- 26001304
Case Manager (RN)
Help people navigate complex health needs with clarity, compassion, and strong clinical judgment. As a Case Manager, you will partner with members, families, and care teams to create practical care plans that improve health outcomes, reduce avoidable hospital stays, and make care easier to access and follow.
Responsibilities
- Build and lead care plans that address medical and psychosocial needs across the full care journey.
- Align members, providers, and the health plan on clear goals, next steps, and measures of success.
- Coach and advocate for members so they understand options, follow the plan, and feel supported.
- Coordinate services and monitor progress to improve quality of care and member experience.
- Identify creative, benefit-aligned solutions that reduce fragmentation and avoid unnecessary services.
- Complete timely, accurate documentation and utilization review to support safe, effective care decisions.
- Educate members on conditions, treatment options, and cost drivers so they can make informed choices.
- Escalate quality-of-care concerns or complex clinical questions to the Medical Director when needed.
- Contribute to team improvement by sharing feedback on workflows and supporting training or mentorship as assigned.
Qualifications
Required
- Active Registered Nurse (RN) license in good standing (multistate preferred where applicable).
- Minimum 3 years of recent clinical experience.
- Ability to communicate clearly in writing and verbally with members, families, and providers.
- Strong judgment and problem-solving skills, with attention to detail and follow-through.
- Comfort using care management and documentation tools (Windows and Microsoft Word included).
- Certified Case Manager (CCM) certification, or ability to obtain it within 18 months of hire.
Preferred
- Case management experience in a health plan, hospital, behavioral health or care coordination setting.
- ASN or BSN or higher nursing degree.
- Experience improving workflows, participating in quality programs, or helping train new team members.
- Ability to interpret plan benefits and apply them to real member situations.
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 annual salary of 57,600 – 96,000 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
At The Cigna Group, 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), 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, click here.
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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 need a reasonable accommodation to complete the online application process, please email [email protected] for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.
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.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
