24/7 Clinical Navigation

2 months ago

Remote, Oregon, United States The Cigna Group Full time

REQUIRED WORK HOURS:

Full time job with a minimum of forty hours per week five days a week. Shift days and times may vary due to business need. All staff schedules include rotating shifts, weekends and holiday time.

As a 24/7 Clinical Navigation & Support (CN&S) Care Manager (CM) you will deliver a guided, predictable and streamlined care experience for customers. The CN&S team is the destination for customers identifying a clinical need by providing one unique entry to address in the moment needs of the customer. You will help customers navigate the mental health system, including utilization of benefits and accessing direct care services.

As clinicians we support customers and families facing challenges big and small. We want to make sure accessing care is easy and sensible. You will help customers to process the unexpected from an evidence-based perspective, tapping into customer's strengths. Common situations include routine/acute/urgent/emergent need for care in order to direct customers toward specialized or higher levels of care (HLOC).

A CM for the CN&S team works on a queue, taking telephonic calls in the moment, as well as scheduled calendar appointments. CMs work in a team oriented, fast-paced environment. The team is staffed 24/7 in support of the full organization. CMs engages in a dialogue with the customer to assess the current need and provide a quality customer service experience.

CMs will meet the customer where they are, assess their need and triage appropriately. CMs seek to reduce barriers and navigate the customer to the right care at the right time. CMs will deliver a quality experience in one interaction. In addition, CMs support 100% follow up, working with the customer until that in the moment issue has been resolved.

The CM performs some or all of the following functions:

  • Clinical case assessment of needs and crisis risk assessment
  • Employee Assistance Consultation (EAC) for employer
  • Employee Assistance Telephonic Consultation for employees and members of household
  • Behavioral Telephonic Consultation
  • Confide Services Assessment
  • Brief Case Management
  • Utilization Management

Duties and Responsibilities:

  • Assess the customer's immediate risk and need, and provide clinically appropriate referrals for care and treatment
  • De-escalate and safety planning
  • Use clinical expertise, professional judgment and best practice
  • Determine the biopsychosocial need(s) of the customer
  • Educate customers about their benefit plan coverage, how to access coverage via digital application and platforms
  • Assist customers with navigating access to care
  • Provides customers with solutions and next steps
  • Partner with peers and leaders promoting and embracing a culture of change; supporting all parties through the change process
  • Demonstrate the ability to be agile and flexible in their work process.
  • Deliver excellent clinical judgment and interpersonal communication skills
  • Exemplify diplomacy with customers and providers who may not be receptive to the information shared
  • Understand confidentiality and privacy regulations
  • Demonstrate excellent verbal and written communication

Qualifications:

  • Requires a Master's degree or PhD in a mental health field with a current independent licensure in the state of employment (LADC, LPC, LMHC, LCSW, LMFT, RN or LP).
  • 5 plus years post licensure inpatient or outpatient experience as a mental health and/or substance use clinician with demonstrated understanding of multiple therapeutic modalities, including brief therapy and managed care experience preferred.
  • Knowledge and experience with Employee Assistance Programs (EAP) and the application of ASAM, MCG , and LOCUS/CALOCUS criteria preferred.
  • CEAP certification optional
  • Proficient with multiple software and system applications.

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 annual salary of 65, ,100 USD / yearly, 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: for support. Do not email 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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