Nurse Case Manager Senior Analyst

ESP Cigna European Services; Madrid; Presencial; EUR 40.000 - 60.000; Jornada completa

Descripción de la vacante

A global health services provider in Madrid is seeking a Nurse Case Manager to assess and coordinate health needs for individuals worldwide. The ideal candidate will possess a Bachelor's in Nursing and 3-5 years of experience in international clinical management. Strong communication skills and the ability to work independently in a multicultural environment are essential for this full-time position.

Formación

• 3-5 years of experience in international clinical management.
• Languages required: English, Spanish, and a third European language.
• Ability to act as an advocate for the customer.
• Demonstrates strong analytical skills.

Responsabilidades

• Assess and coordinate care for members' health needs.
• Provide clinical information to members.
• Establish patient-centric goals.
• Work with a multicultural population globally.

Conocimientos

Clinical knowledge

Interpersonal skills

Problem-solving skills

Organizational skills

Leadership skills

Computer Skills

Conflict Management

Project Portfolio Management

Educación

Bachelor in Nursing

Herramientas

Microsoft Office

Descripción del empleo

Overview

LOOKING FOR A NEW CHALLENGE IN AN INTERNATIONAL ENVIRONMENT

Your Mission:

The Nurse Case Manager will assess, plan, implement, coordinate, monitor, and evaluate options and services to meet an individual's health needs. Assistance may include providing clinical information regarding medical conditions or treatments, identifying providers, and coordinating complex care plans. The Nurse Case Manager will promote quality, cost-effective outcomes, and manage care needs through education and health advocacy to members serviced. The Nurse Case Manager is able to work independently and effectively communicate to internal and external customers by telephone, email, or face-to-face with customers.

Key Areas

Skills and responsibilities:

• Uses clinical knowledge to assess diagnosis and treatment plans and goals and identifies gaps in care or risks for readmission or complications.
• Manages / coordinates an active volume of cases by providing information and coordination to customers worldwide in a multicultural population.
• Establishes patient-centric goals and interventions to meet the member's needs.
• Interfaces with the member, family members / caregivers, and the healthcare team as well as internal matrix partners.
• Balances business needs with patient advocacy.
• Assesses member health status and treatment plan and identifies any gaps or barriers to healthcare.
• Coordinate care for customers by reviewing medical and claim information, ensuring compliance with approved services and fees, and discussing cases with hospital staff and physicians.
• Establishes a documented patient-centric case management plan involving all appropriate parties (client, physician, providers, employers, etc.), identifies anticipated case results/outcomes criteria for case closure, and promotes communication within all parties involved.
• Work with Cigna physicians to evaluate complex cases and receive appropriate clinical expertise on diagnosis and treatment plans.
• Deliver clinical programs to customers including case management, chronic condition management, lifestyle coaching, pre-assignment assessment, and other programs delivered by global clinical operations.
• Coordinate care with other nurses around the world when local or regional expertise is important for better care or to comply with regulations.
• Maintain accurate workflow and process documents.
• Adhere to professional practice within scope of licensure and certification, quality assurance standards, and all case management policy and procedures.
• Participate in unit and corporate training initiatives and demonstrate evidence of continuing education to maintain clinical expertise and certification as appropriate.
• Serve as clinical liaison to clients.

Qualifications

• Bachelor in Nursing; 3-5 years of experience in international clinical management.
• Languages required: English, Spanish, and a third European language (French, Dutch, Italian, or German).
• Demonstrated organizational and leadership skills.
• Strong interpersonal and communication skills.
• Demonstrates problem-solving and analytical skills.
• Ability to act as an advocate for the customer while complying with internal policies and procedures and contractual/legal compliance requirements.
• Ability to operate a personal computer proficiently with Microsoft Office products, call center software, and a variety of software.
• Ability to build solid working relationships with staff, matrix partners, customers, and providers.

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions, including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status, or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: for support. Do not email for an update on your application or to provide your resume as you will not receive a response.

Required Experience: Manager

Key Skills

• Project Portfolio Management
• Motivational Interviewing
• HIPAA
• Computer Skills
• Intake Experience
• Lean Six Sigma
• Conflict Management
• Case Management
• Team Management
• Program Development
• Social Work
• Addiction Counseling

Employment Type: Full-Time

Experience: years

Vacancy: 1