Job description

Under the general direction of the supervisor, To increase operational efficiency of the specialty case management unit and ensure customer satisfaction by providing accurate information to callers, performing referral related activities and miscellaneous unit support duties Utilizes effective communication, courtesy and professionalism in all interactions, both internally and externally.

Major responsibilities and desired results:
Provides initial customer contact for incoming calls, performing but not limited to the following activities:
accesses automated system to open/document cases
collects and provides data entry of case information
provides accurate information to callers based on an understanding of customer and service requirements
determines the course of action for each call based on pre-established guidelines, channeling to appropriate staff may redirect, forward calls to care manager specialist
Communicates professionally with callers, patients, healthcare providers, insurance community, and specialists to provide and verify information; to explain processes; to answer questions regarding products and services and take appropriate specialty case management referrals.
Communicates professionally with callers, patients, healthcare providers, insurance community and specialists to ask assessment questions and make appropriate determination of outcome per the established stratification or screening to
Adheres to quality assurance standards and all case management policies and procedures, especially those related to confidentiality

Performs these additional unit duties as appropriate:
interfaces on behalf of care manager specialist to arrange review time based on provider/clinician availability
supports and assists with training and precepting as required
actively participates on special projects and internal/external customer demonstrations
interfaces with sales and account management staff as needed
creates and makes necessary corrections in customer reports
retrieves phone mail as needed
creates and maintains specialty cases and data tracking grids or reports
assigns specialty cases as appropriate
Performs outbound calls to patients, healthcare providers, insurance community, and specialists to obtain additional information needed to create cases or complete assessments on an as needed basis.

Minimum requirements:
High School Graduate or equivalent
Prior experience in customer service role/operation
Strong telecommunications and customer service skills
Advanced computer skills

Preferred requirements:
Licensed Practical Nurse (LPN)
Basic knowledge and understanding of Cigna products and services
Working knowledge of medical terminology as it relates to specialty services
Working knowledge of Cigna technology and telephone systems
Ability to work independently and to make independent decisions and ability to work unsupervised on special projects
Ability to adapt and be flexible within fast-paced dynamic environment
Ability to adapt to a high volume contact center environment
Ability to function as part of a team
Time management skills

Exhibits core competencies for HSS:
Demonstrated leadership skills
Strong presentation skills
Demonstrated ability to participate on/lead projects and workflow improvement initiatives
Ability to act as change agent to support organization's objectives

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 23 - 34 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.

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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