Senior RN Case Manager: Complex Care & Outcomes

Fiber Broadband; Lima (OH); Remote; USD 58,000 - 96,000; Full time

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 full care journey. You will connect members, providers, and plan partners to deliver the right care at the right time, improving outcomes and reducing costs.

Responsibilities include leading case planning, coordinating services across settings, and coaching members on treatment options.

Qualifications

• Active RN license (state-appropriate) with ASN or higher.
• Compact license required if live in a Nursing Compact state.
• Minimum 3 years of clinical practice in Oncology, Behavioral Health, In-patient, Critical Care, or Med/Surg.
• Strong skills in care planning, care coordination, and patient advocacy across the continuum of care.
• Clear, respectful communication with members, families, providers, and business partners.
• Comfort using a PC and Word and ability to learn new systems.

Responsibilities

• Lead complex case planning from intake through resolution, aligning clinical needs, benefits, and community resources.
• Partner with members, families, providers, and internal teams to set goals and track progress toward better health outcomes.
• Reduce fragmentation by coordinating services across settings and adjusting plans as needs change.
• Use utilization review and documentation to ensure services meet criteria and maximize benefits.
• Coach members on their condition, treatment options, and next steps.
• Escalate quality-of-care or complex clinical questions to the Medical Director and drive timely decisions.
• Strengthen team performance by supporting quality reviews, leading risk meetings, and mentoring new team members.

Skills

Care planning

Care coordination

Patient advocacy

Communication

PC proficiency

Education

ASN or higher

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 full care journey. You will connect members, providers, and plan partners to deliver the right care at the right time, improving outcomes and reducing costs.

Responsibilities include leading case planning, coordinating services across settings, and coaching members on treatment options.