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PAC Social Worker - eviCore - Work At Home at Cigna

Posted in General Business 30+ days ago.

Type: Full-Time
Location: Bloomfield, Connecticut





Job Description:

The Social Worker will perform clinical and operational processes related to Post-Acute Care services including but not limited to long-term acute care, skilled nursing, inpatient rehab facilities, home health care, DME, care management, and utilization review. The social worker will address discharge barriers that impede the patient's ability to adhere to their medical care plan by levering knowledge of plan benefits as well as community resources. At times social workers may work in various regions and provide cross coverage between regions. This will vary by market and panel size. Social worker must have the ability to work independently and effectively communicate to internal and external customers. Social workers in addition to supporting our patients also support all other team members and disciplines and will provide consults, trainings and education as appropriate.

This role is Work at Home which allows most work to be performed at home. Employees must be fully vaccinated if they choose to come to an onsite office.

Key Responsibilities


  • Identifies high-risk/high-cost patients for social service intervention.

  • Initiates contact with patient/family, physician, and health care providers/suppliers to discuss the alternative treatment plan.

  • Conducts telephonic evaluations and screenings as necessary and documenting findings in a timely manner

  • Collaborates with the care team to achieve identified patient outcomes.

  • Coordinates the treatment plan to accommodate the health service needs of the patient, benefit availability, and community resources.

  • Attends in and actively participates the care team meetings

  • Other Duties as assigned.


Job Related Skills:

  • Excellent time management, organizational, research, analytical, negotiation, communication (oral and written) and interpersonal skills

  • Strong skills in the following areas: teamwork, assessment complex issues, ability to recommend changes and resolve problems through effective decision making

  • Knowledge of managed care and utilization review requirements and procedures.

  • Ability to work within changing business environment and balance business needs with patient advocacy

  • Management of local community based resources that may meet needs of patients

  • Strong personal computer skills, EMR experience, MS word, Excel, Outlook experience, and Internet research desired


Minimum Qualifications

  • Current Licensure as a MSW (Social Worker) in the state of employment

  • Three (3) to five (5) years recent experience in a Home health, SNF, and/or rehab experience preferred

  • Preferred Qualifications (Experience)

  • Clinical experience in acute care, a clinical setting, or in case management including experience/expertise in one of the following selected fields of social work:

  • Hospital/Community Coordination of Care

  • Skilled Nursing/Rehabilitation/ Long Term Care

  • Managed Care/Geriatric Social Work

  • Home Health/Hospice/Palliative



  • Communicates Effectively- Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences


  • Manages Ambiguity- Operating effectively, even when things are not certain or the way forward is not clear


  • Manages Complexity- Making sense of complex, high quantity, and sometimes contradictory information to effectively solve problems


  • Situational Adaptability- Adapting approach and demeanor in real time to match the shift in demands of different situations


  • Collaborates - Building partnerships and working collaboratively with others to meet shared objectives

For this position, we anticipate offering an annual salary of $53,600 - $89,400, 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.





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