RN Nurse Case Management Sr. Analyst

Cigna; United States; Remote; USD 65,000 - 110,000; Full time

Job summary

Cigna is looking for a Nurse Case Manager Senior Analyst to promote health outcomes for members by managing care with a patient-centered approach. The role requires assessing health needs, developing care plans, and fostering effective communication within a multidisciplinary team. You will benefit from competitive salary and comprehensive health-related benefits from day one of employment.

Benefits

Comprehensive health benefits

401(k) with company match

Tuition reimbursement

Paid time off

Paid holidays

Qualifications

• Active unrestricted Registered Nurse (RN) license in state or territory of the United States.
• Two years full-time equivalent of direct clinical care to the consumer.
• CCM certification within three years of hire preferred.

Responsibilities

• Establish collaborative relationships with clients and providers.
• Assess member health status and develop case management plans.
• Implement and monitor ongoing case management processes.

Skills

Communication

Negotiation

Analytical Skills

Time Management

Organizational Skills

Education

Active RN License

Tools

MS Word

Excel

Outlook

Job description

This position, the Nurse Case Manager Senior Analyst, through the case management process, will promote the improvement of health outcomes to members and assist those members experiencing the burdens of illness and injury. The Case Manager will assess, plan, implement, coordinate, monitor and evaluate options and services to meet an individual’s health needs within case load assignments of a defined population based on business perspectives. The Case Manager will promote quality cost-effective outcomes managing care needs through the continuum of care utilizing effective verbal and written communication skills and a consumerism approach through education and health advocacy to members serviced.Ability to work independently and effectively communicate to internal and external customers in a telephonic environment.

Responsibilities:

Establishes a collaborative relationship with client (plan participant/member), family, physician(s), and other providers to determine medical history and current status and to assess the options for optimal outcomes.

Obtains informed verbal consent and takes all steps to obtain written consent as appropriate.

Promote consumerism through education and health advocacy.

Assesses member’s health status and treatment plan and identifies any gaps or barriers to healthcare. 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.

Implements, coordinates, monitor and evaluate the case management plan on an ongoing, appropriate basis.

Adheres to professional practice within scope of licensure and certification quality assurance standards and all case management policy and procedures

Participates in unit and corporate training initiatives and demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate.

Demonstrates sensitivity to culturally diverse situations, clients and customers.

Active unrestricted Registered Nurse (RN) license in state or territory of the United States Two years full-time equivalent of direct clinical care to the consumer

Preferred requirements:

Within three (3) years of hire as a case manager, the case manager will become CCM certified.

Excellent time management, organizational, research, analytical, negotiation, communication (oral and written) and interpersonal skills

Strong personal computer skills, MS word, Excel, Outlook experience, and Internet research desired

Strong skills in the following areas: teamwork, conflict management, assessment complex issues, ability to recommend changes and resolve problems through effective decision making

Experience in medical management and case management in a managed care setting is highly desirable

Knowledge of managed care products and strategies

Demonstrated sensitivity to culturally diverse situations, participants and customers

This position, the Nurse Case Manager Senior Analyst, through the case management process, will promote the improvement of health outcomes to members and assist those members experiencing the burdens of illness and injury. The Case Manager will assess, plan, implement, coordinate, monitor and evaluate options and services to meet an individual’s health needs within case load assignments of a defined population based on business perspectives. The Case Manager will promote quality cost-effective outcomes managing care needs through the continuum of care utilizing effective verbal and written communication skills and a consumerism approach through education and health advocacy to members serviced.Ability to work independently and effectively communicate to internal and external customers in a telephonic environment.

Responsibilities:

• Establishes a collaborative relationship with client (plan participant/member), family, physician(s), and other providers to determine medical history and current status and to assess the options for optimal outcomes.

• Obtains informed verbal consent and takes all steps to obtain written consent as appropriate.

• Promote consumerism through education and health advocacy.

• Assesses member’s health status and treatment plan and identifies any gaps or barriers to healthcare. 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.

• Implements, coordinates, monitor and evaluate the case management plan on an ongoing, appropriate basis.

• Adheres to professional practice within scope of licensure and certification quality assurance standards and all case management policy and procedures

• Participates in unit and corporate training initiatives and demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate.

• Demonstrates sensitivity to culturally diverse situations, clients and customers.

Minimum requirements:

Active unrestricted Registered Nurse (RN) license in state or territory of the United States Two years full-time equivalent of direct clinical care to the consumer

Preferred requirements:

• Within three (3) years of hire as a case manager, the case manager will become CCM certified.

Competencies preferred :

• Excellent time management, organizational, research, analytical, negotiation, communication (oral and written) and interpersonal skills

• Strong personal computer skills, MS word, Excel, Outlook experience, and Internet research desired

• Strong skills in the following areas: teamwork, conflict management, assessment complex issues, ability to recommend changes and resolve problems through effective decision making

• Experience in medical management and case management in a managed care setting is highly desirable

• Knowledge of managed care products and strategies

• Demonstrated sensitivity to culturally diverse situations, participants and customers

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 65,700 - 109,500 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.

We want you to be healthy, balanced, and feel secure. That’s why 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) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group .

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: [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.

About the company

Cigna is an American worldwide health services organization based in Bloomfield, Connecticut.

Notice

Talentify is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

Talentify provides reasonable accommodations to qualified applicants with disabilities, including disabled veterans. Request assistance at [e-mail] or 407-000-0000.

Federal law requires every new hire to complete Form I-9 and present proof of identity and U.S. work eligibility.

An Automated Employment Decision Tool (AEDT) will score your job-related skills and responses. Bias-audit & data-use details: www.talentify.io/bias-audit-report . NYC applicants may request an alternative process or accommodation at [e-mail] or 407-000-0000.