C

Cigna Group

Sells health coverage and pharmacy benefits

RN Care Coordinator

Medical, Clinical & VeterinaryConfirmed live in the last 24 hours
Full-timeMayfield, OH, USAIn-person

About the Job

Requirements

  • Hold a current, unrestricted Ohio state RN license and maintain it.
  • Have at least three years of clinical practice experience.
  • Have strong oral and written communication skills.
  • Have excellent computer skills, including software such as Word and Excel.
  • Have interpersonal skills and the ability to work in a team environment, remain flexible, and learn new information and skills quickly.
  • Be comfortable communicating with direct-care, onsite health, telephonic coaching, and case-management clinical partners.
  • Be self-directed and able to work independently.
  • Hold current BLS/CPR/AED certification.
  • Have strong problem-solving skills.
  • If working from home occasionally or permanently, obtain internet service through cable broadband or fiber optic with speeds of at least 10 Mbps download and 5 Mbps upload.

Responsibilities

  • Identify and refer appropriate customers to eligible Cigna Healthcare and client-specific health and wellness programs.
  • Support care coordination for individual customers and coordinate care for high-risk populations in an appropriate, efficient, high-quality, and cost-effective manner; refer customers to clinical partners such as complex or specialty case management.
  • Serve as the central conduit among the employer, providers including primary care providers and the onsite health clinic, and available Evernorth programs and resources.
  • Support established processes for reviewing patient-level actionable data and reports used to identify customers for outreach and engagement.
  • Maintain timely, compliant, and efficient documentation and information exchange to drive appropriate outreach, engagement, and positive clinical outcomes.
  • Communicate with matrix partners and refer customers to appropriate internal and external programs to support outcomes.
  • Identify cases appropriate for complex case management and follow the referral process.
  • Work with Evernorth's internal team to support care coordination and data analysis.
  • Build effective relationships with local network providers, guide customers to high-quality network providers, and refer them to the onsite health center.
  • Identify gaps in care and work with providers or local community resources to close them.
  • Establish and maintain professional, collaborative relationships with customers or employees, employers, care providers, and Evernorth partners to improve clinical, quality, and cost outcomes for the aligned employee population.
  • Coordinate with health-management matrix partners on additional engagement and promotion opportunities.
  • Direct customers with specific non-clinical questions to the appropriate resource.

Desired Qualifications

  • Multistate licensure is preferred.
  • Case management experience is preferred.
  • Commitment to ongoing education is preferred.
  • Experience working with high-risk patients is preferred.
  • Experience in project development and working in a matrix environment is preferred.
  • CHES or NBHWC certification.
  • Health coaching experience, including chronic disease management.

About the Company

Cigna Group

Sells health coverage and pharmacy benefits

The Cigna Group sells health coverage and pharmacy services to employers, health plans and individuals, and most of its business runs through Evernorth, its health services arm. Evernorth owns Express Scripts, one of the largest pharmacy benefit managers in the U.S., which negotiates drug prices and processes prescriptions for plan sponsors, plus the specialty pharmacy Accredo. Its Cigna Healthcare unit sells medical, dental and behavioral coverage, mostly to employers that fund their own plans, and earns premiums and administrative fees, while Evernorth earns service fees and drug margins. The company was formed in 1982 through the merger of Connecticut General and INA and is based in Bloomfield, Connecticut.

Company size
10,001+
Company stage
Not listed
Total funding
Not listed
Headquarters
Bloomfield, CT
Founded
1982

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