Social Work Case Management Lead Analyst – CareAllies

Case Management Lead Analyst
Social Workers are responsible for assisting with the delivery of cost-effective, quality –based health care services for health plan customers by addressing the individual socioeconomic needs of the customer, providing information regarding their benefit plan as well as community resources. Assists health plan contracted providers with addressing customer social needs as well. Utilizes specific skill set to assess, coordinate, monitor and evaluate options and services in order to facilitate appropriate healthcare outcomes for customers. Performs community visits or telephonic outreaches to customers that have been identified through the Care Transition Coaching Program, and ensures Case Management program objectives are met. Social Workers also focus on outreach, follow ups, and assist with coordination of benefits when needed.

How you’ll make a difference:
Initiates contact with patient/family, physician, and health care providers/suppliers as part of the Care Transition Coaching Program. Conducts on-site evaluations (customer home visits) as is necessary.
Identifies customer needs through the Initial Assessment, and ensures continuity of care by coordinating/providing support after planned and/or unplanned transitions, initiating post discharge follow up calls which may include primary care physician and specialist appointment scheduling.
Perform telephonic outreach.
Screen customers for Low Income Subsidy or Medicaid and refer to appropriate agencies for application for programs.
Assist customers with community transportation resources as needed.
Provide Coverage Gap assistance or acquiring of high cost medications for impacted customers through initiation of Patient Assistance Program applications.
Assists RN Case Managers with Case Management Program screening and assessment.
Refers cases or submits requests for assistance to the Medical Director as appropriate.
Documents all customer and provider contact, social service needs notes, and Care Transition Coaching documentation within the integrated care management notation system.
Attend and participate in weekly Team rounds.
Communicates with all departments to resolve issues or document trends.
Understands and follows administrative guidelines (policy and procedure) of the department.
Attends and actively participates in staff meetings.
Other Duties as assigned.

What you should have:
Master’s Degree in Social Work (MSW) and
Licensed Clinical Social Worker (LCSW) or Licensed Masters Social Work (LMSW)
Three or more years’ experience in an acute care, managed care or social services environment
Medicare and Medicaid Knowledge
Verbal and written communication skills
Interpersonal skills
Basic Mathematical and statistical ability
Organizational skills
Typing and computer knowledge
Knowledge of community resources
Bilingual (English/Spanish) preferred

For this position, we anticipate offering an annual salary of $60,400 – $100,600, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

Helping our customers achieve healthier, more secure lives is at the heart of what we do. While you take care of our customers, we’ll take care of you through a comprehensive benefits program that helps you be at your best. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and best in class 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 dozens of corporate discounts on essentials you use every day. For more details on our employee benefits programs, please visit the “Life at Cigna” tab on our career site: www.cigna.com/careers

About Cigna
Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you’ll enjoy meaningful career experiences that enrich people’s lives. What difference will you make?

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.