RN - Maternity / NICU Case Manager - Remote

Cigna Healthcare•Pittsburgh, PA

2d•Remote

About The Position

The RN Case Manager plays a critical role in delivering Cigna’s whole‑person health strategy by serving as a trusted advocate and clinical partner for customers, families, and caregivers. This role focuses on care coordination, customer engagement, and health navigation to improve outcomes and deliver exceptional customer experience. The Case Manager demonstrates Cigna’s Care Solutions cultural beliefs, acting with accountability, collaboration, compassion, and innovation in support of both customer needs and business objectives. How You’ll Make an Impact Partner with customers to assess needs, develop individualized care plans, and document interventions and outcomes in Cigna medical management systems. Collaborate with customers and providers to establish goals, interventions, and evidence‑based plans of care. Apply motivational interviewing, behavior change strategies, and shared decision‑making to drive engagement and improved health outcomes. Empower customers to effectively navigate the healthcare system and communicate with providers. Coordinate care across customers, caregivers, providers, and internal partners via phone and digital channels (email, text, chat). Collaborate with interdisciplinary teams—including pharmacists, nutritionists, behavioral clinicians, Medical Directors, and Medical Management programs—to support whole‑person health. Track, analyze, and document daily activity, volume, and outcomes to support performance and quality goals. Follow established policies, procedures, and Case Management performance measures. Efficiently navigate multiple systems and applications in a fast‑paced, customer‑focused environment. Complete required training and maintain clinical knowledge, licensure, and certifications.

Requirements

Active, unrestricted Registered Nurse (RN) license in a U.S. state or territory.
Minimum of two (2) years of full‑time direct patient care experience as an RN.
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

Specialty case management experience, with Maternity / NICU experience preferred for specialty roles.
Ability to obtain a URAC‑recognized Case Management certification within four (4) years of hire.
Strong clinical judgment with the ability to assess risk, prioritize care, and act decisively.
Excellent verbal and written communication skills across phone and digital platforms.
Proficiency in Microsoft Word, Excel, Outlook, and online research tools.
Demonstrated ability to resolve conflict, collaborate across teams, and interact with diverse populations.
Strong organizational skills, adaptability, and comfort managing multiple complex cases simultaneously.

Responsibilities

Partner with customers to assess needs, develop individualized care plans, and document interventions and outcomes in Cigna medical management systems.
Collaborate with customers and providers to establish goals, interventions, and evidence‑based plans of care.
Apply motivational interviewing, behavior change strategies, and shared decision‑making to drive engagement and improved health outcomes.
Empower customers to effectively navigate the healthcare system and communicate with providers.
Coordinate care across customers, caregivers, providers, and internal partners via phone and digital channels (email, text, chat).
Collaborate with interdisciplinary teams—including pharmacists, nutritionists, behavioral clinicians, Medical Directors, and Medical Management programs—to support whole‑person health.
Track, analyze, and document daily activity, volume, and outcomes to support performance and quality goals.
Follow established policies, procedures, and Case Management performance measures.
Efficiently navigate multiple systems and applications in a fast‑paced, customer‑focused environment.
Complete required training and maintain clinical knowledge, licensure, and certifications.