Nurse Case Manager Senior Analyst
Through the case management process, the Nurse Case Manager Senior Analyst position aims to promote the improvement of health outcomes for members and assist those experiencing the burdens of illness and injury.
Responsibilities and Desired Results
- Obtain informed verbal and written consent.
- Establish collaborative relationships with clients, families, physicians, and other providers.
- Promote consumerism through education and health advocacy.
- Assess member’s health status and treatment plan, identifying gaps or barriers to healthcare.
- Implement, coordinate, monitor, and evaluate the case management plan.
- Adhere to professional practice, quality assurance standards, and case management policies.
- Participate in training initiatives and demonstrate continuing education.
- Demonstrate sensitivity to culturally diverse situations, clients, and customers.
Minimum Requirements
- Active and unrestricted Compact Registered Nurse (RN) license.
- Three years full-time equivalent of direct clinical care.
- Case Management experience strongly preferred.
- Medicare experience strongly preferred.
- CCM Certification preferred.
- Requires high-speed broadband wired internet with a modem; cannot support hot spots or satellite-based internet.
Preferred Requirements
- CCM certification within three (3) years of hire.
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 teamwork, conflict management, assessment of complex issues, ability to recommend changes, and problem resolution 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.
- Perform precert and concurrent reviews for transplant members.
- Collaborate with Facilities and Health Care Providers telephonically to obtain clinical information.
- Manage own caseload and coordinate all assigned cases.
Internet Connection Requirement
If working from home, 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.
Salary and Benefits
Anticipated annual salary: $65,700 – $109,500 USD, depending on relevant factors, including experience and geographic location. This role is eligible to participate in an annual bonus plan. Comprehensive benefits include medical, vision, dental, well-being and behavioral health programs, 401(k) with company match, company-paid life insurance, tuition reimbursement, and paid time off.
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, advocates for better health through every stage of life, guiding customers through the health care system and empowering them with information to make informed choices for improving their health and vitality.
Equal Employment Opportunity
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth, 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: [email protected] for support. Do not email [email protected] 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.
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