Rn-Clinical Care Coordinator, Texas Market

Specific Job Title
Clinical Care Coordinator (Tele RN)
Description of the broader org / team
(Optional, but preferred.)
Description of the Position / Role Summary
Telephonic patient care role. Primarily responsible for patient triage, care coordination, and patient/family education in the Clinical Care Coordinators assigned POD. Clinical Care Coordinator supports providers and their respective patients, and also addresses client-facing needs per POD/market. May perform virtual visits based on patient need.
Key Responsibilities (List)
Nursing Triage
1. Assess and triage immediate health concerns transferred to nursing team by clinical support staff.
2. Provide telephonic nursing assessment and triage supported by triage protocols. This includes, timely and accurate triage documentation, escalation, and follow up
3. Initiate medication changes and other orders, as directed by provider in response to a triage call.
Health Literacy Improvement
1. Improves Health literacy and coaches consumers on chronic conditions including disease process and trajectory, medication education including possible side effects, plan of care, and individualized care goals management in a culturally sensitive and acceptable manner for the patient or caregiver.
2. Identifies problems or gaps in care, and offers opportunity for intervention
3. Coordinates services and referrals to health programs, and participates in patient education and outreach tied to HEDIS initiatives
4. Works to improve access to care, and works as part of the team to manage heath care cost and utilization
Provider Support
1. Completes telephonic nursing assessments including social determinants of health screenings, post hospital discharge screenings, triage, and other assessments assigned by provider
2. Assists with organizing and running a chronic care and/or interdisciplinary care team rounds where high risk patients and care plans are identified
3. Participate using a team approach to create a care plan for the patient
4. Maintain and update spreadsheets and documents provided by health plan to prep weekly rounds of documentation
Post-Acute Management and Coordination
1. Participation in weekly care coordination with health plan case management as directed by market needs
2. Referral Management Care Coordination and tracking of hospice consults within 24 hrs. of order placement
Diagnostics and Lab Result Management
1. Obtain Pre Authorization for all CT, MRI, Echo’s ordered by providers (Pt Coordinators to schedule)
2. Serves as a guide in their POD for all escalated orders and results as clinically appropriate
Other telephonic patient care and provider support duties as assigned
Competencies:

• Courage – Stepping up to address difficult issues, saying what needs to be said
• Communicates Effectively – Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences
• Manages Complexity – Making sense of complex, high quantity, and sometimes contradictory information to effectively solve problems
• Demonstrates Self-Awareness- using a combination of feedback and reflection to gain productive insight into personal strengths and weaknesses
• Manages Ambiguity- Operating effectively, even when things are not certain or the way forward is not clear
• Situational Adaptability- Adapting approach and demeanor in real time to match the shift in demands of different situations
• Collaborates – Building partnerships and working collaboratively with others to meet shared objectives

Minimum Qualifications (Include Licensure as applicable)
(No more than 5-7)
1) Active, unrestricted RN license in the state of Residence
2) Ability to obtain compact license and/or additional state licensure as needed, expected to apply to markets within 90 days of hire.
3) 3+ years of experience as a Registered Nurse
4) Proficient level of experience with Microsoft Office applications, and strong technical aptitude
5) EMR experience and proficiency
6) BSN or ADN degree
Preferred Qualifications
(No more than 5-7, if applicable.)
1) Previous experience working with the geriatric population/ chronic condition experience
2) Home Health experience
3) Triage experience
4) Case management experience
5) Previous customer service experience
6) Previous experience in a telephonic role
7) Highly organized, self-directed worker with an ability to function in high volume environment
8) Strong verbal and written communication skills
9) Prior clinical experience in palliative care, end of life, hospice, oncology, ICU, geriatrics is preferred.
10) Knowledge of STARS and Hedis metrics a plus
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 The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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.