Senior RN Case Manager & Care Navigator

Cigna Health and Life Insurance Company; Arizona; Hybrid; USD 58,000 - 96,000; Full time

Benefits offered by this job

Medical insurance

Vision insurance

Dental insurance

401(k)

Life insurance

Tuition reimbursement

Paid time off

Paid holidays

Leaves of absence

Job summary

Cigna Healthcare, a division of The Cigna Group, is seeking a Case Management Senior Analyst (RN Case Manager) to guide complex cases across the care journey. You will connect members, providers, and plan partners to improve outcomes and reduce costs while ensuring a compassionate experience.

Responsibilities include leading complex case planning, coordinating across inpatient to outpatient settings, and using utilization review to maximize benefits and ensure quality care.

Qualifications

• Active RN license (state-appropriate) with an ASN or higher.
• Compact license required if living in a Nursing Compact state.
• Minimum 3 years of recent clinical practice in Oncology, Behavioral Health, In-patient, Critical Care, or Med/Surg.
• Strong skills in care planning, care coordination, and patient advocacy.
• Clear written and verbal communication with members, families, providers, and business partners.
• CCM credential desirable or ability to obtain within 12 months of hire.
• Experience interpreting benefit plan documents and applying guidelines to real member situations.
• QA or risk-review experience preferred.

Responsibilities

• Lead complex case planning from intake through resolution, aligning clinical needs, benefits, and community resources to support safe, timely care.
• Partner with members, families, providers, and internal teams to set clear short- and long-term goals and track progress toward better health outcomes.
• Reduce fragmentation by coordinating services across settings (inpatient, rehab, outpatient, preventive) and adjusting plans as needs change.
• Use utilization review and strong documentation to ensure services meet criteria, benefits are maximized, and care is both effective and cost-aware.
• Coach members on their condition, treatment options, and next steps so they can make informed choices and stay engaged in their care.
• Escalate quality-of-care or complex clinical questions to the Medical Director and help drive timely, well-informed decisions.
• Strengthen team performance by supporting quality reviews, leading risk meetings as needed, and mentoring new team members.

Skills

Care planning

Care coordination

Patient advocacy

Communication

Education

ASN or higher nursing degree

CCM credential (or eligible)

Tools

Windows

Word

Job description

Cigna Healthcare, a division of The Cigna Group, is seeking a Case Management Senior Analyst (RN Case Manager) to guide complex cases across the care journey. You will connect members, providers, and plan partners to improve outcomes and reduce costs while ensuring a compassionate experience.

Responsibilities include leading complex case planning, coordinating across inpatient to outpatient settings, and using utilization review to maximize benefits and ensure quality care.