Job Description
The Medicare Care Management HRA Support Specialist is responsible for outreaching to Cigna Healthcare Medicare customers to screen health, lifestyle, care coordination needs and engage them in internal Care Management programs. Job related functions include telephonic customer outreach to complete health screenings, educating customers on available benefits, coordinating with internal teams to ensure timely hand-off to appropriate care teams, and maintaining documentation for regulatory review. The HRA Navigator must ensure all necessary information is collected, reviewed, and processed according to established policies.
Potential activities that may occur during telephonic customer interaction will vary, but may include :
- Completing telephonic HRA assessments or processing incoming mailed or faxed HRAs
- Assisting with the scheduling of medical appointments
- Connecting customers to case management and community resources
- Addressing gaps in care and educating customer on having an annual face to face visit with their provider.
- Educating customers on plan benefits
- Routing customer referrals to appropriate care management team based on identified needs.
- Escalating customer concerns or issues appropriately
Requirements :
- Possesses strong written and verbal communication skills with a focus on top- quality customer service and health care coordination.
- Empathetic attitude with ability to offer emotional support.
- Experience and knowledge of multiple aspects of the health care system.
- Excellent listening skills
- Helps customers identify problems or barriers and navigate health care resources.
- Passion for the proper care and well-being of customers
- Proficient in computer application skills and navigation, including email (Outlook), spreadsheets (Excel), Word processing, and data input, including ability to utilize dual monitors.
- Works well in a team approach with strong interpersonal skills
- Ability to handle multiple tasks, set priorities and develop action items. Detail oriented.
- Knowledge of regulatory requirements with emphasis on Medicare
- High school diploma, college degree preferred or equivalent managed care experience.
- 1+ years experience in managed care or related work in Health Services with emphasis on population management preferred.
- 1+ years experience with processes that involve telephone contact and process management preferred.