Care Senior Associate-Early Morning Shift-Required Hours (28 Hours): Tues/Wed from 5am-11am CDT; Fri from 5am-11am CDT & Sat from 8am-6pm CDT

The Personal Advocate position is responsible for representing Cigna Behavioral Health (CBH) to all inbound callers within a call center environment and assuring caller’s contact with CBH is positive. Advocates are many times the first encounter customers have with Cigna and thus are responsible for giving a positive first impression. The Advocacy tasks of this position are varied and often complex in nature requiring flexibility and multi-tasking capabilities. Responsibilities may include but are not limited to: educating customers on benefits, eligibility, referrals, non-clinical resources and assessing for potential risk of harm or substance abuse concerns. This position services calls in a warm and empathic manner as many of the calls are sensitive in nature. Independent problem solving skills are critical to success within the role along with intelligent judgment of assessing the caller’s needs. Based upon the call type and requests advocates should be able to use customer service skills, knowledge of the mental health/substance abuse field and Cigna training to effectively address callers needs in an educational manner. This position is an entry level role with opportunity for growth within the company. Incumbents will utilize telephonic communication the majority of the time with some web, and internal CBH materials to achieve first time resolution for callers.

Responsibilities:

1.The primary responsibility of the Advocate role is answering calls from customers. The majority of the day will be answering inbound calls from customers looking to access, understand, or utilize services

Within a call an advocate may:

Register participants in the intake system and opens case files

Educate participants on their benefits based upon individual plan design and other clinical or non-clinical resources available

Conduct an intake as needed to assess for presenting concern and risk of harm or substance abuse concerns

Provide participants with names and phone numbers of nearest providers

Multi-task by maneuvering through various computer programs and screens

As needed an advocate may also:

Write authorizations to ensure claims are paid correctly.

Provide follow-up calls to participants to ensure correct information is given

Send eligibility requests to determine effective coverage dates or to verify correct benefits are loaded

Send complaints to initiate grievance process for customers

On all calls an advocate is responsible for:

Providing high quality customer service as identified by Advocacy department quality standards

Using independent problem solving skills to make sound decisions in assessing the needs of the callers by giving accurate information and providing first call resolution

Understanding the business needs of the role, while balancing the needs of the customer (?)- Wording. Should it match the verbiage above (Advocacy department quality standards )

Taking an educational approach to ensure callers are able to understand the complexities of accessing care

Demonstrating a complete awareness and understanding of the responsibilities and workflows of the various departments within Cigna

2.Advocates have secondary responsibilities which will allow for continuous improvement in the role and professional development. Secondary responsibilities are essential to advocate’s success and may include:

Assisting less seasoned peers by helping answer questions

Participating in staff meetings and in-service seminars

Initiating tasks in order to make improvements to current workflows that parallel with CBH’s mission.

Developing an action plan for professional development

Working with matrix partners, leadership and peer group to help ensure processes are up to date and effective

Participating in team building activities to boost morale

Completing additional assigned projects and tasks

Maintaining a high level of working knowledge about CBH’s customers and products.

Expectations:

Stay within the role for a minimum of 1 year

Actively engage with customers in a positive, professional and empathic manner = 100 % goal

Provide high quality customer service = no more then six off-target call scores within a full calendar year (pro-rated)

Follow appropriate workflows and HIPAA guidelines = 100% goal

Adhere to a pre-determined daily schedule = 92% goal

Be on time with minimal unexcused absences = Adhere to Cigna Standard Policies

Be professional and communicate effectively with internal and external matrix partners = receives consistent positive feedback

Required qualifications

Bachelor’s degree in mental health field or psychology/social work related field (can also include: family communications, health coaching, community/public health or other related major). This is a non-clinical role and does not require a license

Previous customer service experience or related position

Superb interpersonal communication

Effective listening and organizational skills

Ability to manage multiple tasks, setting priorities where needed

Independently problem solve, with ability to function without constant supervision

A demonstrated ability to type effectively; with strong PC skills/word processing experience and ability to learn new computer software systems

Ability to learn new workflows and tasks quickly

Ability to work independently and be a team player

Preferred qualifications

Leadership skills

Masters degree in mental health field or psychology/social work related field

Previous call center environment experience

Creative and innovative thinking