The job profile for this position is Nurse Case Management Senior Analyst, which is a Band 3 Senior Contributor Career Track Role.

Excited to grow your career?

We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!

Our people make all the difference in our success.

This position, the SW/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 or Social Work license in state or territory of the United States. Compact RN license a plus

Two years full-time equivalent of direct clinical care to the consumer.

Ideal candidate would have previous case management experience with the Medicare/Medicaid population specifically focusing on Special Needs Plan. Model of Care documentation requirements, care coordination working with hospital settings and Primary Care Physician offices.

Knowledge of community resources is also helpful.

Excellent verbal and written communication and interpersonal skills

Ability to learn new processes and systems quickly Strong time management and organization skills

Ability to prioritize the work Strong research and analytical and problem solving skills

Ability to work independently

Knowledge of managed care preferred. Effective coaching/education skills Ability to work in rapidly changing environment

Experience Senior population Chronic conditions

Ability to work with people with significant educational and or socioeconomic barriers impacting their health Education

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 role is WAH/Flex which allows most work to be performed at home. Employees must be fully vaccinated if they choose to come onsite.

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.

Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link .

For this position, we anticipate offering an annual salary of $64,700 - $107,800, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

Helping our customers achieve healthier, more secure lives is at the heart of what we do. While you take care of our customers, we'll take care of you through a comprehensive benefits program that helps you be at your best. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and best in class 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 dozens of corporate discounts on essentials you use every day. For more details on our employee benefits programs, please visit the "Life at Cigna" tab on our careersite: www.cigna.com/careers

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives. What difference will you make?

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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

Cigna 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.