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A leading healthcare company seeks a skilled professional for case management, focusing on customer health improvement through coaching and support. Candidates should have strong clinical abilities and at least three years of experience, with a Master's degree preferred. This role requires independent work and the ability to drive health engagement initiatives in a collaborative setting.
Provides advanced professional input to complex Case Management assignments/projects. Handles more complex, high acuity cases and/or account sensitive cases. Performs prospective, concurrent, and retrospective reviews for inpatient acute care, rehabilitation, referrals, and select outpatient services. Ensures that case management program objectives are met by evaluating the effectiveness of alternative care services and maintaining cost-effective, quality care. Evaluates, recommends, and maintains relationships with inpatient and outpatient counseling/treatment facilities. Evaluates employee counseling and treatment needs, making recommendations for program adjustments. May assist in designing and conducting training and educational seminars. Manages own caseload and coordinates all assigned cases. Acts as a team leader when implementing new tools or case management initiatives. Supports and guides junior professionals. Works independently, requiring only expert-level technical support. Exercises judgment in selecting and adapting techniques and procedures. Uses in-depth professional knowledge to develop models, procedures, and monitor trends within Case Management. A Master’s Degree in a healthcare-related field with current licensure may be required.
At Cigna, we listen to, advocate for, and collaborate with our customers to empower them to identify their health goals and own their solutions.
Here's how you'll make a difference:
What we expect from you:
Bonus points for:
For remote work, a broadband or fiber optic internet connection of at least 10Mbps download and 5Mbps upload is required.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care, and benefit solutions to improve health and vitality. We innovate to make illness prediction, prevention, and treatment more accessible. Join us in driving growth and improving lives.
Qualified applicants are considered regardless of race, color, age, disability, sex, pregnancy, sexual orientation, gender identity, veteran status, religion, national origin, or other protected characteristics.
If you need reasonable accommodation for the application process, email: SeeYourself@cigna.com. Do not email for application updates or resumes.
The Cigna Group maintains a tobacco-free policy and may not hire tobacco/nicotine users in certain states unless they participate in a cessation program. Consideration of criminal histories will be in accordance with laws.