Offer summary

Qualifications:

Licensed Speech Therapist in state of employment, Minimum of ten years of clinical experience, Experience with pediatric and adult patients preferred, Strong computer skills.

Key responsabilities:

Interact with providers on clinical issues and non-certification matters

Perform prospective, retrospective, and concurrent reviews

Conduct peer to peer consultations

Participate in the Grievance and Appeals Process

Job description

Responsibilities:

Interact with providers on clinical issues and matters related to non-certification and other clinical issues as well as interaction with non-clinical staff and acts as an intermediary with the department Director. Responsible to perform prospective, retrospective and concurrent review consistent with eviCore clinical review protocols and URAC standards. Responsible to perform peer to peer consultations. Comprehension of the principles and procedures of utilization management of the AAHCC/URAC standards. Full knowledge and understanding of eviCore’s clinical guidelines/medical policies. Interpret clinical data as applicable. Participate in Grievance and Appeals Process. Other duties as necessary.

Minimum Experience:

Licensed Speech Therapist in state of employment

Minimum of ten (10) years of clinical experience

Experience with pediatric and adult patients preferred

Clinical review experience prefferred

Strong computer skills

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 30 - 50 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com 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.

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