Job Description

Role must be flexible on start and stop shift times. Work at home position.

Major responsibilities and desired results:

• Obtains informed verbal consent and takes all steps to obtain written consent as appropriate.
• Establishes a collaborative relationship with client (plan participant/member), family, physician(s), and other providers to determine medical history and current status and to assess the options for optimal outcomes.
• Promote consumerism through education and health advocacy.
• Assesses member\xe2\x80\x99s health status and treatment plan and identifies any gaps or barriers to healthcare. Establishes a documented patient centric case management plan involving all appropriate parties (client, physician, providers, employers, etc), identifies anticipated case results/outcomes, criteria for case closure, and promotes communication within all parties involved.
• Implements, coordinates, monitor and evaluates the case management plan on an ongoing, appropriate basis.
• Negotiates level of care, intensity and duration with provider(s), as appropriate.
• Acts as a timely and proactive liaison between account, client/family, physician(s) and facilities/agencies
• Maintains accurate record (system) of case management interventions including cost/benefit analysis, savings, and data collection.
• Adheres to professional practice within scope of licensure and certification quality assurance standards and all case management policy and procedures
• Compliant with all accreditation, State and Federal mandates
• Delivers utilization review services when member is in active case management as appropriate
• Participates in unit and corporate training initiatives and demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate.
• Demonstrates sensitivity to culturally diverse situations, clients and customers.
• Based on experience, may provide leadership, preceptor/mentorship, support and coverage to other case management staff and assist case managers in achieving positive outcomes and savings
• Engage our CAC partner (Embedded Care Coordinator) to support service to our customers.
• Additionally the candidate will be responsible for the adoption and demonstration of the Consumer Health Engagement cultural beliefs. They will be responsible for role modeling the six cultural beliefs to drive personal accountability and organizational results.

Qualifications:

• Active unrestricted Registered Nurse (RN) license required
• Eligibility to obtain additional state licensure based on business need as required by Cigna.
• Certification as a case manager preferred
• Minimum of three years full-time direct clinical care to the consumer
• Clinical experience in acute care required
• Excellent time management, organizational, research, analytical, negotiation, communication (oral and written) and interpersonal skills
• Strong computer skills required on an intermediate to advanced level
• Must have access to high-speed broadband wired internet with a modem/router. Cigna does not support hot spots or satellite-based internet or hot spots for this position

This role is WAH which allows work to be performed at home. Employees must be fully vaccinated if they choose to come onsite.

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.

For this position, we anticipate offering an annual salary of 70,400 - 117,300 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That\xe2\x80\x99s why you\xe2\x80\x99ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you\xe2\x80\x99ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 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. For more details on our employee benefits programs, visit .

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Cigna