The Case Management Lead Analyst (Care Manager) works in a fast-paced, call center, team oriented environment providing mental health and substance use risk assessment. The Case Management Lead Analyst (Care Manager) provides appropriate clinical resource assistance to members and callers struggling with mental health or chemical health issues. The Crisis 24/7: Behavioral Triage team is responsible for meeting the needs of callers around the clock and 365 days per year. Case Management Lead Analysts (Care Manager) are expected to work up to 4 holidays per year.

In addition, Case Management Lead Analysts (Care Managers) who work a holiday shift; or are a regular member of a swing shift, weekend shift, or overnight shift will also be responsible to complete utilization management (UM) reviews for pre-certification of care; support the Employee Assistant Consultation team with Critical Incident Stress Management (CISM) and Critical Incident Response Team (CIRT) requests; and provide Employee Assistance Program Consultant calls (TEAC) after the team completes their day.

Schedule : Wed -Sat 4pm - 2am CST

DUTIES & RESPONSIBILITES:

The Case Manager Lead Analyst (Care Manager) role expectations include:

• Assess the caller or member's immediate risk and need, and provide clinically appropriate professional referrals for care and treatment.
  
  


• Determine the bio-psycho-social need of the caller or member, including the Social Determinants of Health (SDoH) and Loneliness initiatives.
  
  


• Clarify and educate callers or members in regard to their benefit plan coverage, access to coverage information and applications, and procedures for accessing care.
  
  


• Assist callers and members to problem solve issues and concerns including access to care, benefits available, facility referrals, professional counseling referrals, and other concerns.
  
  


• Work as a team and individual to deliver on the annual Key Results. Demonstrating the Consumer Health Engagement and Behavioral Health Cultural Belief's: Customer Strong, Me to We, Own It!, Be Bold, Listen to Advocate, Think it Through, contributing to a professional and inspiring workplace.
  
  


• Partner with peers and leaders promoting and embracing a culture of change; supporting all parties through the change process.
  
  


• Demonstrated excellent clinical judgment and interpersonal communication skills.
  
  


• Exemplify considerable diplomacy as callers, customers, and providers are not always receptive to the process.
  
  


• Experience working with confidential information.
  
  


• Employ conflict management, negotiation skills, tact and diplomacy with internal and external stakeholders.
  
  


• Demonstrated excellent verbal and written communication skills.
  
  

QUALIFICATIONS:

The Case Management Lead Analyst must satisfy the following minimum qualifications:

• Requires a Master's degree or PhD in a mental health field with a current independent licensure to practice in the state of employment (LPC, LMHC, LCSW, LMFT, RN or LP).
  
  


• 5+ years post licensure inpatient or outpatient experience as a mental health and/or substance use clinician involving diagnosis and treatment preferred.
  
  


• Knowledge and experience in coordinating alternative level of care treatment and community resources. Clinical creativity is central to the process of developing alternative intervention strategies.
  
  


• Knowledge and experience using ASAM® and MCG ® criteria preferred.
  
  

This position is not eligible to be performed in Colorado.

About Cigna

Cigna 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.