Complex Nurse Case Manager

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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

• 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 navigate the healthcare system and communicate with providers • Coordinate care across customers, caregivers, providers, and internal partners via phone and digital channels • Collaborate with interdisciplinary teams, including pharmacists, nutritionists, behavioral clinicians, Medical Directors, and Medical Management programs • Track, analyze, and document daily activity, volume, and outcomes to support performance and quality goals • Follow established policies, procedures, and Case Management performance measures • 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 your state of residency • Minimum of two (2) years of full-time direct patient care experience as an RN • Specialty case management experience preferred; complex experience preferred for specialty roles • Ability to obtain a URAC-recognized Case Management certification within four (4) years of hire • Strong clinical judgment 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 • Ability to resolve conflict, collaborate across teams, and interact with diverse populations • Strong organizational skills and adaptability • Comfort managing multiple complex cases simultaneously • For home work, cable broadband or fiber optic internet service with at least 10Mbps download and 5Mbps upload

🏖️ Benefits

• Annual bonus plan eligibility • Medical benefits • Vision benefits • Dental benefits • 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