RN Care Coordinator - Evernorth - Houston TX

Cigna Healthcare•Houston, TX

19d•Onsite

About The Position

The RN Care Coordinator supports Evernorth Workplace Care by coordinating personalized care for employees, particularly high-risk populations, and connecting customers with eligible Cigna Healthcare and client-specific health and wellness programs. The role acts as a central link among employers, primary care providers, onsite health clinics, Evernorth programs, and other clinical partners to promote appropriate, efficient, high-quality, and cost-effective care. The coordinator reviews patient-level data to identify people for outreach, engagement, care coordination, and referrals. The role maintains timely and compliant documentation, identifies care gaps, supports referrals to complex or specialty case management, and connects customers with network providers, onsite health services, and community resources. The position is based in downtown Houston, Texas.

Requirements

Current unrestricted Texas RN license and ability to maintain licensure.
Three or more years of clinical practice experience.
Current BLS/CPR/AED certification.
Excellent oral and written communication skills.
Excellent computer skills, including Microsoft Outlook, Word, and Excel.
Excellent interpersonal skills and ability to work in a team environment.
Flexibility and enthusiasm for learning new information and developing skills quickly.
Ability to communicate comfortably with multiple clinical partners.
Ability to work independently and self-direct.
Strong problem-solving skills.
Passion for helping members improve their health and navigate the healthcare system.
If working from home occasionally or permanently, internet service must be cable broadband or fiber optic with speeds of at least 10 Mbps download and 5 Mbps upload.

Nice To Haves

Multistate licensure.
Case management experience.
Commitment to ongoing education.
Experience working with high-risk patients.
Experience in project development and working in a matrix environment.
CHES or NBHWC certification.
Health coaching experience, including chronic disease management.
Dynamic presentation skills and a high energy level.
Positive role model in demonstrating healthy behaviors.

Responsibilities

Identify and refer customers to eligible Cigna Healthcare and client-specific health and wellness programs.
Coordinate care for individual customers and high-risk populations in an appropriate, efficient, high-quality, and cost-effective manner.
Refer customers to appropriate clinical partners, including complex case management and specialty case management.
Serve as a central conduit among employers, providers, onsite health clinics, and Evernorth programs and resources.
Follow processes for reviewing patient-level actionable data and reports to identify customers for outreach and engagement.
Maintain timely, compliant, and efficient documentation and information exchange to support outreach, engagement, and positive clinical outcomes.
Communicate with matrix partners and refer customers to appropriate internal and external programs.
Identify cases appropriate for complex case management and follow referral processes.
Work with Evernorth’s internal team to coordinate care and support data analysis.
Build relationships with local network providers and guide customers to high-quality network providers and the onsite health center.
Identify gaps in care and work with providers or community resources to close them.
Maintain positive, professional, and collaborative relationships with customers and employees, employers, providers, and Evernorth partners.
Coordinate with health management matrix partners on additional engagement and promotion opportunities.
Direct customers with specific non-clinical questions to the appropriate resource.