Clinical Program Manager at Cigna in Memphis, Tennessee

Job Description:

This position has responsibility for planning, directing, and managing the day-to-day operation of multiple group health products and services, with the primary focus on case management programs.  Products delivered contain all services provided by the case management department unit including support of Utilization Management activities, Case Management referrals and Disease State Management referrals. This position is also responsible for Cigna business, as well as healthcare management external channel account support.  Heavy customer interface is also essential to this position.

Responsibilities:

• Establish unit objectives and determine performance standards and goals for direct reports that are consistent with customer requirements and operational objectives for support of the normal business hours and after hour coverage service delivery environment.




• Monitor production and quality of performance against QI standards to assure optimal service delivery and ensure accurate statistical data and reports.  Implement appropriate corrective action as necessary.




• Provide marketing and customer service functions, including account management, sales presentations, proposals, responses to complaints and concerns, data analysis of customer reports, and recommendations to improve results.




• Participate in interviewing, hiring, and retaining qualified professional staff.  Evaluate staff performance, encourage new skill development, motivate staff and assist employees in establishing appropriate career tracts.  Participate in development of supervisors and high potentials with the organization.




• Initiate action regarding new policies, procedures and programs to ensure continual improvements in effectiveness, quality, results, profitability, productivity and efficiency of operation.




• Maintain expert knowledge of all product lines directs the implementation of pilots, new products, enhancements and serve as a field resource for Home Office product development and management.




• Support cross-selling and service integration opportunities by managing case finding functions for other Healthcare Management capabilities.




• Support diversity by promoting diversity in selection process, employee retention, customer initiatives, and developmental plan for high potentials.




• Support the specialty case management program

Requirements:

Master’s Level in Clinical Social work

Three years management experience AND Active unrestricted Social worker  (SW) license in state or territory of the United States

Individuals who directly supervise Case Managers must have at least one of the following qualifications:

A Masters (or higher) degree in a health related field AND licensure as a health professional (where such licensure is available), OR

Certification as a case manager, OR

Professional certification in a clinical specialty and at least three (3) years of experience as a case manager; AND

If they have supervised the CM process for 3 or more years, must hold a certification as a case manager

Preferred Requirements :

Clinical experience in acute or case management within a specialty area ( Social work)

Demonstrated ability as a manager to support and facilitate with sales/training/account service management including provider site visits.

Demonstrates ability as a manager to provide leadership with a focus on staff development.

Excellent time management, organizational, research, analytical, negotiation, communication (verbal and written) and interpersonal skills.

Expert knowledge of the insurance industry and claims processing.

Service marketing/account management experience a plus.

Computer skills and typing expertise.

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About Cigna

Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. We offer an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products. Together, with our 74,000 employees worldwide, 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 Cigna, you’ll enjoy meaningful career experiences that enrich people’s lives while working together to make the world a healthier place. What difference will you make?  To see our culture in action, search #TeamCigna on Instagram.

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.