Nurse Case Manager

Role Overview

• Collaborates with customer in creation of care plan and documents plan in medical management system.
• Partners with each customer to establish goals and interventions to meet the customer’s needs.
• Establishes plan of care in conjunction with the customer and provider then document into a medical management system.
• Utilizes motivational interviewing, behavior change, and shared decision making to help customers achieve optimal health and well-being.
• Empowers customers with skills to enhance interaction with their providers.
• Interfaces with the customer, family members/caregivers, providers, and internal partners to coordinate the needs of the customer through telephonic, email, text, and chat interactions.
• Collaborates with nutritionist, pharmacist, behavioral clinician, Medical Director and customer's provider and other Cigna Medical Management programs to provide whole-person health support.
• Tracks daily activities to trend volume and outcomes.
• Follows standard operating procedures.
• Toggles between multiple systems and applications.
• Research relevant topics in health promotion and disease prevention as required for specific customers.
• Prioritizes work to meet commitments aligned with organizational goals.
• Understands and adheres to Case Management performance measures to deliver on key results.
• Completes training within the communicated time limit as required per role.
• Demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate.

Requirements

• Active unrestricted Registered Nurse (RN) license in state or territory of the United States
• Two years of full-time direct patient care setting as an RN required.
• Must have a nursing degree from an accredited nursing program
• Must be flexible to work days or evenings based on business needs
• Available to work evenings with a 12% shift differential
• Within four (4) years of hire as a case manager will possess a URAC-recognized certification in case management.
• Excellent communication skills including telephonic (verbal) and digital (messaging, emails).
• Strong computer skills in Microsoft Word, Excel, Outlook, and ability to perform thorough internet research.
• Ability to recognize, address and resolve conflicts in a professional, collaborative manner.
• Demonstrates effective organizational skills and flexibility to meet the business needs.

Benefits

• medical
• vision
• dental
• well-being and behavioral health programs
• 401(k)
• company paid life insurance
• tuition reimbursement
• a minimum of 18 days of paid time off per year
• paid holidays