RN – Complex Nurse Case Manager
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Job Description
RN Case Manager partnering with customers for individualized care plans and health navigation. Delivering Cigna’s whole-person health strategy for improved outcomes and customer experience.
Responsibilities:
- Partner with customers to assess needs, develop individualized care plans, and document interventions and outcomes in Cigna medical management systems.
- Collaborate with customers and providers to establish goals, interventions, and evidence-based plans of care.
- Apply motivational interviewing, behavior change strategies, and shared decision-making to drive engagement and improved health outcomes.
- Empower customers to effectively navigate the healthcare system and communicate with providers.
- Coordinate care across customers, caregivers, providers, and internal partners via phone and digital channels (email, text, chat).
- Collaborate with interdisciplinary teams—including pharmacists, nutritionists, behavioral clinicians, Medical Directors, and Medical Management programs—to support whole-person health.
- Track, analyze, and document daily activity, volume, and outcomes to support performance and quality goals.
- Follow established policies, procedures, and Case Management performance measures.
- Efficiently navigate multiple systems and applications in a fast-paced, customer-focused environment.
- Complete required training and maintain clinical knowledge, licensure, and certifications.
Requirements:
- Active, unrestricted Registered Nurse (RN) license in a U.S. state or territory
- Minimum of two (2) years of full-time direct patient care experience as an RN
- Specialty case management experience, with Complex experience preferred for specialty roles
- Ability to obtain a URAC-recognized Case Management certification within four (4) years of hire
- Strong clinical judgment with the ability to assess risk, prioritize care, and act decisively
- Excellent verbal and written communication skills across phone and digital platforms
- Proficiency in Microsoft Word, Excel, Outlook, and online research tools
- Demonstrated ability to resolve conflict, collaborate across teams, and interact with diverse populations
- Strong organizational skills, adaptability, and comfort managing multiple complex cases simultaneously
Benefits:
- Medical, vision, dental, and well-being and behavioral health programs
- 401(k)
- Company paid life insurance
- Tuition reimbursement
- Minimum of 18 days of paid time off per year
- Paid holidays
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