Nurse Case Management Lead Analyst

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $77.5k - $129.1k / year

⏰ Full Time

🟠 Senior

🧐 Analyst

👻 Ghost score 0%

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The Cigna Group

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛡️ Insurance

Healthcare • Insurance

The Cigna Group is a global health services company that provides medical, dental, pharmacy, behavioral and supplemental insurance products and benefits to individuals, families, employers, brokers, providers and Medicare beneficiaries. It offers employer-sponsored group plans, individual and family plans (including Open Enrollment offerings), Medicare, international health insurance covering more than 200 countries, and digital member services through the myCigna platform (including telehealth and claims management). Its products are delivered through operating subsidiaries such as Cigna Health and Life Insurance Company and other regional affiliates.

📋 Description

• Provides advanced professional input to complex Nurse Case Management assignments and projects • Plans, implements, and evaluates appropriate health care services in conjunction with physician treatment plans • Handles complex, high-acuity, and account-sensitive cases involving the largest reserves • Assesses, plans, implements, coordinates, monitors, and evaluates options and services to facilitate appropriate healthcare outcomes • Evaluates alternative care services to ensure program objectives, cost-effective care, and quality care are maintained • Performs prospective, concurrent, and retrospective reviews for inpatient acute care, rehabilitation, referrals, and select outpatient services • Reviews initial liability disability claims when needed • Leads implementation of new tools or case management programs and initiatives • Manages own caseload and coordinates assigned cases • Supports and provides direction to more junior professionals • Works autonomously and applies expert judgment to complex techniques and procedures • Develops models and procedures and monitors trends within Nurse Case Management

🎯 Requirements

• Registered Nurse (RN) license in state of primary residence • BSN preferred • Compact nursing license preferred • Minimum 2 years of nursing experience in prior authorizations or case management preferred • Proficiency with Microsoft Office • Basic database navigation • Knowledge of pharmacy and pharmaceuticals preferred • Ability to manage multiple priorities • Ability to work independently • Ability to collaborate effectively across teams • Home internet through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload

🏖️ Benefits

• Annual bonus plan eligibility • Medical, vision, and dental benefits from day one • Well-being and behavioral health programs • 401(k) • Company-paid life insurance • Tuition reimbursement • Minimum of 18 days of paid time off per year • Paid holidays • Leaves of absence • Work-at-home arrangement • Cable broadband or fiber optic internet service with at least 10Mbps download/5Mbps upload required for home working