Case Management Analyst - Dedicated OG Advocate at Cigna in Memphis, Tennessee

Job Description:

***This role is WAH/Flex which allows most work to be performed at home. Employees must be fully vaccinated if they choose to come onsite.***

Shift: 10:30-7pm CST (Mon-Fri)

Job Summary:

The Personal Advocate position is responsible for representing Cigna Behavioral Health (CBH) to all inbound callers within a call center environment and assuring caller's contact with CBH is positive. Advocates are many times the first encounter customers have with Cigna and thus are responsible for giving a positive first impression. The Advocacy tasks of this position are varied and often complex in nature requiring flexibility and multi-tasking capabilities. Responsibilities may include but are not limited to: educating customers on benefits, eligibility, referrals, non-clinical resources and assessing for potential risk of harm or substance abuse concerns.

This position services calls in a warm and empathetic manner as many of the calls are sensitive in nature. Independent problem solving skills are critical to success within the role along with intelligent judgment of assessing the caller's needs. Based upon the call type and requests advocates should be able to use customer service skills, knowledge of the mental health/substance abuse field and Cigna training to effectively address callers needs in an educational manner. This position is an entry level role with opportunity for growth within the company. Incumbents will utilize telephonic communication the majority of the time with some web, and internal CBH materials to achieve first time resolution for callers.

Responsibilities:

The primary responsibility of the Advocate role is answering calls from customers. The majority of the day will be answering inbound calls from customers looking to access, understand, or utilize services.

Within a call an advocate may:

• Register participants in the intake system and opens case files

• Educate participants on their benefits based upon individual plan design and other clinical or non-clinical resources available

• Conduct an intake as needed to assess for presenting concern and risk of harm or substance abuse concerns

• Provide participants with names and phone numbers of nearest providers


• Multi-task by maneuvering through various computer programs and screens

As needed an advocate may also:

• Write authorizations to ensure claims are paid correctly.

• Provide follow-up calls to participants to ensure correct information is given


• Send eligibility requests to determine effective coverage dates or to verify correct benefits are loaded


• Send complaints to initiate grievance process for customers

On all calls an advocate is responsible for:

• Providing high quality customer service as identified by Advocacy department quality standards

• Using independent problem solving skills to make sound decisions in assessing the needs of the callers by giving accurate information and providing first call resolution

• Understanding the business needs of the role, while balancing the needs of the customer

• Taking an educational approach to ensure callers are able to understand the complexities of accessing care


• Demonstrating a complete awareness and understanding of the responsibilities and workflows of the various departments within Cigna

QUALIFICATIONS:

• Master's degree in mental health field or psychology/social work related field (can also include: family communications, health coaching, community/public health or other related major). NOTE: This is a non-clinical role and does not require a license


• Previous customer service experience or related position


• Superb interpersonal communication


• Effective listening and organizational skills


• Ability to manage multiple tasks, setting priorities where needed


• Independently problem solve, with ability to function without constant supervision


• A demonstrated ability to type effectively; with strong PC skills/word processing experience and ability to learn new computer software systems


• Ability to learn new workflows and tasks quickly


• Ability to work independently and be a team player


• Previous call center environment experience preferred

Qualified applicants will be considered without regard to race, color, age, disability, sex (including pregnancy), childbirth 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.

This position is not eligible to be performed in Colorado.

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.