About the Company
Cigna Corporation is a global health service company dedicated to helping people improve their health, well-being, and sense of security. With a diverse portfolio of health services, including medical, dental, behavioral health, pharmacy, vision, and group life and disability benefits, Cigna serves customers in over 30 countries and jurisdictions. We are committed to a collaborative culture that fosters innovation and empowers our employees to make a meaningful difference in the lives of our customers.
Job Description
We are seeking a highly motivated and experienced Case Management Registered Nurse (RN) to join our dynamic team. This is a 100% Work-From-Home (WFH) opportunity, allowing you to provide essential care coordination services from the comfort of your home office. As a Case Management RN at Cigna, you will play a crucial role in assessing, planning, implementing, coordinating, monitoring, and evaluating the options and services required to meet an individual’s health needs. You will advocate for our members, ensuring they receive appropriate, cost-effective care and achieve optimal health outcomes. This role involves working closely with members, their families, providers, and other healthcare professionals to navigate complex healthcare systems and facilitate seamless transitions of care.
Key Responsibilities
- Conduct comprehensive assessments of members' health needs, including physical, psychological, social, and functional status.
- Develop individualized care plans in collaboration with members, their families, and treating physicians.
- Coordinate with healthcare providers, community resources, and other stakeholders to ensure timely and appropriate service delivery.
- Educate members and families on their health conditions, treatment options, and self-management techniques.
- Monitor members' progress towards established goals and revise care plans as necessary.
- Facilitate smooth transitions of care across different healthcare settings.
- Perform utilization review to ensure medical necessity and appropriate level of care.
- Maintain accurate and thorough documentation of all case management activities in compliance with company policies and regulatory requirements.
- Identify potential barriers to care and develop strategies to overcome them.
- Participate in interdisciplinary team meetings and continuous quality improvement initiatives.
Required Skills
- Current, unrestricted Registered Nurse (RN) license in the state of New Hampshire or a compact state license.
- Minimum of 3 years of clinical experience in an acute care setting, community health, or managed care environment.
- Strong understanding of case management principles, healthcare delivery systems, and community resources.
- Excellent verbal and written communication skills, with the ability to build rapport and effectively educate members.
- Demonstrated critical thinking, problem-solving, and decision-making abilities.
- Proficiency in using electronic health records (EHR) and various computer applications.
- Ability to work independently and manage a diverse caseload effectively.
- Strong organizational skills and attention to detail.
Preferred Qualifications
- Bachelor of Science in Nursing (BSN) preferred.
- Certified Case Manager (CCM) certification.
- Experience in an insurance or managed care setting.
- Familiarity with Medicare, Medicaid, and commercial health plans.
- Experience with specific patient populations (e.g., chronic disease management, complex care, behavioral health).
Perks & Benefits
- Competitive salary and performance-based incentives.
- Comprehensive health, dental, and vision insurance plans.
- 401(k) plan with company matching contributions.
- Generous paid time off (PTO) and paid holidays.
- Opportunities for professional development and continuing education.
- Employee assistance program (EAP).
- Company-provided equipment for your home office setup.
- Flexible work-life balance with a 100% remote work model.
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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