Remote Concurrent Review Care Coordinator II – eviCore

Cigna Healthcare

Apply Now

Unlock Proven Email Templates to Land Your Dream Job!

 

Join successful job seekers – Complete a 3-minute LinkedIn survey now and get your templates instantly!

 

👉  Send Me the Templates Now!

Virtual, US Category Operations Posted Date:07/05/2023 Job Id 23012940

The Registered Nurse will perform clinical and operational processes related to transition / coordination of care and utilization / case management of Post-Acute Care services including but not limited to long term acute care, skilled nursing and inpatient rehab facilities, home health care, care management, and utilization review. The Registered Nurse is responsible for:

  • Implementation, evaluation and coordination of the plan of care for all assigned patients.
  • Develop care plan and other case management tools by participating in meetings.
  • Identifies progress toward desired care outcomes; intervening to overcome deviations in the expected plan of care; reviewing the care plan with patients in conjunction with the direct care providers.
  • Monitors delivery and utilization of care by completing patient rounds with Medical Directors.

Minimum Education, Licensure and Professional Certification requirement: 

  • Associated degree in Nursing required; Bachelor degree in Nursing preferred.
  • Current unrestricted Registered Nurse licensure in state of residence.

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, SNF,  and/or  rehab experience desired
  • 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
  • Hours: Monday – Friday; either 8:00- 5:00 EST or 8:00 – 5:00 CST
  • Holiday, weekend, and on-call rotation.

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 25 – 38 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 Services

Evernorth 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com 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.