Genetic Counselor Clinical Reviewer - EviCore - Remote

Delivers specific delegated tasks assigned by a supervisor in Utilization Management. Handles moderately complex medical review, utilization review, credentialing/re-credentialing, quality assurance/improvement, and/or health education programs/cases. Collaborates with physicians and multidisciplinary team members to determine appropriate course of action for treatment. May analyze treatment patterns and utilization trends. Contributes to the development and implementation of action plans to improve policies and quality. Completes day-to-day Health Services tasks without immediate supervision but has ready access to advice from more experienced team members. Tasks involve a degree of forward planning and anticipation of needs/issues. Resolves non-routine issues escalated from more junior team members. May require specialized licensure.

Genetic Counselor Job Description:

The Genetic Counselor is responsible for the following:

• Laboratory molecular and genetic testing clinical case review activities.
• Evaluate telephone, fax, or web requests for authorization of coverage of molecular and genetic laboratory requests from physician offices; comparing requests against established clinical protocols; and authorizing coverage of services or referring requests for expert clinical review as appropriate.
• Be available as an expert advisor for physicians and labs on the appropriate use of genetic testing, including new and cutting-edge tests entering the market.

Minimum Education, Licensure and Professional Certification Requirement: 

• Master’s degree in genetic counseling. 
• Board certified American Board of Genetic Counseling or American Board of Medical Genetics. 
• Licensure (if available) in state of residence.

Minimum Experience required:

• Minimum of 2 years' experience as a Genetic Counselor.
• Experience with computer data entry, customer service, and managed care beneficial.

          

Required Skills:

• Strong interpersonal skills with the ability to clearly explain complex medical information in both verbal and written form. 
• Ability to work independently, be flexible and adaptable. 
• Comfort and familiarity with pediatric, adult, and perinatal genetics and related genetic tests.

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 69,000 - 115,000 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, vete