RN- Complex Nurse Case Manager- Remote

Case managers are healthcare professionals, who serve as customer advocates to coordinate, support, and guide care for our customers, families, and caregivers to assist with navigating through the healthcare journey.

Additionally, the candidate will be responsible for the adoption and demonstration of the Care Solutions cultural beliefs.

They will be responsible for role modeling the six cultural beliefs to drive personal accountability and organizational results.


* Customer Strong: I deliver world-class experiences for all my customers.


* Me to We: I take accountability to trust, partner, and deliver.


* Own It: I see a need and deliver value because I care.


* Evolve and Adapt: I learn and adapt to meet evolving business needs.


* Be Bold: I pioneer and think broadly to solve challenges.


* Take Care: I prioritize self-care and act with compassion toward colleague.

Day in the Life Responsibilities


* Collaborates with customer in creation of care plan and documents plan in medical management system.


* Partners with each customer to establish goals and interventions to meet the customer's needs.


* Establishes plan of care in conjunction with the customer and provider then document into a medical management system.


* Utilizes motivational interviewing, behavior change, and shared decision making to help customers achieve optimal health and well-being.


* Empowers customers with skills to enhance interaction with their providers.


* Interfaces with the customer, family members/caregivers, providers, and internal partners to coordinate the needs of the customer through telephonic, email, text, and chat interactions.


* Collaborates with nutritionist, pharmacist, behavioral clinician, Medical Director and customer's provider and other Cigna Medical Management programs to provide whole-person health support.


* Tracks daily activities to trend volume and outcomes.


* Follows standard operating procedures.


* Toggles between multiple systems and applications.


* Research relevant topics in health promotion and disease prevention, as required for specific customers.


* Prioritizes work to meet commitments aligned with organizational goals.


* Understands and adheres to Case Management performance measures to deliver on key results.


* Completes training within the communicated time limit as required per role.


* Demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate.

Minimum requirements:

Active unrestricted Registered Nurse (RN) license in state or territory of the United States.

Minimum of two years full-time direct patient care as an RN required.

Preferred requirements:


* Complex Case Management experience preferred.


* Must have an active and unencumbered RN License


* Within four (4) years of hire as a case manager will possess a URAC-recognized certification in case management.


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