When an individual or family member contacts Cigna Behavioral Health for assistance related to Autism, they are assigned to an Autism Case Manager who will assist the family by providing ongoing case management, addressing all questions and concerns related to Autism benefits, treatments and community supports. The Autism Team is also responsible for educating customers and health care professionals on the medical necessity review process for Intensive Behavioral Interventions (including Applied Behavior Analysis) and reviewing any request with the health care professional directly.

This position is a great opportunity for licensed behavioral health clinicians to use their industry experience in a managed care setting focused on clinical excellence for participant members. The role offers a great salary with an excellent benefits package that starts your first day of employment including a continuing education program with funding and extra leave time.         

RESPONSIBILITIES:

• Evaluates appropriate health care services and treatment plans in conjunction with outpatient providers.

• Refer to Health Professionals with Autism expertise.

• Complete Utilization Management for Applied Behavior Analysis and higher levels of care for individuals with primary diagnosis Autism.

• Provide services that will assist the customer/family members in understanding their options based on their benefits.

• Educate the customer/family members about treatment options, including the need for medical interventions (if appropriate).

• Ensures that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained.

• Performs case management, as needed,  in a telephonic customer- facing environment which involves utilizing a coaching approach that provides support and resources to the customers.

• Assistance in the identification of member health education needs

• Develop SMART goals with our customers to empower them to lead and maintain a healthy lifestyle

• Assesses readiness to change and implements actions to assist members in moving through stages of change to reach their goals

• Perform research for community and educational resources to assist customers in their journey

• Consult with and assist team members in cases where a member’s behavioral health or emotional issues are impacting their ability to set and/or achieve goals

• Educate and refer members on available health resources and CIGNA Medical Management as appropriate to approach customer holistically

• Collaboration with other team members such as medical directors, pharmacist, nurse clinicians, etc.

• Provides suggestions for improvements and enhancements to outpatient coaching programs based on data/experience

• Able to manage multiple health records and systems to accurately document customer interactions and progress

• Must be able to comply with HIPAA standards and regulations in telephonic conversation and in documenting medical records.

• Flexibility to assist other teams and partners as needed.

• Perform other related duties incidental to the work described herein

Requirements

• Specialized training or experience working with Autism Spectrum Disorder is preferred.

• Experience with UM (Utilization Management) is preferred as Case Managers review with providers.

• Requires Master's degree mental health discipline and independent licensure to practice in the state of employment (LICSW, LMFT, LCPC, LPC, LPCC, Licensed Psychologist, Psych RN)

• Three to five years post-license mental health experience preferred but will also consider a new independently licensed therapist

• Experience with direct member communication (written and verbal), experience in telephonic counseling/coaching preferred

• Working knowledge of motivational strategies, materials development, training and consultation preferred.

• Proven administrative abilities, with strong computer and software application skills.
  Excellent interpersonal skills and the ability to work in a team environment

• Demonstrated ability to set priorities including, but not limited to time management and organizational skills

• A high energy level and excellent written and oral communication skills are essential.

• Passion for health improvement of members

• Strong research and analytical skills

• Effective negotiation skills

• Ability to manage own caseload and coordinate all assigned cases         

For this position, we anticipate offering an annual salary of $58,600 - $97,700, 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 Evernorth

Evernorth, Cigna Corporation’s health services segment, exists to elevate health for all. We're building on our legacy and redefining health care as we know it. Unbiased in how we think, we create without limitation. We partner without constraints, deliver value differently and act in the interest of humanity. Solving across silos, closing gaps in care, and empowering clients, customers, and people everywhere to move onward and upward. When you work with us, you’ll be empowered to solve the problems others don’t, won’t or can’t. Join us. 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.