Behavioral Health Member Advocate - Click to Chat - Evernorth Health Services - Remote

The Behavioral Advocate role is a non-clinical position within an inbound contact service center that supports the complex and unique needs of the Evernorth Behavioral Health customer population. Behavioral advocates service inbound Chats from key stakeholders to offer the most individualized, connected, and streamlined service experience. Behavioral advocates use their empathy and compassion to educate, guide, and assist the customers through their behavioral health journey. This helps ensure resolution of concerns on the first interaction, and helping to build an effective and positive relationship with Cigna/Evernorth.

The types of chat interactions a Behavioral Advocate may service include (but are not limited to): inquiries about provider referrals and how to access care and/or community resources, eligibility verification, and benefits, as well as inquiries about our Employee Assistance Program. This may also include website navigation support on the web or mobile applications. A Behavioral Advocate will utilize a wide range of applications to service and document these interactions. Independent problem solving, priority-setting, and technical savviness are essential to carry out the responsibilities of this role. Due to the sensitive nature of the Chat conversations relating to mental health and/or substance use, a professional and customer centric approach is expected while maintaining the utmost level of privacy.

Responsibilities:

The primary responsibility of this role is to answer inbound Chats from customers. Chat Advocates on occasion will also support Inbound Customer calls as business needs arise. Outbound calls may be necessary for follow-up and resolution of outstanding issues.

Within a Chat, an Advocate may:

• Perform a pre-scripted clinical intake assessment, and utilize their expertise and training to identify a customer at risk of harm to self or others and/or substance use concerns
• Serve as a crisis line by connecting a customer in distress or with a higher clinical need with a licensed clinician when necessary
• Determine eligibility for services, quote benefits, or inform of authorization requirements and other plan details
• Adhere to State and Federal compliance, and HIPAA requirements
• Provide referrals for various types of services based on a customer’s clinical need and/or specialty requests
• Provide guidance and support inquiries regarding our Employee Assistance Program (EAP) and similar product types
  • Confirm program eligibility
  • Generate, review and/or send an authorization to ensure claims are paid correctly
• Determine other customer needs and assist with connecting them to community resources in their greatest time of need
• Provide accurate benefit information and appropriate disclaimers to establish expectations regarding claims processing
• Send appropriate resources to customers via email or other preferred method
• Recognize the need to submit a complaint/grievance on the customer’s behalf
• Use internal online resources to research standard operating procedures and current workflows to find the correct resolution
• Strong competency with quick decision making and solving problems, ensure accurate information is given, and an exceptional drive to achieve resolution on the first interaction in a way that is customer focused
• Assist customers with website navigation and educate about the self-service tools, assessments, and webinar resources

Skills

• Exceptional Customer Service experience
• Prior experience working in a patient focused environment preferred  
• Ability to maintain a professional and positive image to external customers and build their trust in our organization
• Strong resiliency in a fast-paced working environment, managing/coping with change, and adaptability to different situations
• Proficiency with exercising empathy and compassion
• Superb interpersonal communication skills
• Strong proficiency with active listening, analytical, time management, and organizational skills
• Ability to effectively prioritize varying responsibilities and multiple tasks
• Intuitive technical capabilities with the ability to quickly understand and apply working knowledge on several proprietary systems. Functional knowledge of Microsoft Word and Excel
• Strong independent problem solving and resourcefulness skills
• Able to excel and/or prior successful experience in a virtual team environment
• Ability to type effectively and troubleshoot basic technical/computer issues
• Adaptable to change in a fast-paced working environment

Education

Bachelor’s Degree required

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