About the Company
Cigna is a global health service company dedicated to helping people improve their health, well-being, and sense of security. With a mission to improve the health, well-being and peace of mind of those we serve, Cigna offers a comprehensive range of health services, including medical, dental, behavioral health, pharmacy, and other products and services. We are committed to fostering a diverse and inclusive environment where our employees can thrive and make a meaningful impact.
Job Description
Cigna is seeking a dedicated and experienced Case Management RN to join our remote team. This is a 100% Work from Home position, allowing you to make a significant impact on patient care from the comfort of your home office. As a Case Management RN, you will be responsible for assessing, planning, implementing, coordinating, monitoring, and evaluating the options and services required to meet an individual’s health needs. You will apply a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate options and services to meet an individual’s health needs through communication and available resources to promote quality, cost-effective outcomes. This role involves working closely with patients, families, and healthcare providers to ensure optimal health outcomes and resource utilization within an insurance framework.
Key Responsibilities
- Conduct comprehensive assessments of members' health needs, including physical, psychological, social, and environmental factors.
- Develop individualized care plans in collaboration with the member, family, and healthcare team, identifying specific goals and interventions.
- Coordinate and monitor the delivery of healthcare services, ensuring timely access to necessary care and resources.
- Educate members and their families on health conditions, treatment options, self-management strategies, and available benefits.
- Evaluate the effectiveness of care plans and make adjustments as needed to achieve desired outcomes.
- Facilitate communication between members, providers, and other stakeholders to ensure seamless transitions of care.
- Identify and address barriers to care, such as transportation, financial constraints, or lack of social support.
- Document all interactions and interventions accurately and thoroughly in the electronic health record.
- Adhere to all regulatory requirements, ethical standards, and company policies.
- Participate in interdisciplinary team meetings and continuous quality improvement initiatives.
Required Skills
- Active, unrestricted Registered Nurse (RN) license in New Mexico or a compact state.
- Minimum of 3 years of clinical experience as a Registered Nurse.
- Demonstrated experience in case management, care coordination, or utilization review within an insurance or managed care setting.
- Strong clinical assessment and critical thinking skills.
- Excellent communication, interpersonal, and negotiation skills.
- Proficiency in using electronic health records (EHR) and standard office software.
- Ability to work independently and manage a diverse caseload effectively.
- Strong organizational and time management abilities.
Preferred Qualifications
- Bachelor of Science in Nursing (BSN).
- Certification in Case Management (CCM) or other relevant certifications.
- Experience with telehealth platforms and remote work environments.
- Knowledge of health plan benefits, community resources, and managed care principles.
Perks & Benefits
- Competitive salary and performance-based bonuses.
- Comprehensive health, dental, and vision insurance.
- 401(k) retirement plan with company match.
- Paid time off (PTO) and company holidays.
- Tuition reimbursement and professional development opportunities.
- Employee assistance program (EAP).
- Work-life balance with a 100% remote work model.
- Opportunities for career advancement within a global health service company.
How to Apply
If you are interested in this position, please click the "Apply Now" button below. To ensure your application is properly considered, please prepare the following:
- An up-to-date Resume or CV
- A brief cover letter summarizing your experience and motivation
Applications are reviewed on a rolling basis. Only shortlisted candidates will be contacted for an interview.
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