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Case Management Lead Analyst - Behavioral Health

Company: HCPro, Inc.
Location: Plano
Posted on: September 13, 2020

Job Description:



The individual is an independently licensed professional (LICSW, LP, LPCC, LPC, LMFT, RN, etc.) who has a specialty in behavioral health. This position is responsible for providing, assessment, evaluation, and referral of customers with behavioral health issues. The Case Manager (CM) will assess for and prioritize customers' bio-psycho-social-medical needs, and helps the customer connect with resources found within their own community. The Case Manager not only plays an important role in following up directly with customers, who have known behavioral health concerns, but aligns and coordinates with the behavioral, medical and pharmacy team members to address customer concerns in real time.

The CM has knowledge of behavioral and medical diagnosis. They are versed in evidence based treatment practices. They partner with behavioral CMs, Coaches, Cigna Nurse Case Managers or other CHC staff providing care for Cigna customers who are referred. They collaborate and coordinate care with the larger multidisciplinary team to plan and direct customer's treatment program. They need to have knowledge and experience working with those with the Serious and Persistent Mental Illness. Will have an understanding in accessing community resources to help customers with basic needs like food, housing, medication, transportation, etc.

CM will be a part of a client designated team.


Access and complete needs assessment with customers who have complex medical and psychiatric conditions.

Collaborate with Matrix Partners to obtain necessary information in order to provide the most appropriate resources.

Manage own caseload and coordinate all assigned cases.

Assist customers with connecting to community resources identified to meet their needs.

Ensures the appropriate next steps are put in place for referrals into medical, pharmacy or behavioral coaching programs, in addition to any alignment with a behavioral provider

Works with family members and caregivers to enhance customer's well-being

Actively participates in integrated case rounds, providing insights to promote whole person health

Works closely with team members to ensure each customer has the support system they need to recover from their illness or injury.

Actively prepares for and participates in client visits and audits

Works with the Medical and Behavioral Physician Advisors

Be open to suggesting and implement improvements and enhancements to behavioral health programming based on data/ experience

Consults with MD, Clinical Supervisor, Lead Clinician, or assigned mentor in all cases when needed.

Coordinates with UM team if authorization is required and ensures clinical records on each customer are completed.

Performs additional tasks/projects as needed, requested or assigned

Attends all required trainings and adheres to all regulatory mandates impacting utilization review and accreditation procedures

Adheres to Cigna's Medical Necessity Guidelines.

Complies with all Cigna Behavioral Health, policies and Standard Operating Procedures.

Takes initiative for continued professional development.

Work in a virtual and office based team environment which includes contributing to team meetings, participating in clinical rounds with Cigna Medical Directors and attending all required Cigna courses and trainings.

Ensures that all customers are followed up with after discharge from a behavioral health higher level of care. Responsible for ensuring coordination of a stepdown program is in place, and follow up outpatient visits occur as needed.

Social Worker is available to all team members, for consultation.

Reviews cases based on PHQ and/or GAD score, with a focus on customers internal partners present for consultation

Work closely with the behavioral UM and CM teams to align on cases and hand off appropriately


Current unrestricted independent licensure in a behavioral health or medical field (RN, LCSW, LMFT, LPC, LPCC, or Licensed Psychologist)

Knowledge and experience in accessing community resources in order to help customers with basic needs.

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

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: for support. Do not email for an update on your application or to provide your resume as you will not receive a response.

Job Information

Job ID: 54642384

Company Name: Cigna

Job Function: Accounting/Finance

Job Type: Full-Time

Min Education: None

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Keywords: HCPro, Inc., Plano , Case Management Lead Analyst - Behavioral Health, Other , Plano, Texas

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