadsheet applications


• Ability to manage change effectively and assist in leading others through the change process


• Must be a current Express Scripts or Cigna contractor

This position is not eligible to be performed in Colorado.

About Cigna

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.