Cigna Medicare Case Management Nurse Case Manager

Under general supervision, responsible for identifying high risk patients for case management intervention and coordinating the delivery of cost-effective, quality-based health care services for health plan members by development and implementation of alternative treatment plans that address individual needs of the member, their benefit plan, and community resources.
Directs intervention with moderate to high risk members, and provides support and oversight to other team members managing low risk members. Interfaces with providers of medical services and equipment to facilitate effective communication, referrals, development of discharge planning and alternative treatment plan development. Initiates contact with patient/family, physician, and health care providers/suppliers to discuss the alternative treatment plan and conducts on-site or in-home evaluations as necessary.
Monitors, evaluates, extends, revises or closes treatment plans as appropriate. Evaluates cases for quality of care. Communicates case management decisions. Understands and follows policies and procedures and produces and submits reports in a timely manner. Handles high acuity and complex cases. Initiates and leads the multi-disciplinary care planning process.
Minimum Requirements: Current licensure as a Registered Nurse (RN) in applicable state or active license in a state allowing “multistate privilege to practice”. Three or more years’ experience in clinical and case management.
Preferred Requirement : Certified Case Manager (CCM)
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: [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. 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.