LPN/LVN Case Coordinator - McAllen, Texas at Cigna in McAllen, Texas

Job Description:

Summary

Responsible for collaborating with healthcare providers and members to optimize the member's benefits to promote effective use of resources. Required to provide guidance to members regarding barriers to managing their health conditions. Assists members to change behaviors and to locate and access interpersonal, family, and community resources that will make it easier to manage their health.

Essential Duties and Responsibilities:

• Conducts face-to-face and telephonic member assessments (health risk assessments and other assessments).


• Works with member, member's family, and providers to facilitate a comprehensive individualized service plan.


• Uses clinical judgment to identify physical and behavioral health needs, works with the member and caregiver, and making appropriate referrals.


• Works with member to close clinical and pharmacy gaps and to mitigate non-clinical barriers to care.


• Acts as a liaison and facilitates the coordination of benefits, resources, healthcare providers, and institutions.


• Completes and files all assessments and implements the plan of care within the timelines outlined by the state.


• Actively participates in all Health Services staff meetings.


• Other duties as requested;

Required Qualifications:

• Current, unrestricted Licensed Vocational Nurse (LVN) in the state of Texas


• Minimum 5 years clinical experience


• Graduate of an accredited school of nursing.

• At least 2 years of related experience with Medicaid population.


• Reliable transportation, valid and unrestricted driver's license, proof of insurance, and the ability to travel to member's home, other locations within the service delivery area.

• Excellent verbal and written communication skills.

Preferred Qualifications:

• Previous STAR+PLUS experience.


• Case Management experience with Medicare or Medicaid populations a plus


• Experience managing members with chronic disease processes


• Experience working with community resource organizations preferred
  
  
  • Excellent interpersonal and communications skills with nursing staff, physicians, nurse practitioners and other health workers involved in the care of a member
  
  
  • Ability to meet deadlines and manage multiple priorities, and effectively adapt and respond to complex, fast-paced, rapidly growing, and results-oriented environments
  
  
  
  


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


• Able to work in a dynamic, fast-paced team environment and to promote team concepts

Computer Skills:

• Strong knowledge of Microsoft Office products including Excel, Word

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.