Opioid Case Management Lead Analyst - Evernorth Health Services - Remote

The specialty care management programs help individuals make the behavioral changes and first steps necessary to initiate and engage in behavioral treatment. Our case managers are specially trained in coaching individuals with substance use disorders, comorbidities, and pain management conditions. They have the entire suite of Cigna services available allowing them to identify and service each individual’s needs.

The case manager offers Specialty Care Management services that utilize a motivational interviewing approach focusing on decreasing both internal and external barriers that may be preventing the individual from initiating and/or engaging in healthy behaviors or seeking behavioral/medical treatment. A unique approach to pain management called Cognitive Behavioral Coaching or CBC is utilized to assist those that suffer from pain management conditions. These approaches help the individual move toward readiness to change and results in the creation of goals that will improve their health and well-being.

Role Summary        

This position is a great opportunity for licensed behavioral health clinicians or licensed nurses who are passionate about integration and working to reduce the opioid crisis through working with customers at high risk of opioid overdose, substance use issues or chronic pain management issues.  The case manager will utilize a coaching approach and their experience to provide an excellent customer experience. 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.            

 

Major Duties

• Evaluates appropriate health care services and treatment plans in conjunction with outpatient providers.

• Ensures that care management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained.

• Performs care management for specialty programs in a telephonic 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 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         

• Requires Master's degree mental health discipline and independent licensure to practice in the state of employment (LCSW, LMFT, LPC,/LPCC, LMHC, Licensed Psychologist) or active unrestricted Registered Nurse (RN) license in state or territory of the United States

• Three to five years post-license mental health and substance use disorder experience is required.

• Experience with direct member communication (written and verbal), experience in telephonic counseling/coaching preferred

• Highly evolved communicator who is action oriented, creative and courageous

• 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

• 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 65,600 - 109,400 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.

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

Salary : $65,600