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Behavioral Health 24/7 Clinical Navigation & Support Care Manager - Evernorth Health Services- Remot

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 ...


  • Rate: Not Specified
  • Location: Bloomfield, US-CT
  • Type: Permanent
  • Industry: Finance
  • Recruiter: Cigna
  • Contact: Recruiter Name
  • Email: to view click here
  • Reference: 24007844
  • Posted: 2024-06-15 10:06:46 -

  • View all Jobs from Cigna


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