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Position Title:

Case Management Senior Representative

Position Demographic/Background Information

Original date:

1.12.21

Dates updated:

Approval date(s):

Approved by:

Business Unit/Functional Area:

Medicare Advantage Case Management

Band:

2

Role Code:

National Job Description

___ Market/Regional/Business Specific Job

Description (if checked, indicate in notes

below when/how description is used)

Effective date:

Posting Information

Position Scope:

• Communicates with all levels of staff, matrix partners, and customers


• This role supports our clinical teams by completing an assessment that is used to stratify Cigna MA customers' risk level.


• This is a National Position for Medicare Advantage


• Works independently with minimal direction


• Applies knowledge of CIGNA Medicare services


• Operates well in a team environment; contributes to the Case Management team and organization's goals


• Manages to productivity standards

• This role supports our clinical teams by completing an assessment that is used to stratify Cigna MA customers' risk level. Expected to provide excellent customer service to all internal and external customers. This is a non-clinical role.

• Making/receiving outbound/inbound phone calls from customers completing the Health Risk Assessment survey


• Entering data from mailed in surveys.

• Utilizes effective communication, courtesy and professionalism in all interactions, both internally and externally.


• Communicates both internally and externally to provide and verify information; to explain processes.


• Accesses system to collect and enter non-clinical data.


• Provides accurate information to callers based on customer and service requirements within product lines.


• Determines the course of action based on pre-established guidelines; channeling to appropriate staff as needed.


• Performs outbound calls to providers to request additional information on as needed basis.


• Verifies member eligibility


• Other non-clinical functions /tasks as assigned and appropriate per standard policies and procedures.


• Adheres to quality assurance standards and all case management policies and procedures.

Minimum requirements:

• High School diploma or GED equivalent.


• Prior experience in customer service role/operation


• Experience level: 0 -2 years.

Preferred requirements:

• Strong telecommunications and customer service skills


• Ability to work independently and to make independent decisions


• Ability to work unsupervised on special projects


• Basic computer skills and experience (MS Word, Excel, and Outlook)


• Working knowledge of Cigna technology and telephone systems


• Working knowledge of medical terminology and coding as it relates to specialty services


• Ability to adapt and be flexible within fast-paced, dynamic, and changing environment


• Ability to adapt to a high volume contact center environment


• Ability to function as part of a team to achieve common goals


• Time management and priority setting skills


• Ability to consistently met/exceeded APO's


• Demonstrated leadership skills


• Demonstrated ability to participate in or lead projects and workflow improvement initiatives

Standard YCL Information currently auto-populated with posting:

Org Marketing Statement

At Cigna, we are committed to providing our customers with employee benefits, expertise and services that improve the health, well-being and productivity of their employees. CIGNA's people are the key to our success in a changing and increasingly competitive marketplace. The collective skills, behaviors and work experiences of all CIGNA employees enable us to make a real difference in the lives of our members. We seek the most talented and creative minds in the industry to develop innovative solutions our customers value and consumers expect.

Pay Benefits Work Schedule

Cigna offers a competitive compensation and comprehensive benefits package including health and wellness benefits, 401k plan, and work/life balance programs, as well as opportunities for career growth and development.

How To Apply

We encourage you to complete all questions on the candidate profile if you wish to be considered for this opportunity.

EEO Statement

Cigna is an Equal Opportunity Employee

Competencies related to band of the position

For this position, we anticipate offering an hourly rate of $16 - $21, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

Helping our customers achieve healthier, more secure lives is at the heart of what we do. While you take care of our customers, we'll take care of you through a comprehensive benefits program that helps you be at your best. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and best in class well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and dozens of corporate discounts on essentials you use every day. For more details on our employee benefits programs, please visit the "Life at Cigna" tab on our careersite: www.cigna.com/careers

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.