Behavioral Health Inpatient UM Care Manager - Evernorth Health Services - Remote

The ideal candidate for this position is a licensed professional with a background in the insurance industry as a care manager in a behavioral healthcare role, or an individual who has worked in a mental health or chemical dependency treatment facility in the area of utilization management, or in direct provision of service as a mental health or chemical dependency counselor.

As an Inpatient Care Manager at Evernorth, you will use your clinical knowledge and skills to evaluate appropriate health care services and treatment plans in conjunction with inpatient providers. You will partner with facilities and families to identify and implement a holistic approach to treatment outcomes.   You will be part of a virtual organization with multiple sites and must function well both independently as well as part of a larger team.  

This is a 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.

 Responsibilities:

• Perform pre-cert and concurrent reviews for inpatient levels (Detox, Inpatient, Residential, and Partial Hospitalization).

• Collaborate with Facilities and Health Care Providers telephonically to obtain clinical information and ensure quality treatment outcomes in the least restrictive setting utilizing established Medical Necessity Criteria.

• Coordinate with facilities to assist with discharge planning, aftercare follow-up appointments, and integration of services with Medical and Pharmacy.

• Engage with customers and families to understand needs, facilitate access to coaching/case management programs and community resources.

• Work in a team environment which includes contributing to team meetings, participating in clinical rounds with Evernorth Medical Directors for input on utilization management, and attending all required trainings impacting utilization review and accreditation procedures.

• Manage own caseload and coordinate all assigned cases.

• Perform additional tasks/projects as needed, requested or assigned. 

Qualifications

• Requires Master's degree mental health discipline and independent licensure to practice in the state of employment (LCSW, LMFT, LPC, LPCC, or Licensed Psychologist)

• 3 - 5 years post-license mental health experience preferred

• Excellent communication and interpersonal skills with a focus on customer service

• Effective conflict management and negotiation skills

• Ability to adapt to change and problem solve

• Strong time management and organization skills with an ability to set priorities in a fast-paced environment

• Ability to utilize and navigate multiple technology systems

• Knowledge of managed care 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 annual salary of 65,500 - 109,100 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 disea