RN Care Coordinator - Evernorth - Houston TX

Cigna Health and Life Insurance Company; Houston (TX); On-site; USD 70,000 - 90,000; Full time

Job summary

The Evernorth Workplace Care team in Houston, TX is seeking an RN Care Coordinator to support proactive, personalized care for employees and their families. You will coordinate care across onsite clinics, external providers, and Evernorth programs to improve outcomes and manage costs.

Responsibilities include identifying eligible programs, maintaining compliant documentation, and collaborating with employers, clinicians, and care partners to ensure smooth patient journeys and timely

Qualifications

• RN with unrestricted Texas license.
• 3+ years of clinical practice experience.
• BLS/CPR certification.
• Experience in case management preferred.
• Strong communication and interpersonal skills.

Responsibilities

• Identifies and refers appropriate customers to eligible programs within CIGNA Healthcare and Evernorth client programs.
• Supports Care Coordination of the individual customer.
• Coordinates the care of high-risk populations in a cost-effective manner.
• Refers to appropriate clinical partners and acts as a conduit between employer, provider and Evernorth resources.
• Maintains timely compliant documentation and information exchange to drive outreach and engagement.
• Communicates clearly with matrix partners and internal/external programs to support outcomes.
• Identifies cases for complex case management and follows referral processes.
• Works with Evernorth team to support care coordination and data analysis.
• Identifies and builds relationships with local network providers.
• Provides steerage to high-quality providers and onsite health center referrals.
• Identifies gaps in care and works with providers to close gaps.
• Establishes professional relationships with customers, employers, providers, and Evernorth partners to improve outcomes.
• Direct customers with non-clinical questions to the appropriate resource.

Skills

Effective communication

Team player

MS Office skills

High energy

Ability to learn quickly

Education

Registered Nurse licensure

Texas licensure

BLS/CPR certification

Tools

Outlook

Word

Excel

Job description

RN - Care Coordinator – Evernorth Workplace Care - Houston TX

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

Here's how you will support your patients on their wellness journey:

• 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 ensure 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 Texas 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 [MS Office including Outlook, Word and Excel].
• Excellent interpersonal skills.
• Must be able to work in a team environment.
• Flexibility and enthusiasm in learning new information and developing new skills quickly.
• Demonstrate commitment to ongoing education preferred.
• Comfortable communicating with multiple clinical partners.
• Experience working with high-risk patients preferred.
• Experience in project development and working in a matrix environment preferred.
• Self-directness and the ability to 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 downtown Houston TX. 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.

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.

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.