Job Description

When an individual or family member contacts Evernorth Health Services for assistance related to Autism, they are assigned to an Autism Case Manager who will assist the individual or family by providing ongoing case management, addressing all questions and concerns related to Autism benefits, treatments and community supports. The Autism Case Manager works collaboratively with our ABA UM Team, peer reviewers, and health care professionals on the medical necessity review process for Intensive Behavioral Interventions (including Applied Behavior Analysis).

This position is a great opportunity for licensed behavioral health clinicians to use their industry experience in a managed care setting focused on clinical excellence for participant members. The role offers a great salary with an excellent benefits package that starts your first day of employment including a continuing education program with funding and extra leave time.

Responsibilities:

• Refer to Health Professionals with Autism expertise.
• Provide services that will assist the customer/family members in understanding their options based on their benefits.
• Educate the customer/family members about treatment options, including the need for medical interventions (if appropriate).
• Ensures that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained.
• Performs case management, as needed,in a telephonic/digital customer- facing environment which involves utilizing a coaching approach that provides support and resources to the customers.
• Assistance in the identification of member health education needs
• Develop SMART goals with our customers to empower them to lead and maintain a healthy lifestyle
• Assesses readiness to change and implements actions to assist members in moving through stages of change to reach their goals
• Perform research for community and educational resources to assist customers in their journey
• Consult with and assist team members in cases where a member\'s behavioral health or emotional issues are impacting their ability to set and/or achieve goals
• Educate and refer members on available health resources and Evernorth Health Services Medical Management as appropriate to approach customer holistically
• Collaboration with other team members such as medical directors, pharmacist, nurse clinicians, etc.
• Provides suggestions for improvements and enhancements to outpatient coaching programs based on data/experience
• Able to manage multiple health records and systems to accurately document customer interactions and progress
• Must be able to comply with HIPAA standards and regulations in telephonic conversation and in documenting medical records.
• Flexibility to assist other teams and partners as needed.
• Perform other related duties incidental to the work described herein

Qualifications

• Specialized training or experience working with Autism Spectrum Disorder is preferred.
• Requires Master\'s degree mental health discipline and independent licensure to practice in the state of employment (LICSW, LMFT, LCPC, LPC, LPCC, Licensed Psychologist, Psych RN, LBA, LBS etc.)
• Three to five years post-license mental health experience preferred but will also consider a new independently licensed therapist
• Experience with direct member communication (written and verbal), experience in telephonic counseling/coaching preferred
• Working knowledge of motivational strategies, materials development, training and consultation preferred.
• Proven administrative abilities, with strong computer and software application skills.

Excellent interpersonal skills and the ability to work in a team environment

• Demonstrated ability to set priorities including, but not limited to time management and organizational skills
• A high energy level and excellent written and oral communication skills are essential.
• Passion for health improvement of members
• Strong research and analytical skills
• Effective negotiation skills
• Ability to manage own caseload and coordinate all assigned cases

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 annual salary of 62,400 - 104,000 USD / yearly, depending on relevant factors, including experience and geographic location.

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

We want you to be healthy, balanced, and feel secure. That\'s why 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) with company match, 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, visit Life at Cigna Group .

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.

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.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

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