(RN) Nurse Case Management Lead Analyst - Evernorth Health Services -Remote

Cigna

271d • $76,600 - $127,600 • Hybrid

About The Position

Nurse Case managers are healthcare professionals, who serve as customer advocates to coordinate, support, and guide care for our customers, families, and caregivers to assist with navigating through the healthcare journey. Additionally, the candidate will be responsible for the adoption and demonstration of the Care Solutions cultural beliefs. They will be responsible for role modeling the six cultural beliefs to drive personal accountability and organizational results.

Requirements

• Active unrestricted Registered Nurse (RN) license in state or territory of the United States.
• Minimum of two years full-time direct patient care setting as an RN required.
• Must be flexible to work days or evenings based on business needs.

Nice To Haves

• Available to work evenings after 11:30 a.m. with a 12% shift differential.
• Must have an active and unencumbered RN License in the State of Residence.
• Within four (4) years of hire as a case manager will possess a URAC-recognized certification in case management.
• Excellent communication skills including telephonic (verbal) and digital (messaging, emails).
• Skilled in clinical acumen to form a judgement and act.
• Strong computer skills in Microsoft Word, Excel, Outlook, and ability to perform thorough internet research.
• Ability to recognize, address and resolve conflicts in a professional, collaborative manner.
• Demonstrates sensitivity to culturally diverse situations, participants, and customers.
• Demonstrates effective organizational skills and flexibility to meet the business needs.
• Adapts approach and demeanor in real time to match the shifting demands of different situations.
• Ability to manage multiple, complex situations in a fast-paced environment collaborating with clinical and other business partners.

Responsibilities

• Collaborates with customer in creation of care plan and documents plan in medical management system.
• Partners with each customer to establish goals and interventions to meet the customer's needs.
• Establishes plan of care in conjunction with the customer and provider then document into a medical management system.
• Utilizes motivational interviewing, behavior change, and shared decision making to help customers achieve optimal health and well-being.
• Empowers customers with skills to enhance interaction with their providers.
• Interfaces with the customer, family members/caregivers, providers, and internal partners to coordinate the needs of the customer through telephonic, email, text, and chat interactions.
• Collaborates with nutritionist, pharmacist, behavioral clinician, Medical Director and customer's provider and other Cigna Medical Management programs to provide whole-person health support.
• Tracks daily activities to trend volume and outcomes.
• Follows standard operating procedures.
• Toggles between multiple systems and applications.
• Research relevant topics in health promotion and disease prevention, as required for specific customers.
• Prioritizes work to meet commitments aligned with organizational goals.
• Understands and adheres to Case Management performance measures to deliver on key results.
• Completes training within the communicated time limit as required per role.
• Demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate.

Benefits

• Comprehensive health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree