Job Description

The job profile for this position is Case Management Lead Analyst , which is a Band 3 Senior Contributor Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. 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. 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. 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. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. #J-18808-Ljbffr The Cigna Group

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