RN Care Coordinator - Evernorth - Cleveland OH

Utilicom; North Olmsted (OH); Hybrid; USD 78,000 - 129,000; Full time

Benefits offered by this job

401(k)

Company paid life insurance

Tuition reimbursement

Minimum 18 days paid time off per year

Paid holidays

Leaves of absence

Job summary

The Cigna Group's Evernorth Workplace Care unit in Cleveland OH invites a qualified RN to join our care coordination team. You will manage high-risk patients, collaborate with PCPs, onsite clinics, and Evernorth programs to improve health outcomes and reduce costs.

Ideal candidates hold OH RN licensure, have 3+ years of clinical practice, and can navigate complex cases with strong communication and data-driven care management. Eligible for an annual bonus and comprehensive benefits.

Qualifications

• RN with current unrestricted state licensure in Ohio.
• Three or more years of clinical practice experience.
• Case Management experience preferred.
• High energy with excellent oral and written communication skills.
• Proficient in Word and Excel.

Responsibilities

• Identifies and refers appropriate customers to eligible programs within CIGNA Healthcare and client programs.
• Coordinates care for high-risk populations with appropriate clinical partners.
• Acts as central conduit between employer, provider, and Evernorth resources.
• Ensures thorough review of patient data to support outreach and engagement.
• Maintains compliant documentation and information exchange to drive outcomes.
• Builds relationships with local network providers and onsite health centers.
• Identifies gaps in care and coordinates with providers to close them.
• Collaborates with Evernorth teams to support care coordination and data analysis.
• Supports engagement opportunities with health management partners.
• Direct non-clinical questions to appropriate resources.

Skills

RN license OH

Clinical experience

Case management

Communication skills

Computer skills (Word/Excel)

Job description

RN - Care Coordinator – Evernorth Workplace Care - Cleveland OH

Evernorth Workplace Care offers health care delivery services along with population health and health coaching solutions, conducted in person or virtually. Our mission is to deliver proactive, personalized, and holistic patient care and coaching by acting on health data and insights to improve the overall health and wellness of our clients’ employees, and those they care about most, by providing access to high quality, affordable services where they work and live.

Our Evernorth Workplace Care solution isn’t a one-size-fits-all model. Using data-driven insights, we’ll customize a solution that addresses your organization’s most pressing needs—creating a more affordable, predictable, and simple health care experience.

Evernorth Workplace Care - Personalized Care Where You Are

Sound like you? Great! Here’s more on how you’ll make a difference

• Identifies and refers appropriate customers to eligible programs within CIGNA Healthcare (CHC) and all eligible client specific health and wellness programs.
• Supports Care Coordination of the individual customer. Coordinates the care of the high-risk targeted population in an appropriate, efficient, high quality and cost-effective manner. Refers to appropriate clinical partners (i.e. complex case management and / or Specialty Case management).
• Partners, and functions as central conduit between employer, provider (PCP, Onsite Health Clinic) and all available Evernorth programs and resources.
• Supports established processes and procedures that ensures thorough review of patient level actionable data and reports used to support identification of customers for outreach and engagement.
• Assure and maintains timely, compliant, efficient documentation and information exchange to drive appropriate outreach, engagement and positive clinical outcomes with aligned population.
• Communicates clearly with all matrix partners and refers to appropriate internal and external programs to support outcomes.
• Identifies cases appropriate for complex case management and follows process for referral.
• Works effectively with Evernorth's internal team to support coordination of care and data analysis.
• Identifies and builds effective relationships with local network providers. Provides steerage to high quality network providers and referrals to the onsite health center.
• Identifies gaps in care and works with providers and/ or local community resources to close gaps in care.
• Establishes and maintains a positive, professional, and collaborative relationship with customer/employee, employer, providers of care, and Evernorth partners to support improved outcomes (clinical, quality and cost) of aligned employee population.
• Partners and coordinates with health management matrix partners for additional engagement and promotion opportunities.
• Act as resource to direct customers with specific non-clinical questions to the appropriate resource.

Expected Qualifications to best serve your patients

• RN with current unrestricted state licensure in Ohio and ability to maintain
• Multistate licensure is preferred.
• Must have three or more years of clinical practice experience
• Case Management experience is preferred
• A high energy level with excellent oral and written communication skills.
• Excellent Computer skills [specific software e.g. Word and Excel]
• Excellent interpersonal skills. Must be able to work in a team environment and exhibit flexibility and enthusiasm in learning new information and developing new skills quickly.
• Demonstrate commitment to ongoing education preferred.
• Comfortable communicating with multiple clinical partners (direct care, Onsite Health, and telephonic coaching and case management teams).
• Experience working with high-risk patients preferred.
• Experience in project development and working in a matrix environment preferred.
• Self-directness and the ability succeed in an independent role.
• Current BLS/CPR/AED Certification
• Passion for assisting members with health improvement and navigation of the Health Care System.
• Must have strong problem-solving skills

Bonus points for

• CHES or NBHWC
• Health Coaching experience including chronic disease management
• High energy level, with dynamic presentation skills is required.
• Positive role model in demonstrating healthy behaviors

This position will be based in Cleveland OH.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 77,500 - 129,100 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here .

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. 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 need a reasonable accommodation to complete the online application process, please email [e-mail] for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.