Nurse Case Management Senior Analyst

at  The Cigna Group

POSITION SCOPE:

• Manages/coordinates an active caseload of case management cases for Cigna Medicare. Uses clinical knowledge to assess the treatment plan and goals, and identifies gaps in care or risks for readmission or complications.
• Establishes patient centric goals and interventions to meet the member’s needs
• Interfaces with the member, family members/caregivers, and the healthcare team, and embedded care coordinator as well as internal matrix partners.
• Build solid working relationships with internal staff, matrix partners, key functional areas, customers, and providers

SUMMARY DESCRIPTION OF POSITION:

This position, the 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.

MINIMUM REQUIREMENTS:

Active, unrestricted Registered Nurse (RN) Multi-State License. Must be willing to get licensed in non-Compact states as required by the business. Two years full-time equivalent of direct clinical care to the consumer

PREFERRED REQUIREMENTS:

• 1-2 year Case Management experience with Medicare patients