RN- Chronic Kidney Disease Case Manager

The Cigna Group; Pittsburgh (Allegheny County); On-site; USD 70,000 - 85,000; Full time

Job summary

A leading healthcare company seeks a Case Manager in Pittsburgh, PA. This role involves coordinating care for customers and supporting their healthcare journey through comprehensive plans and collaboration with healthcare professionals. Candidates should hold a valid RN license and possess compassion and experience in patient care, particularly in chronic conditions. Join us to make a significant impact in patient health management.

Qualifications

• Minimum two years of full-time direct patient care as an RN required.
• Experience in transplant or kidney disease preferred.
• Must adapt to complex situations and collaborate effectively.

Responsibilities

• Collaborates with customers to create care plans.
• Utilizes motivational interviewing for customer health.
• Engages with providers and caregivers to coordinate care.

Skills

Communication

Clinical Acumen

Organizational Skills

Culturally Sensitive

Education

Active Registered Nurse (RN) License

Certification in Case Management (URAC)

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

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Position Scope

Case managers are healthcare professionals, who serve as customer advocates to coordinate, support, and guide care for our customers, families, and caregivers to assist with navigating through the healthcare journey.

• Customer Strong: I deliver world-class experiences for all my customers.
• Me to We: I take accountability to trust, partner, and deliver.
• Own It: I see a need and deliver value because I care.
• Evolve and Adapt: I learn and adapt to meet evolving business needs.
• Be Bold: I pioneer and think broadly to solve challenges.
• Take Care: I prioritize self-care and act with compassion toward colleagues
  
  

Position Scope

Case managers are healthcare professionals, who serve as customer advocates to coordinate, support, and guide care for our customers, families, and caregivers to assist with navigating through the healthcare journey.

Additionally, the candidate will be responsible for the adoption and demonstration of the Care Solutions cultural beliefs. They will be responsible for role modeling the six cultural beliefs to drive personal accountability and organizational results.

• Customer Strong: I deliver world-class experiences for all my customers.
• Me to We: I take accountability to trust, partner, and deliver.
• Own It: I see a need and deliver value because I care.
• Evolve and Adapt: I learn and adapt to meet evolving business needs.
• Be Bold: I pioneer and think broadly to solve challenges.
• Take Care: I prioritize self-care and act with compassion toward colleagues
  
  

Day In The Life Responsibilities

• Collaborates with customer in creation of care plan and documents plan in medical management system.
• Partners with each customer to establish goals and interventions to meet the customer’s needs.
• Establishes plan of care in conjunction with the customer and provider then document into a medical management system.
• Utilizes motivational interviewing, behavior change, and shared decision making to help customers achieve optimal health and well-being.
• Empowers customers with skills to enhance interaction with their providers.
• Interfaces with the customer, family members/caregivers, providers, and internal partners to coordinate the needs of the customer through telephonic, email, text, and chat interactions.
• Collaborates with nutritionist, pharmacist, behavioral clinician, Medical Director and customer's provider and other Cigna Medical Management programs to provide whole-person health support.
• Tracks daily activities to trend volume and outcomes.
• Follows standard operating procedures.
• Toggles between multiple systems and applications.
• Research relevant topics in health promotion and disease prevention, as required for specific customers.
• Prioritizes work to meet commitments aligned with organizational goals.
• Understands and adheres to Case Management performance measures to deliver on key results.
• Completes training within the communicated time limit as required per role.
• Demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate.
  
  

Minimum Requirements

Active unrestricted Registered Nurse (RN) license in state or territory of the United States. Minimum of two years full-time direct patient care as an RN required.

Preferred Requirements

• Must have an active and unencumbered RN
• Experience in Transplant or Kidney Disease
• Within four (4) years of hire as a case manager will possess a URAC-recognized certification in case management.
• Excellent communication skills including telephonic (verbal) and digital (messaging, emails).
• Skilled in clinical acumen to form a judgement and act.
• Strong computer skills in Microsoft word, Excel, Outlook, and ability to perform thorough internet research.
• Ability to recognize, address and resolve conflicts in a professional, collaborative manner.
• Demonstrates sensitivity to culturally diverse situations, participants, and customers.
• Demonstrates effective organizational skills and flexibility to meet the business needs.
• Adapts approach and demeanor in real time to match the shifting demands of different situations.
• Ability to manage multiple, complex situations in a fast-paced environment collaborating with clinical and other business partners.
  
  

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

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.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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