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RN Nurse Case Management Manager Service Coordination, McAllen Texas, Laredo, Texas or San Antonio, Texas at Cigna in McAllen, Texas

Posted in General Business 30+ days ago.

Type: Full-Time





Job Description:

Summary

Health Services Sr. Specialist is responsible for supervising and ensuring the delivery of service coordination functions following the model of Cigna-HealthSpring.

Essential Duties and Responsibilities:


  • Leads, directs, and monitors the delivery of all service coordination functions.

  • Implements procedures and policies established by Cigna-HealthSpring that enhance the quality of life for people receiving services.

  • Provides leadership and collaboration with other Health Services Sr. Specialists to assure compliance with local, state and federal regulations, nursing practice standards as well as standard operational structure across the Texas.

  • Ensures effective and efficient budget management in providing the best utilization of resources.

  • Provides effective staff management (hiring, development, training, performance feedback, etc.) that assures utilization of personnel to best meet the needs of the people receiving supports and services.

  • Supports Health Services training that assures the best possible delivery of health related supports and services.

  • Ensures the completion of accurate service coordination documentation to provide continuity of care and record storage.

Required Qualifications:

Candidate must reside in McAllen, Laredo or San Antonio, Texas


  • Must be a Registered Nurse with a current, unrestricted Texas License

  • At least two years of experience in management or administration

  • Strong organizational and time management skills

  • Must have strong computer skills using MS office products including Word, Excel, Power Point, and Outlook

  • Excellent verbal,  written, communication and presentation skills

  • Strong knowledge of the Medicare/Medicaid Managed Care business

    • Ability to meet deadlines and manage multiple priorities

    • Effectively adapt and respond to complex, fast-paced, changing environment.



  • Ability to make decisions on what needs to be done based on clearly established guidelines

  • Experience managing process workflows.

Preferred Knowledge, Skills, Abilities:


  • Bachelor’s degree preferred

  • Previous STAR+PLUS experience

  • Home Health Case Management experience with Medicare or Medicaid populations a plus

  • Experience managing members with chronic disease processes 

  • Experience working with community resource organizations

  • Experience with care management software applications

About Cigna

Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. We offer an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products. Together, with our 74,000 employees worldwide, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation.

When you work with Cigna, you’ll enjoy meaningful career experiences that enrich people’s lives while working together to make the world a healthier place. What difference will you make?  To see our culture in action, search #TeamCigna on Instagram.

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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.