The EAP Clinical Consultant will act as the operational clinical SME for EAP/Employer Services supporting processes workflows escalations and strategic initiatives. This role will interface with matrix partners (e.g. Account Managers Sales Product Claims Provider Relations) to ensure alignment between operational capabilities and client expectations thereby enhancing retention and satisfaction.
Serve as the primary point of contact for internal partners regarding EAP clinical operations (member and employer services).
Provide consultative support during implementation of new EAP accounts including clarification of protocols (e.g. CISM DOT/SAP FFD Nuclear Screening).
Lead coordination of optional services rollouts ensuring operational readiness and accurate system configuration (e.g. OLAM Groups & Benefits).
Investigate and resolve escalated clinical service delivery issues from clients brokers and internal teams.
Collaborate with matrix partners to identify root causes implement corrective actions and ensure service recovery.
Maintain and analyze the Employer Services Log Repository to track trends and inform improvements.
Act as operational/clinical liaison for key EAP vendors (e.g. WPO CLC MSA PsyBar R3 Continuum).
Address service issues coordinate quarterly/annual reviews and support workflow enhancements.
Own support and maintain EAP-related communication templates and program materials (e.g. ROI forms customer letters IRIS site manager microsite).
Partner with Compliance and Privacy teams to ensure all external communications meet regulatory standards.
Participate in cross-functional initiatives such as Enhancing Clinical Value Disaster Readiness and EAP/Confide Migrations.
Represent EAP in governance and advisory committees (e.g. Behavioral Technical Writing EBH Escalation Advisory Board).
Provide education to Account Management teams on EAP workflows protocols and operational solutions.
Support finalist presentations and RFP/RFI responses related to Employer Services.
Licensed behavioral health clinician (e.g. LCSW LPC LMFT PhD/PsyD) preferred.
Deep understanding of EAP clinical operations employer services and behavioral health systems.
CEAP Certification required within 2 years of role attainment.
Strong analytical problem-solving and communication skills.
Experience managing escalations and service recovery in a matrixed environment.
Proficiency in systems such as OLAM TruCare PMRS DG/CAMs and CART.
This role will report to the Senior Manager of Case Management and collaborate closely with EAP leadership clinical operations and account management teams.
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. Thats why youll enjoy a comprehensive range of benefits with a focus on supporting your whole health. Starting on day one of your employment youll 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: for support. Do not email 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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Cigna Healthcare offers health insurance plans such as medical and dental to individuals and employers, international health insurance, and Medicare coverage.