**Must have open availability between 7AM - 8PM MST

The Care Coordinator is responsible for maintaining workflow activities for the Post Acute Care Services for inbound and outbound communications between eviCore Healthcare stakeholders and external hospitals, physicians and Post-Acute Care providers.

The Care Coordinator demonstrates complete understanding of how to research and resolve issues pertaining to the pre-certification of services as well as delivery of services and day-to-day operational concerns using defined processes.

Demonstrates full understanding and ability to differentiate the Care Coordination processes across multiple states to ensure compliance with state regulations and commercial plans. They are responsible for communicating all state specific and national health care laws toexternal hospitals, physicians and Post-Acute Care providers including the appeals/reconsideration policies.

Inbound and outbound communications tasks include coordination of inbound requests from hospitals, physicians and Post-Acute Care providers for status checks on existing cases, directing calls to internal departments, notification calls to hospitals and Post-Acute Care providers regarding incomplete pre-certification requests, as well as authorization approvals.

In addition, this position is responsible for outbound calls to members, providers, physicians and hospitals to ensure member is receiving ordered/approved services. The Care Coordinator is responsible for evaluating client trends to report and partner with the appropriate internal stakeholders in order to address and resolve through facilitation of communication between clients, providers, IT and other eviCore healthcare team members.

Minimum Education, Licensure and Professional Certification requirement:

• High School graduate with diploma or equivalent.


• Associates or Bachelor's degree preferred

Minimum Experience required (number of years necessary to perform role) :

• 2+ year of experience in healthcare contact center or customer service required


• Medical background with Post-Acute Care experience desired


• Experience with insurance products including Managed Care and commercial plans


• Various schedules to cover operating hours (7AM - 8PM MST)
  
  
  • Maintain flexibility to variations in work volume/work schedule, which sometimes require extended working hours.
  
  
  • Position may require rotating weekend and holiday coverage. Certain postings may require regular weekend coverage based on business and client needs.
  
  
  
  

Required Skills:

• Provides excellent customer service to clients and providers by ensuring there is full understanding of the resolution or action plan


• Ability to navigate multiple platforms that contain provider data, member information, and authorizations.


• Daily focus on attaining productivity standards, recommending new approaches for enhancing performance and productivity when appropriate


• Time-management : Ability to effectively manage one's time and resources to ensure that work is completed efficiently. Excellent organizational skills


• Communication: Ability to provide clear verbal and written information via in-person, email, and phone to customers, co-workers, and leadership


• Critical-Thinking/Decision-making : Ability to choose a course of action or developing appropriate solutions by identifying and understanding issues, problems, and opportunities


• Autonomy: Ability to work independently with little to no supervision


• Ability to complete special projects or other duties as assigned


• Proficient with various applications or software, such as: Microsoft Outlook, Word, Excel, and PowerPoint and demonstrate ability to utilize all resources to support the manual functionality of the PAC system

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.