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The Cigna Group
The Cigna Group
Asigurare de sănătateAsistență medicalăProduse farmaceutice
The Cigna Group este o companie globală din domeniul sănătății, care își desfășoară activitatea prin Cigna Healthcare și Evernorth Health Services. Activitatea sa combină serviciile de sănătate, asigurările de sănătate și gestionarea beneficiilor farmaceutice pentru a sprijini sănătatea și bunăstarea clienților, beneficiarilor și pacienților. Compania se concentrează, de asemenea, pe practici etice în domeniul sănătății și al inteligenței artificiale, pe echitatea în sănătate, pe guvernanța de mediu și socială responsabilă și pe inovarea modului în care sunt furnizate îngrijirile.
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Locurile de muncă ale companiei

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.

USStatele Unite ale Americii
57.600 $ – 96.000 $ / an
RemoteNormă întreagăSeniorLimbă Obligatorie: englezăAnalist de afaceri

Descriere

  • 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

Cerințe

  • 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

Beneficii

  • 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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