RN – Complex Nurse Case Manager

Role Overview

• 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 effectively navigate the healthcare system and communicate with providers.
• Coordinate care across customers, caregivers, providers, and internal partners via phone and digital channels (email, text, chat).
• Collaborate with interdisciplinary teams—including pharmacists, nutritionists, behavioral clinicians, Medical Directors, and Medical Management programs—to support whole-person health.
• Track, analyze, and document daily activity, volume, and outcomes to support performance and quality goals.
• Follow established policies, procedures, and Case Management performance measures.
• Efficiently 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 a U.S. state or territory
• Minimum of two (2) years of full-time direct patient care experience as an RN
• Specialty case management experience, with Complex experience preferred for specialty roles
• Ability to obtain a URAC-recognized Case Management certification within four (4) years of hire
• Strong clinical judgment with the ability 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
• Demonstrated ability to resolve conflict, collaborate across teams, and interact with diverse populations
• Strong organizational skills, adaptability, and comfort managing multiple complex cases simultaneously

Benefits

• Medical, vision, dental, and 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