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
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
Actively prepares for and participates in client visits and
Works with the Medical and Behavioral Physician Advisors
Be open to suggesting and implement improvements and
enhancements to behavioral health programming based on data/
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
Attends all required trainings and adheres to all regulatory
mandates impacting utilization review and accreditation
Adheres to Cigna's Medical Necessity Guidelines.
Complies with all Cigna Behavioral Health, policies and Standard
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
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
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
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
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
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
Job ID: 54642384
Company Name: Cigna
Job Function: Accounting/Finance
Job Type: Full-Time
Min Education: None
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