Case Management Analyst – LPN

🔥 20 hours ago

🇺🇸 United States – Remote

💵 $24 - $37 / hour

⏰ Full Time

🟢 Junior

🧐 Business Analyst

👻 Ghost score 0%

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The Cigna Group

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1982

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Healthcare • Healthcare Insurance • Pharmaceuticals

The Cigna Group is a global health company committed to improving the health and vitality of its clients, customers, and patients. With its two divisions, Cigna Healthcare and Evernorth Health Services, the company focuses on enhancing quality of life through healthcare services and pharmacy benefits management. The Cigna Group is dedicated to ethical practices in healthcare and artificial intelligence, and strives to create positive change in the healthcare system. It also emphasizes its Environmental, Social, and Governance (ESG) responsibilities, aiming to impact health equity and foster innovation in healthcare delivery.

📋 Description

• Assess clinical information and identify members who may benefit from case management • Conduct initial outreach and engagement activities • Gather information, identify immediate needs, and facilitate referrals to case management, disease management, or community resources • Coordinate referral requests and apply clinical policies and guidelines • Support pre- and post-surgical planning, discharge follow-up, and referrals to chronic care or disease management programs • Serve as a resource for referrals to specialized vendor partners while following client-specific requirements • Communicate information to members, providers, and internal partners • Document each interaction in the appropriate system • Meet quality assurance, protocol, and documentation standards • Solve problems and manage competing priorities • Share knowledge, support training, contribute to meetings or committees, and complete improvement work • Build expertise in claims processes, benefit documents, and evolving technology to make accurate and consistent decisions

🎯 Requirements

• Active, unrestricted LPN or LVN license in your primary state of residence • Minimum of 1 year of clinical practice experience • Experience in Maternity Management, Pre/Post Surgical, or Oncology preferred • Ability to review and apply clinical information, benefit documents, policies, and procedures to individual situations • Strong written, verbal, listening, organization, and follow-through skills • Ability to manage multiple priorities, meet deadlines, and make sound decisions with professionalism and patience • Basic computer skills, including Microsoft Windows and Word, with the ability to learn and adapt to new software • Experience in case management, care coordination, discharge planning, claims review, or a health plan setting preferred • Knowledge of claims processing procedures and quality assurance requirements preferred • Experience serving as a trainer, preceptor, subject matter expert, or committee contributor preferred • Home internet connection 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 starting on 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 • Remote work/home-based arrangement • Cable broadband or fiber optic internet requirement for home working