Cigna (RN) Inpatient Nurse Case Manager (Central Time Zone) in Phoenix, Arizona
(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.
• 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
Employee Status: Individual Contributor
Job Type: Full-time
Job Level: Day Job
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