Posted in General Business 30+ days ago.
Type: Full-Time
NOTE: This role will be work at home. You must reside close to one of the following office locations:
Pittsburgh, PA
Phoenix, AZ
Plano, TX
Position Scope:
This position, the Case Manager Specialist, 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. The CAC aligned Case Manager has enhanced collaboration with Physician Group Embedded Care Coordinators (ECC).
Major responsibilities and desired results:
RN license required
MUST reside near Pittsburgh, PA or Phoenix, AZ or Plano, TX
Minimum of 3 years direct patient care required
Oncology or Hospice experience strongly preferred
Excellent time management, organizational, research, analytical, negotiation, communication (oral and written) and interpersonal skills
Strong personal computer skills, MS word, Excel, Outlook experience, and Internet research desired
Knowledge of the insurance industry and claims processing
Service marketing/sales and business acumen experience a plus
Strong skills in the following areas: teamwork, conflict management, assessment complex issues, ability to recommend changes and resolve problems through effective decision making
Experience in medical management and case management in a managed care setting is highly desirable
Knowledge of managed care products and strategies
Demonstrated sensitivity to culturally diverse situations, participants and customers
Ability to work within changing business environment and balance business needs with patient advocacy
Experience managing multiple projects in a fast paced matrix driven environment
Demonstrated ability to coach and educate other case management staff
Demonstrate effective organizational skills and flexibility to meet the business needs
This position is not eligible to be performed in Colorado.
About Cigna
Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, 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 us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives. What difference will you make?
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.
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