Cigna (RN) Inpatient Nurse Case Manager (Central Time Zone) in Phoenix, Arizona

Description:

(RN) Inpatient Nurse Case Manager (Central Time Zone)

Role will work Monday- Friday 8:00 am- 5:00 pm Central Standard Time

You MUST reside in either: Plano, TX or Phoenix, AZ or Pittsburgh, PA

Training in Cigna office for about 10 weeks, then will move to work at home.

• Plans, implements, and evaluates appropriate health care services in conjunction with the physician treatment plan.

• Establishes patient centric goals and interventions to meet the member’s needs while inpatient and post inpatient stay

• Handles more complex, high acuity cases, and/or account sensitive cases involving largest reserves.

• Utilizes clinical skills to assess, plan, implement, coordinate, monitor and evaluate options and services in order to facilitate appropriate healthcare outcomes for members.

• Ensures that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained.

• Performs prospective, concurrent, and retrospective reviews for inpatient acute care, rehabilitation, referrals, and select outpatient services.

• Act as liaison and patient advocate between account, participant, family, physician(s) and facilities/agencies. Take appropriate action to ensure participant and practitioner satisfaction within benefit constraints.

• May review initial liability disability claims to determine extent and impact of insured's medical condition, medical restrictions and limitations and expected duration.

• Performs leadership role on team when implementing new tools or case management programs/initiatives and acts s resource to others.

Qualifications:

Requirements include:

• RN with current unrestricted state licensure required.

• Three to five years minimum clinical practice experience required

• Utilization management experience strongly preferred

• 2 years case management experience strongly preferred

• May require experience with short or long term disability and knowledge of workers' compensation regulations.

• Excellent communication and interpersonal skills.

• Excellent time management, organization and negotiation skills.

• Strong research and analytical skills.

• Ability to assess complex issues, recommend changes and resolve problems. Knowledge of managed care preferred.

• Works independently, receiving direction from manager for new or unprecedented situations.

• Manages own caseload and coordinates all assigned cases.

Primary Location: Plano-Texas

Other Locations: United States-Arizona-Phoenix, United States-Work From Home Jobs, United States-Pennsylvania-Pittsburgh

Work Locations: 25500 N Norterra Drive, Bldg B Phoenix 85085

Job: Med Mgt--Case Management

Schedule: Regular

Shift: Standard

Employee Status: Individual Contributor

Job Type: Full-time

Job Level: Day Job

Travel: No

Job Posting: May 17, 2018, 11:07:34 AM

Qualified applicants will be considered for employment without regard to age, race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status. Need an accommodation? Email: SeeYourself@cigna.com