The job profile for this position is Case Management Analyst, which is a Band 2 Senior Contributor Career Track Role.

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Work Schedule: Mon-Fri, 9:00pm-5:30pm CST

This position has advanced support responsibilities within the EAP department and performs a variety of duties related to coordination of services for EBH customers, providers, and client HR/managers.

Provides assistance to EAC and Clinical Navigation and Support teams administratively and by locating providers to respond to requests for Critical Incident services; scheduling Telephonic Consultation appointments; securing urgent appointments for participants in crisis and/or management referral cases; performing ad hoc provider searches and negotiating rates for services with out of network providers; coordinating provider schedules with customer needs for extended onsite services (i.e., coordinating layoff services for multiple sites.).

This position has a significant impact on the quality of EAP services provided to high-level management within our client companies. Services are being rendered, often to the level of management within the company that has authority and responsibility for contract retention with Evernorth.  

RESPONSIBILITIES:

• Locate Critical Incident Health Care Providers for the Critical Incident Stress Management (CISM) cases handled by the Employee Assistance Consultant (EAC) staff.

• Educates providers regarding protocols for CISM services, including maintaining appropriate communications with client contacts, providing information on Employee Assistance Program (EAP) benefits, and reviewing billing reimbursement procedures.

• Find EAP providers for urgent appointment requests, management referrals, and for crisis calls/crisis situations handled by the EAC and CN&S teams.

• Assists with Telephonic Consultation Scheduling, including managing the Outlook calendar, Outlook bin, TruCare bin, and inbound call queue.

• Conduct outreach calls for scheduled appointment telephonic consultations.

• Conduct EAP Ad Hoc searches for EAC management referral cases when indicated.

• Outreach EAP Participants to conduct an EAP Participant Survey.

• Process and file ROIs, SAP Claims, EAP Case Closure Requests, and more.

• Process Critical Incident Provider Reimbursement forms for Accounts Payable and troubleshoot payment inquiries from providers as needed.

• Maintain all documentation in Aster and DG for CISM requests and provider reimbursements.

• Maintain documentation for Telephonic Consultations and Management Referrals in TruCare and/or CAMS.

• Assist clinicians with administrative needs & 911 calls.

• Conduct outreach attempts on MDLive & EBCG Referrals to connect customers to behavioral health resources.

• Process restricted account administrative handoff requests by consistently monitoring a TruCare Bin, Outlook Bin and Webex Chat. 

• Complete assigned projects for process improvements.

• Consistently meet handle time, wrap up, and quantity goals currently in place for the year.

QUALIFICATIONS:

• Bachelor’s degree; mental health field preferred

• Minimum of two years related work experience

• Strong attention to detail required

• Strong interpersonal skills

• Ability to independently problem solve

• Ability to be a self-starter

• Takes initiative with a team-oriented attitude

• Excellent organizational skills are necessary to ensure all related paperwork is accurate and processed in a timely manner.

• Able to pivot between tasks quickly

• Technical knowledge of automated databases, tracking systems, and spreadsheet applications

• Excellent PC skills

• Strong numeric skills

• Proven customer service skills

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an hourly rate of 24 - 37 USD / hourly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here.

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.

Please note that you must meet our posting guidelines to be eligible for consideration.  Policy can be reviewed at this link.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.