Case Management Analyst

Job Description

***This role is WAH/Flex which allows most work to be performed at home. Employees must be fully vaccinated if they choose to come onsite.***

The hours posted for this role are 10:00-6:30pm CST or 10:30-7:00pm CST

• This position supports Advocates in their duties, which include: engagement of the member for Behavioral issues. Responsibility for representing the Member Advocate teams to all inbound callers, education of members in regards to available programs and services. Sharing information on benefits and claims, referrals to appropriate providers and educational material.
  
  The Advocacy tasks for this position are often complex in nature and the Lead Member Advocate would be responsible for not only having a high level of knowledge in these processes, but the ability to coach and support advocates learning these tasks. This position also has responsibility for facilitating and leading process improvement initiatives within their designated unit and work in conjunction with various matrix partners within CHS to ensure timely and correct workflow processes. Represents the Member Advocate function in various capacities throughout the organization and duties as assigned.
  
  RESPONSIBILITES:
• Defines, develops and provides information and analysis to drive the decision-making process and support business operations for internal and external customers. May assist with researching, analysis and recommending operational policies/ processes/ procedures to standardize and develop best practices for the organization. Skills critical to this career path including project management, leadership and business expertise. Tactical focus, expertise in at least one business process area, works with guidance to scope, plan and management small-scale department projects. Possess a high level communication skills and experience communicating with several groups simultaneously.
• Supports the performance metrics of the Operating Unit and, where appropriate, assists in implementation and support of initiatives which impact them including duties associated with assisting members on the queue.
• Interfaces with matrix partners to effectively communicate across the organization.
• Participates in Team and Operating Unit meetings, as requested, to identify trends and opportunities that can have a positive impact on results.
• Responsible for meeting Quality Indicators
• Assists team members in difficult cases by way of research and claim resolution
• Assists Account Managers in resolution of member account issues
• Supports Team Leader role in Team Leader absence
• Helps maintain staffing schedules and other programs to ensure appropriate phone coverage
• Additional duties as appropriate for role
• BACKGROUND:
  
  Candidate must have:
• Proven track record of leadership, consensus building, and decision-making
• Experience in strategic planning and business development
• Experience working successfully in a matrix environment
• Skilled in customer service, leadership, and oral and written communications
• Demonstrated ability to understand and effectively relate to professionals at all levels of an enterprise
• REQUIREMENTS
• Bachelor's degree in behavior health or human services field
• Minimum one year experience as Member Advocate preferred
• Minimum one year of experience in a mental health or social service field
• Proven leadership with evidence of increasing responsibility
• Strong interpersonal and human relations skills with the ability to effectively resolve difficult situations
• Motivated self-starter with strong organization and analytical skills
• Ability to remain flexible in an intense and dynamic work environment while managing multiple priorities
• Excellent oral, written and presentation skills
• Ability to think strategically while understanding how specific decisions impact overall vision/mission
• Highly proficient with Excel, Word and database applications
• Ability to type effectively; strong PC Skills/worked processing experience
• Experience in a service-focus environment
• Ability to maintain a professional and positive image to internal and external customers

This position is not eligible to be performed in Colorado.

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: for support. Do not email for an update on your application or to provide your resume as you will not receive a response.