We use cookies. Find out about cookies here. By continuing to browse this site you are agreeing to our use of cookies.

Inpatient Case Management Lead Analyst - Behavioral Health -Evernorth, Plano, Texas

Created09/14/2021
Reference21017251
CategoryOperations
Job typeFull Time
CountryUnited States
StateTexas
CityPlano
Zip75023
SalaryCompetitive
The ideal candidate for this position is a licensed professional with a background in the insurance industry as a care manager in a behavioral healthcare role, or an individual who has worked in a mental health or chemical dependency treatment facility in the area of utilization management, or in direct provision of service as a mental health or chemical dependency counselor.

As an Inpatient Care Manager at Cigna, you will use your clinical knowledge and skills to evaluate appropriate health care services and treatment plans in conjunction with inpatient providers. You will partner with facilities and families to identify and implement a holistic approach to treatment outcomes. You will be part of a virtual organization with multiple sites and must function well both independently as well as part of a larger team.

This position is with Evernorth, a new business within the Cigna Corporation.

Responsibilities:
  • Perform precert and concurrent reviews for inpatient levels (Detox, Inpatient, Residential, and Partial Hospitalization).
  • Collaborate with Facilities and Health Care Providers telephonically to obtain clinical information and ensure quality treatment outcomes in the least restrictive setting utilizing established Medical Necessity Criteria.
  • Coordinate with facilities to assist with discharge planning, aftercare follow-up appointments, and integration of services with Cigna Medical and Pharmacy.
  • Engage with customers and families to understand needs, facilitate access to Cigna coaching/case management programs and community resources.
  • Work in a team environment which includes contributing to team meetings, participating in clinical rounds with Cigna Medical Directors for input on utilization management, and attending all required trainings impacting utilization review and accreditation procedures.
  • Manage own caseload and coordinate all assigned cases.
  • Perform additional tasks/projects as needed, requested or assigned.


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.

Qualifications
  • Requires Master's degree mental health discipline and independent licensure to practice in the state of employment (LCSW, LMFT, LPC, LPCC, or Licensed Psychologist)
  • 3 - 5 years post-license mental health experience preferred
  • Excellent communication and interpersonal skills with a focus on customer service
  • Effective conflict management and negotiation skills
  • Ability to adapt to change and problem solve
  • Strong time management and organization skills with an ability to set priorities in a fast paced environment
  • Ability to utilize and navigate multiple technology systems
  • Knowledge of managed care preferred


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.
Employer460 Evernorth Behavioral Health, Inc.