The Registered Nurse or Licensed Practical Nurse responsibilities include but not limited to:
Perform clinical and operational processes related to transition / coordination of care/case management of Post-Acute Care services including but not limited to Home Health, DME, Care Coordination/Care management.
Ensure the member is receiving all services or equipment as ordered by the physician.
Assist with the coordination between providers and members.
Hours: Monday - Friday; Shift may vary. May be required to work any 8 hour shift between 7a-7p EASTERN time zone.
Position is full time.
Position is telephonic and remote
Weekend rotation
Minimum Education and License Requirement:
Associate Degree in Nursing Required; Bachelor Degree in Nursing preferred; Certification in nursing.
Current and valid unrestricted Registered Nurse license or Licensed Practical Nursing license in state of residence.
Multistate license status preferred.
Minimum Experience Required:
Minimum 5 years clinical experience with at least 3 years managed care
experience
2 – 4 years’ experience in utilization management required.
Home health, DME experience desired
Commercial/Medicare/Medicaid managed care programs preferred
Ability to sit at a desk 50% of the time and utilize the computer, telephone, and other office equipment, throughout the entire work day; walking and standing
Dependable and reliable work schedule is essential
Required Skills:
Time-management: Ability to effectively manage one’s time and resources to ensure that work is completed efficiently Excellent organizational skills
Communication: Ability to provide clear verbal and written information via in-person, email, and phone to customers, co-workers, and leadership
Critical-Thinking/Decision-making: Ability to choose a course of action or developing appropriate solutions by identifying and understanding issues, problems, and opportunities
Autonomy: Ability to work independently with little to no supervision
Proficient in computer literacy skills with ability to use and troubleshoot Microsoft Word, Excel, Outlook, and PowerPoint with ability to type 30 wpm preferred.
Experience using videoconferencing systems such as WebEx
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an hourly rate of 27 - 41 USD / hourly, depending on relevant factors, including experience and geographic location.This role is also anticipated to be eligible to participate in an annual bonus plan.We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group .About Evernorth Health ServicesEvernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.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: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.