The Bilingual Social Work Care Manager works with identified at risk members for care management intervention and coordination of the delivery of cost-effective quality based health care services for health plan members. The behavioral and clinical expertise of the social work team is leveraged to best meet customer needs and encourage healthy behaviors, address health equity and social… determinants of health concerns, and proactively address top admission driving diagnoses. The social work CM interfaces with the medical and behavioral health care management teams as necessary and develops individualized care plans in conjunction with the customer and/or representative.
Key Responsibilities:
• Interfaces with the care team to facilitate effective communication, referrals, and development of an integrated care plan
• Monitors and evaluates that the plan remains appropriate. Extends, revises or closes treatment plans as is appropriate
• Conducts telephonic evaluations and screenings as necessary and documents findings in a timely manner
• Collaborates with the care team to achieve identified patient outcomes
• Coordinates the treatment plan to accommodate the health service needs of the customer, incorporating community resources when available
• Connects customers to community resources to mitigate gaps around SDoH
• Attends and actively participates in care team meetings
• Engages patient and family in goals of care conversations and advance care planning
• Balances business needs with patient advocacy
• Builds solid working relationships with internal team members, matrix partners, key functional areas, customers and providers
• Provides decision support where multiple treatment options are available
• Empowers customers with skills to provide enhanced interaction with their providers
Qualifications:
• LMSW or LCSW in applicable state required
• Bilingual in Spanish preferred
• Certified Case Manager Preferred
• Three or more years’ experience in a care management setting
• Strong communication skills to effectively work with the healthcare team and customer
• Keen problem-solving techniques
• Ability to navigate in a fast-paced working environment
• Strong organizational skills – is able to quickly gather key information and respond with sound clinical judgment
• Anticipates and adopts new technology and provides feedback to drive innovation.
• Ability to partner with a team to build cohesion and drive outcomes for our programs and customers.
• Ability to recognize, address and resolve conflicts in a professional, collaborative manner.
• Demonstrates sensitivity to culturally diverse situations, participants and customers.
• Demonstrates effective organizational skills and flexibility to meet the business needs
• Strategic thinker who can come up with several solutions to solve a problem and will analyze them quickly to determine the best course of action.
• Prioritizes work to meet commitments aligned with organizational goals.
• Substantial knowledge of Microsoft Office including SharePoint, Outlook, PowerPoint, Excel and Word.
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 55,900 – 93,100 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. ThatÂ’s why youÂ’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, youÂ’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 Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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, 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: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State
