Care Solutions Member Advocate - Evernorth Health Services - Remote

Cigna; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

Cigna is seeking a Care Solutions Member Advocate for a full-time remote position. The role involves engaging with members regarding their healthcare needs, educating them about available programs, and ensuring high-quality service. Candidates should have a high school diploma, with a preference for a Bachelor's degree and experience in healthcare or customer service.

Benefits

Comprehensive health benefits

401(k) with company match

Tuition reimbursement

Paid time off

Qualifications

• High school diploma or equivalent required.
• Bachelor’s Degree strongly preferred.
• Previous experience in a healthcare field preferred.

Responsibilities

• Engagement and education of clinical programs with all members.
• Responsible for meeting phone metrics and quality indicators.
• Initiates the complaint process.

Skills

Customer service

Communication

Flexibility

Education

High school diploma or equivalent

Bachelor’s Degree

Job description

Care Solutions Member Advocate - Evernorth Health Services - Remote

This is a full-time, Telephonic, remote work at home role. Employees must conduct business in a secure area in their home, ensuring that discussions are confidential and cannot be overheard by others.

The Personal Advocate performs duties related to the engagement of members for various medical and health conditions. The personal advocate is responsible for representing Cigna on all outbound and/or inbound calls through education to members in regards to available programs and services. Provides suitable educational materials and refers to appropriate programs based on the caller’s needs.

Main Responsibilities:

• Engagement and Education of clinical programs with all members.
• Ability to listen and stay focused on the member while using various systems to verify and document data.
• Ability to be flexible and adapt to changing workflows in a fast-paced environment.
• Educate participants with respect to presenting issues and the parameters of services.
• Responsible for meeting phone metrics and quality indicators at 90% or greater each month.
• Initiates the Complaint process.
• Demonstrates awareness and understanding of the responsibilities and workflows of the various departments within the site.
• Assigns cases to the appropriate staff member based on specific guidelines
• Participates and actively contributes in staff meetings and in-service seminars.
• Completes additional tasks and projects as assigned.

Qualifications:

• High school diploma or equivalent required
• Bachelor’s Degree strongly preferred.
• Previous experience in a healthcare field preferred.
• Customer service and/or call center experience preferred.
• Training is 6 weeks long and will have a day shift schedule. No vacation time is allowed during training.

This is a full-time, Telephonic, remote work at home role. Employees must conduct business in a secure area in their home, ensuring that discussions are confidential and cannot be overheard by others.

The Personal Advocate performs duties related to the engagement of members for various medical and health conditions. The personal advocate is responsible for representing Cigna on all outbound and/or inbound calls through education to members in regards to available programs and services. Provides suitable educational materials and refers to appropriate programs based on the caller’s needs.

Main Responsibilities:

• Engagement and Education of clinical programs with all members.
• Ability to listen and stay focused on the member while using various systems to verify and document data.
• Ability to be flexible and adapt to changing workflows in a fast-paced environment.
• Educate participants with respect to presenting issues and the parameters of services.
• Responsible for meeting phone metrics and quality indicators at 90% or greater each month.
• Initiates the Complaint process.
• Demonstrates awareness and understanding of the responsibilities and workflows of the various departments within the site.
• Assigns cases to the appropriate staff member based on specific guidelines
• Participates and actively contributes in staff meetings and in-service seminars.
• Completes additional tasks and projects as assigned.

Qualifications:

• High school diploma or equivalent required
• Bachelor’s Degree strongly preferred.
• Previous experience in a healthcare field preferred.
• Customer service and/or call center experience preferred.
• Training is 6 weeks long and will have a day shift schedule. No vacation time is allowed during training.

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 hourly rate of 24 - 36 USD / hourly, 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. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’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 Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. 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: [e-mail] for support. Do not email [e-mail] 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.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

About the company

Cigna is an American worldwide health services organization based in Bloomfield, Connecticut.

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