Cigna Careers – Nurse Case Management Senior Analyst

Website Cigna

Job Description:

The Service Coordinator is responsible for assessing member’s functional and medical needs to collaborate with providers and coordinate and case/care management to STAR+PLUS and/or MMP Members residing in Nursing Facilities. The Service Coordinator has an overarching philosophy of providing quality care in the least restrictive environment promoting independent living, self-determination, and community integration.

Job Responsibilities:

  • Acts as a liaison and facilitates the coordination of benefits, resources, healthcare providers, and institutions.
  • Maintains a maximum weekly face to face visit schedule of twelve members with average caseload of 120.
  • Attends and actively participates in Nursing Facility care plan meetings for assigned Members to collaborate with nursing facility staff to mitigate barriers to care and prevent hospitalizations.
  • Works with member, member’s family, nursing facility and providers to develop a comprehensive Individualized service plan.
  • Works with member to close functional, clinical, and pharmacy gaps.
  • Collaborates with transition team to create a viable discharge plan for members expressing desire to return to the community through MFP process.
  • Conducts a comprehensive F2F (Nursing Facility assessments) 4 times per year with Members residing in a Skilled Nursing Facility.
  • Completes and files all assessments within the timelines outlined by the state.
  • Uses clinical judgment to identify physical and behavioral health needs and works with the member and caregiver to establish an appropriate plan of care to ensure needs are met.

Job Requirements:

  • Strong organizational and time management skills
  • Must be a current Cigna or Express Scripts contractor
  • Must have strong computer skills using MS office products including Word, Excel, and Outlook
  • The ability to travel to members’ homes, and other locations within the service delivery area.
  • Must be a Registered Nurse with a current, unrestricted Texas License
  • Excellent verbal and written communication skills
  • Must have reliable transportation, a valid and unrestricted driver’s license and proof of insurance.

Qualification & Experience:

  • High School Diploma or GED Required.Experience working with community resource organizations preferred
  • Experience with care management software applications preferred.
  • Home Health Case Management experience with Medicare or Medicaid populations a plus
  • Experience managing members with chronic disease processes and

Job Details:

Company: Cigna

Vacancy Type: Full Time

Job Functions: Health Care Provider

Job Location: Bedford, TX, US

Application Deadline: N/A

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