全职 Case Management Associate Analyst 工作, 薪水, The Cigna Group Federal Territory 公司招聘中 - Ricebowl

Job Description :

You are the key person for CARE Coordination files IOH, where you are working together with all parties involved, internal as well as external. This implies that:

• you take care of the communication with health care providers in order to obtain all the necessary (medical and administrative) information;
• you are in close contact with the insured/patient (i.e. comfort calling);

• you will contact the client’s organization if needed; • you negotiate high costs with providers and doctors,

• you steer patients to the right care giver,
• you explore cost containment opportunities together with the colleagues from Claims Review;
• you work closely with the other organizations (i.e. Network, Fraud Waste and Abuse, Clinical Case Management);
• registering cost containment achievements in dedicated tools and formats,
• clarifying files to authorized parties;
• Issuance of guarantee of payments (GOP) in complex files.
• You coordinate out of country care files and Evacuations mainly is Asia Region, together with other Cigna departments and external assistance providers.
• All our clients and healthcare providers are internationally located. Therefore you manage the English language well, both spoken and written.

Profile:

Active and fluent in at least English any other language is an asset (French is highly recommended) .

At least 1 year experience in IOH Care Team and 1 year in current role completed is a MUST.

• Strong negotiation skills, (i.e. a strong focus on cost containment without never losing sight of commercial benefits and maintaining provider relationships),
• Strong coordinating skills (i.e. accurate, efficient, assimilate different information, critical, negotiating, communicative, skilled decision maker, ...)
• Written skills: conveys messages in clear language, paying attention to accent/circumstances
• and appropriate style
• Customer-focused: communicates empathically
• Accurate: works accurately by giving complete and correct answers
• Responsible: ensures that assigned contracts are followed up in a diligent, timely and accurate manner.
• Disciplined: follows procedures, agreements and document flows correctly
• Efficient: able to strike the right balance between quality and quantity

• Team-player: enjoys working as part of a team • Discrete: exercises utmost discretion when dealing with confidential (medical) information Specific Knowledge:

• Use of necessary reference works
• Knowledge of Microsoft Office- and proprietary IT application

About The Cigna Group

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.