Case Management Lead Representative Details

Case Management Lead Representative

Cigna - Fenton, MO

Employment Type : Full-Time

Work Schedule: Mon-Fri 10:30am - 7:00pm CST
Please Note: Work-at-Home is only offered to internals who are already set up as Work-at-Home

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:
Bachelor’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.

If you require an accommodation based on your physical or mental disability please email: SeeYourself@cigna.com. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

About Cigna
Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, 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 us, or one of our subsidiaries, you’ll enjoy meaningful career experiences that enrich people’s lives. 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.