RN Care Coordinator - Evernorth - Houston TX

Cigna Group•Houston, TX

18d

About The Position

Evernorth Workplace Care delivers health care, population health, and health coaching services in person or virtually. The RN Care Coordinator supports personalized patient care and coaching by using health data and insights to improve the health and wellness of clients’ employees. This role coordinates care for individual customers and high-risk populations, connecting employees, employers, providers, and Evernorth programs and resources to promote appropriate, efficient, high-quality, cost-effective care and positive clinical outcomes. The position is based in downtown Houston, Texas. If working from home occasionally or permanently, the internet connection must be through a cable broadband or fiber optic provider with speeds of at least 10 Mbps download and 5 Mbps upload.

Requirements

Current, unrestricted Texas RN state licensure; ability to maintain multistate licensure is preferred.
At least three 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 new skills quickly.
Comfort communicating with multiple clinical partners.
Self-direction and ability to succeed in an independent role.
Strong problem-solving skills.
Passion for helping members improve their health and navigate the health care system.
High energy level and dynamic presentation skills.
Positive role model in demonstrating healthy behaviors.
If working from home occasionally or permanently, access to cable broadband or fiber optic internet with at least 10 Mbps download and 5 Mbps upload.

Nice To Haves

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.

Responsibilities

Identify and refer appropriate customers to eligible Cigna Healthcare and client-specific health and wellness programs.
Support care coordination for individual customers and coordinate appropriate, efficient, high-quality, cost-effective care for targeted high-risk populations.
Refer customers to appropriate clinical partners, including complex case management and specialty case management.
Serve as a central conduit among employers, providers such as primary care physicians and onsite health clinics, and available Evernorth programs and resources.
Use established processes to review patient-level actionable data and reports, supporting identification of customers for outreach and engagement.
Maintain timely, compliant, 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 the referral process.
Work with Evernorth's internal team to coordinate care and support data analysis.
Build effective relationships with local network providers, guide customers toward high-quality network providers, and refer them to the onsite health center.
Identify gaps in care and work with providers or local community resources to close them.
Maintain positive, professional, collaborative relationships with customers and employees, employers, care 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.