The Cigna Group
The Cigna Group
The Cigna Group एक वैश्विक स्वास्थ्य सेवा कंपनी है, जो Cigna Healthcare और Evernorth Health Services के माध्यम से कार्य करती है। इसका काम स्वास्थ्य सेवाओं, स्वास्थ्य बीमा और फार्मेसी लाभ प्रबंधन को एकीकृत करके ग्राहकों, क्लाइंट्स और रोगियों के स्वास्थ्य एवं कल्याण में सहायता करना है। कंपनी नैतिक स्वास्थ्य सेवा और कृत्रिम बुद्धिमत्ता से जुड़ी प्रथाओं, स्वास्थ्य समानता, जिम्मेदार पर्यावरणीय और सामाजिक शासन तथा स्वास्थ्य सेवाएं प्रदान करने के तरीकों में नवाचार पर भी ध्यान केंद्रित करती है।

Senior RN Case Management Analyst, United States Remote

Guide complex cases across Cigna Healthcare’s care continuum as an RN case manager, coordinating providers, benefits, and resources to improve outcomes and limit avoidable costs.

विवरण

  • Manage complex cases from initial intake through resolution
  • Connect clinical needs with benefits and community resources to support safe, timely care
  • Work with members, families, providers, and internal teams to set goals and monitor health outcomes
  • Coordinate care across inpatient, rehabilitation, outpatient, and preventive settings
  • Refine care plans as member needs evolve
  • Apply utilization review and thorough documentation to verify service criteria and maximize benefits
  • Educate members about conditions, treatment options, and next steps
  • Refer quality-of-care concerns and complex clinical questions to the Medical Director
  • Contribute to quality reviews and facilitate risk meetings when needed
  • Coach and support newly hired team members

आवश्यकताएँ

  • Hold an active, state-appropriate Registered Nurse license
  • Have an Associate Degree in Nursing (ASN) or higher
  • Hold a compact nursing license if residing in a Nursing Compact state
  • Bring at least three years of recent clinical practice in Oncology, Behavioral Health, Inpatient, Critical Care, or Med/Surg
  • Demonstrate strong care planning, care coordination, and patient advocacy skills across the continuum of care
  • Communicate clearly and respectfully in writing and conversation
  • Use a PC, Windows, and Microsoft Word comfortably, with the ability to learn new systems
  • Previous case management experience is preferred
  • A Certified Case Manager (CCM) credential is preferred, or must be obtainable within 12 months of hire
  • Experience interpreting benefit plan documents and applying guidelines is preferred
  • Quality improvement or training and mentorship experience is preferred
  • Maintain home cable broadband or fiber optic internet with at least 10 Mbps download and 5 Mbps upload speeds

लाभ

  • Eligible for the annual bonus plan
  • Medical, vision, and dental coverage begins on the first day
  • Access to well-being and behavioral health programs
  • 401(k) retirement plan
  • Company-paid life insurance
  • Tuition reimbursement
  • At least 18 days of paid time off each year
  • Paid holidays
  • Leaves of absence
  • Work-from-home arrangement
  • Home work requires cable broadband or fiber optic internet

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