Provides advanced professional input to complex case management assignments/projects. Handles more complex, high acuity cases and/or account sensitive cases. Performs prospective, concurrent, and retrospective reviews for inpatient acute care, rehabilitation, referrals, and select outpatient services. Ensures that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained. Evaluates, recommends, and maintains close relationship with inpatient and outpatient counseling/treatment facilities. Evaluates employee counseling and treatment needs and makes recommendation on changes or additions to appropriate programs. May assist with designing and conducting training and educational seminars. Manages own caseload and coordinates all assigned cases. Performs leadership role on team when implementing new tools or case management programs/initiatives. Supports and provides direction to more junior professionals. Works autonomously, only requiring "expert" level technical support from others. Exercises judgment in the evaluation, selection, and adaptation of both standard and complex techniques and procedures. Utilizes in-depth professional knowledge and acumen to develop models and procedures, and monitor trends, within Case Management. May require a Master's Degree in a health care related field with current licensure.
At Cigna, we listen to, advocate for, and collaborate with our customers to empower them to identify their health goals and own their solutions.
Sound like you? Great! Here's more on how you'll make a difference:
Provide onsite face-to-face customer coaching and support
Identify customer health education needs through targeted health assessment activities.
Collaborate with customers to establish health improvement plans, set personalized evidence-based goals, and support customers in achieving those goals.
Empower customers to become an active participant in their own health outcomes.
Assist Customer in overcoming barriers to better health
Lead and support a variety of Health and wellness promotional activities, such as group coaching, wellness challenges and Health related seminars.
May perform biometric screenings, including finger sticks, blood pressure, body composition, etc.
Utilize biometric values and motivational interviewing techniques to collaborate with customer to drive to improve clinical outcomes.
Provide support for health-related site events, which include open enrollment, wellness committee facilitation, flu shot events, health fairs, etc.
Responsible for the adoption and demonstration of the Consumer Health Engagement cultural beliefs. Be a role model for the six cultural beliefs to drive personal accountability and organizational results.
What we expect from you:
Strong clinical skills with at least 3 or more years of experience health coaching, health education and health promotion
Current ACLS/BLS/CPR/AED Certification
Extensive diabetes education experience in both 1:1 and group settings required.
Bachelor's degree in a health-related field. Master's degree preferred.
High energy level, with dynamic presentation skills is required.
Positive role model in demonstrating healthy behaviors
Passion for health improvement
Ability to work independently
Customer-centric focus
Ability to proactively collaborate professionally with the client and other matrix partners.
Understand and own a variety of clinical targets and outcome measurements. Develop action plans that drive clinical value for the customers and clients.
Proven administrative abilities, with strong computer and software application skills.
Bonus points for:
Registered Dietitian
Certified Diabetes Educator
CHES (Certified Health Education Specialist)
Motivational interviewing training/experience.
Smoking cessation and diabetes experience
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.
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.
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