When an individual or family member contacts Cigna Behavioral Health 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 Coaching and Support Team is also responsible for educating customers and health care professionals on the medical necessity review process for Intensive Behavioral Interventions (including Applied Behavior Analysis) and reviewing any request with the health care professional directly.
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.
Refer to Health Professionals with Autism expertise.
May Complete Utilization Management for Applied Behavior Analysis and higher levels of care for individuals with primary diagnosis Autism.
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 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 CIGNA 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
Specialized training or experience working with Autism Spectrum Disorder is preferred.
Experience with UM (Utilization Management) is preferred as Case Managers review with providers.
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
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 services innovation.
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 an accommodation based on your physical or mental disability please email: [email protected] Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.
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