Opioid Case Management Lead Analyst - Evernorth Health Services - Remote

The specialty care management programs help individuals make the behavioral changes and first steps necessary to initiate and engage in behavioral treatment. Our case managers are specially trained in coaching individuals with substance use disorders, comorbidities, and pain management conditions. They have the entire suite of Cigna services available allowing them to identify and service each individual’s needs.

The case manager offers Specialty Care Management services that utilize a motivational interviewing approach focusing on decreasing both internal and external barriers that may be preventing the individual from initiating and/or engaging in healthy behaviors or seeking behavioral/medical treatment. A unique approach to pain management called Cognitive Behavioral Coaching or CBC is utilized to assist those that suffer from pain management conditions. These approaches help the individual move toward readiness to change and results in the creation of goals that will improve their health and well-being.

Role Summary        

This position is a great opportunity for licensed behavioral health clinicians or licensed nurses who are passionate about integration and working to reduce the opioid crisis through working with customers at high risk of opioid overdose, substance use issues or chronic pain management issues. The case manager will utilize a coaching approach and their experience to provide an excellent customer experience. The role offers a great salary with an excellent benefits package that starts your first day of employment including a continuing education program with funding and extra leave time.            

Major Duties

• Evaluates appropriate health care services and treatment plans in conjunction with outpatient providers.

• Ensures that care management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained.

• Performs care management for specialty programs in a telephonic customer- facing environment which involves utilizing a coaching approach that provides support and resources to the customers.

• Assistance in the identification of member health education needs

• Develop SMART goals with our customers to empower them to lead and maintain a healthy lifestyle

• Assesses readiness to change and implements actions to assist members in moving through stages of change to reach their goals

• Perform research for community and educational resources to assist customers in their journey

• Consult with and assist team members in cases where a member’s behavioral health or emotional issues are impacting their ability to set and/or achieve goals

• Educate and refer members on available health resources and Medical Management as appropriate to approach …