Case Management Lead Analyst

Social Workers are responsible for assisting with the delivery of cost-effective, quality -based health care services for health plan customers by addressing the individual socioeconomic needs of the customer, providing information regarding their benefit plan as well as community resources. Assists health plan contracted providers with addressing customer social needs as well.Utilizes specific skill set to assess, coordinate, monitor and evaluate options and services in order to facilitate appropriate healthcare outcomes for customers. Performs community visits or telephonic outreaches to customers that have been identified through the Care Transition Coaching Program, and ensures Case Management program objectives are met. Social Workers also focus on outreach, follow ups, and assist with coordination of benefits when needed.

How you'll make a difference:

• Initiates contact with patient/family, physician, and health care providers/suppliers as part of the Care Transition Coaching Program. Conducts on-site evaluations (customer home visits) as is necessary.


• Identifies customer needs through the Care Transition Coaching program, and ensures continuity of care by coordinating/providing support after planned and/or unplanned transitions, initiating post discharge follow up calls which may include primary care physician and specialist appointment scheduling.


• Perform telephonic outreach and home visits.


• Screen customers for Low Income Subsidy or Medicaid and refer to appropriate agencies for application for programs.


• Assist customers with community transportation resources as needed.


• Provide Coverage Gap assistance or acquiring of high cost medications for impacted customers through initiation of Patient Assistance Program applications.


• Assists RN Case Managers with Case Management Program screening and assessment.


• Refers cases or submits requests for assistance to the Medical Director as appropriate.


• Documents all customer and provider contact, social service needs notes, and Care Transition Coaching documentation within the integrated care management notation system.


• Attend and participate in weekly Complete Health Team rounds.


• Communicates with all departments to resolve issues or document trends.


• Understands and follows administrative guidelines (policy and procedure) of the department.


• Attends and actively participates in staff meetings.


• Other Duties as assigned.

What you should have:

• Master's Degree in Social Work (MSW) and


• Licensed Clinical Social Worker (LCSW) or Licensed Masters Social Work (LMSW)


• Three or more years experience in an acute care, managed care or social services environment


• Medicare and Medicaid Knowledge


• Verbal and written communication skills


• Interpersonal skills


• Basic Mathematical and statistical ability


• Organizational skills


• Typing and computer knowledge- able to type 35WPM


• Knowledge of community resources


• Bilingual (English/Spanish)

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.