Behavioral Health Personal Advocate - Remote, United States - The Cigna Group

Description

The job profile for this position is Case Management Analyst, which is a Band 2 Senior Contributor Career Track Role.

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Training Schedule: Monday-Friday 830AM-5PM CST (7 weeks)

Production Schedule: Monday-Friday 1030AM-7PM CST

The Personal Advocate position is responsible for representing Cigna Behavioral Health (CBH) to all inbound callers within a call center environment and assuring caller's contact with CBH is positive. Advocates are many times the first encounter customers have with Cigna and thus are responsible for giving a positive first impression. The Advocacy tasks of this position are varied and often complex in nature requiring flexibility and multi-tasking capabilities. Responsibilities may include but are not limited to: educating customers on benefits, eligibility, referrals, non-clinical resources and assessing for potential risk of harm or substance abuse concerns.

This position services calls in a warm and empathetic manner as many of the calls are sensitive in nature. Independent problem solving skills are critical to success within the role along with intelligent judgment of assessing the caller's needs. Based upon the call type and requests advocates should be able to use customer service skills, knowledge of the mental health/substance abuse field and Cigna training to effectively address callers needs in an educational manner. This position is an entry level role with opportunity for growth within the company. Incumbents will utilize telephonic communication the majority of the time with some web, and internal CBH materials to achieve first time resolution for callers.

Responsibilities:

The primary responsibility of the Advocate role is answering calls from customers. The majority of the day will be answering inbound calls from customers looking to access, understand, or utilize services.

Within a call an advocate may:

• Register participants in the intake system and opens case files
• Educate participants on their benefits based upon individual plan design and other clinical or non-clinical resources available
• Conduct an intake as needed to assess for presenting concern and risk of harm or substance abuse concerns
• Provide participants with names and phone numbers of nearest providers
• Multi-task by maneuvering through various computer programs and screens

As needed an advocate may also:

• Write authorizations to ensure claims are paid correctly.
• Provide follow-up calls to participants to ensure correct information is given
• Send eligibility requests to determine effective coverage dates or to verify correct benefits are loaded
• Send complaints to initiate grievance process for customers

On all calls an advocate is responsible for:

• Providing high quality customer service as identified by Advocacy department quality standards
• Using independent problem solving skills to make sound decisions in assessing the needs of the callers by giving accurate information and providing first call resolution
• Understanding the business needs of the role, while balancing the needs of the customer
• Taking an educational approach to ensure callers are able to understand the complexities of accessing care
• Demonstrating a complete awareness and understanding of the responsibilities and workflows of the various departments within Cigna

QUALIFICATIONS:

• Masters Degree
• Previous customer service experience or related position
• Superb interpersonal communication
• Effective listening and organizational skills
• Ability to manage multiple tasks, setting priorities where needed
• Independently problem solve, with ability to function without constant supervision
• A demonstrated ability to type effectively; with strong PC skills/word processing experience and ability to learn new computer software systems
• Ability to learn new workflows and tasks quickly
• Ability to work independently and be a team player
• Previous call center environment experience preferred

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 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.

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.

Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.