RN Collaborative Care - Evernorth - Houston TX

Cigna Healthcare•Houston, TX

1d•Remote

About The Position

Evernorth Workplace Care offers health care delivery services along with population health and health coaching solutions, conducted in person or virtually. Our mission is to deliver proactive, personalized, and holistic patient care and coaching by acting on health data and insights to improve the overall health and wellness of our clients’ employees, and those they care about most, by providing access to high quality, affordable services where they work and live. Our Evernorth Workplace Care solution isn’t a one-size-fits-all model. Using data-driven insights, we’ll customize a solution that addresses your organization’s most pressing needs—creating a more affordable, predictable, and simple health care experience. Evernorth Workplace Care - Personalized Care Where You Are Sound like you? Great! Here’s more on how you’ll make a difference: Identifies and refers appropriate customers to eligible programs within CIGNA Healthcare (CHC) and all eligible client specific health and wellness programs. Supports Care Coordination of the individual customer. Coordinates the care of the high-risk targeted population in an appropriate, efficient, high quality and cost-effective manner. Refers to appropriate clinical partners (i.e. complex case management and / or Specialty Case management) Partners, and functions as central conduit between employer, provider (PCP, Onsite Health Clinic) and all available Evernorth programs and resources. Supports established processes and procedures that ensures thorough review of patient level actionable data and reports used to support identification of customers for outreach and engagement. Assure and maintains timely, compliant, efficient documentation and information exchange to drive appropriate outreach, engagement and positive clinical outcomes with aligned population. Communicates clearly with all matrix partners and refers to appropriate internal and external programs to support outcomes. Identifies cases appropriate for complex case management and follows process for referral. Works effectively with Evernorth's internal team to support coordination of care and data analysis. Identifies and builds effective relationships with local network providers. Provides steerage to high quality network providers and referrals to the onsite health center. Identifies gaps in care and works with providers and/ or local community resources to close gaps in care. Establishes and maintains a positive, professional, and collaborative relationship with customer/employee, employer, providers of care, and Evernorth partners to support improved outcomes (clinical, quality and cost) of aligned employee population. Partners and coordinates with health management matrix partners for additional engagement and promotion opportunities Act as resource to direct customers with specific non-clinical questions to the appropriate resource. This position is with Evernorth, a new business within the Cigna Corporation.

Requirements

RN with current unrestricted state licensure within home state.
Must have three or more years of clinical practice experience
A high energy level with excellent oral and written communication skills.
Excellent Computer skills [specific software e.g. Word and Excel]
Excellent interpersonal skills. Must be able to work in a team environment and exhibit flexibility and enthusiasm in learning new information and developing new skills quickly.
Comfortable communicating with multiple clinical partners (direct care, Onsite Health, and telephonic coaching and case management teams).
Self-directness and the ability succeed in an independent role.
Current BLS/CPR/AED Certification
Passion for assisting members with health improvement and navigation of the Health Care System.
Must have strong problem-solving 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.

Nice To Haves

Case Management experience is preferred
Demonstrate commitment to ongoing education preferred.
Experience working with high-risk patients preferred.
Experience in project development and working in a matrix environment preferred.
CHES
Health Coaching experience including chronic disease management
High energy level, with dynamic presentation skills is required.
Positive role model in demonstrating healthy behaviors

Responsibilities

Identifies and refers appropriate customers to eligible programs within CIGNA Healthcare (CHC) and all eligible client specific health and wellness programs.
Supports Care Coordination of the individual customer.
Coordinates the care of the high-risk targeted population in an appropriate, efficient, high quality and cost-effective manner.
Refers to appropriate clinical partners (i.e. complex case management and / or Specialty Case management)
Partners, and functions as central conduit between employer, provider (PCP, Onsite Health Clinic) and all available Evernorth programs and resources.
Supports established processes and procedures that ensures thorough review of patient level actionable data and reports used to support identification of customers for outreach and engagement.
Assure and maintains timely, compliant, efficient documentation and information exchange to drive appropriate outreach, engagement and positive clinical outcomes with aligned population.
Communicates clearly with all matrix partners and refers to appropriate internal and external programs to support outcomes.
Identifies cases appropriate for complex case management and follows process for referral.
Works effectively with Evernorth's internal team to support coordination of care and data analysis.
Identifies and builds effective relationships with local network providers.
Provides steerage to high quality network providers and referrals to the onsite health center.
Identifies gaps in care and works with providers and/ or local community resources to close gaps in care.
Establishes and maintains a positive, professional, and collaborative relationship with customer/employee, employer, providers of care, and Evernorth partners to support improved outcomes (clinical, quality and cost) of aligned employee population.
Partners and coordinates with health management matrix partners for additional engagement and promotion opportunities
Act as resource to direct customers with specific non-clinical questions to the appropriate resource.