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The Cigna Group
The Cigna Group
HealthcareHealthcare InsurancePharmaceuticals
The Cigna Group is a global healthcare company operating through Cigna Healthcare and Evernorth Health Services. Its work combines healthcare services, health insurance, and pharmacy benefits management to support the health and wellbeing of customers, clients, and patients. The company also focuses on ethical healthcare and artificial intelligence practices, health equity, responsible environmental and social governance, and innovation in how care is delivered.
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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.

USUnited States
$57,600 – $96,000 / year
RemoteFull-timeSeniorEnglish RequiredBusiness Analyst

Description

  • 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

Requirements

  • 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

Benefits

  • 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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