Cigna EHE Health Coach

Key responsibilities:

• Establish health improvement plans based on member specifications
• Establish personalized goals
• Support customers in achieving those goals through behavior changes to improve health status
• Work with customers to reduce health risks and improve quality of life
• Communicates results of reviews verbally, in the medical record, and through official written notification to the primary care team, specialty providers, care managers, vendors and members in adherence with regulatory and contractual requirements
• Provides decision-making guidance to clinical teams on service planning as needed
• Works closely with Clinicians, Medical Staff and Peer Reviewers to facilitate escalated reviews in accordance with Standard Operating Procedures
• Ensures accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy
• Works with Manager and other clinical leadership to ensure that departmental and organizational policies and procedures as well as regulatory and contractual requirements are met
• Additional duties as requested by supervisor
• Maintains knowledge of CMS and State regulatory requirements
• Education Requirements:
• Associate’s degree required,
• LPN/LVN- you must hold a valid, current license issued by the state in which the candidate resides
• Desired Experience (nice to have):
• Customer experience
• Remote work experience
• Proficient with Microsoft Teams and Office.
• Required Knowledge, Skills & Abilities (must have):
• Ability to complete assigned work in a timely and accurate manner
• Ability to work independently
• Desired Knowledge, Skills, Abilities & Language (nice to have):
• Flexibility and understanding of individualized care plans
• Ability to influence decision making
• Strong collaboration and negotiation skills
• Strong interpersonal, verbal, and written communication skills
• Comfort working in a team-based environment
• Knowledge of Medicare and Mass health services and benefits
• Hourly wage $24.00
• Hours: Monday through Friday 7AM to 8PM Central Time
• This is a fully remote work at home role. You must have a secure, private wok at home area with a hardwired internet connection with speeds greater than 5MB upload and 10MB download.
• Sagility Offers Competitive Benefits Including:
• Medical
• Dental
• Vision
• Life Insurance
• Short-Term and Long-Term Disability
• Flexible Spending Account
• Life Assistance Program
• 401K with employer contribution
• PTO and Sick Time
• Tuition Reimbursement
• Join our team, we look forward to talking with you!
• An Equal Opportunity Employer/Vet/Disability
• Location