(RN) Nurse Case Manager Premium Solutions

Position Scope

Hours for the position: Must be able to work an 8-hour-shift between the business hours of 9a-9p EST. Flexibility is required to meet business needs. Must be open to work evenings.

Role Summary:
The Nurse Case Manager serves as a customer advocate partnering with members families and providers to coordinate care and support navigation of the healthcare system. This role focuses on whole-person health behavior change and delivering high-quality customer-centered outcomes aligned with Care Solutions cultural beliefs.

Key Responsibilities:

• Partner with customers to develop implement and document individualized care plans.
• Use motivational interviewing behavior change strategies and shared decision-making to support health goals.
• Coordinate care with providers caregivers and internal clinical partners to support whole-person health.
• Engage customers through telephonic digital and written communication channels.
• Track and document activities outcomes and progress in medical management systems.
• Follow standard operating procedures and meet defined case management performance measures.
• Maintain clinical expertise through required training and continuing education.

Required Qualifications:

• 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.
• Nursing degree from an accredited nursing program.
• Ability to work an 8-hour shift between 9:00 a.m. and 9:00 p.m. EST including evenings as business needs require.
• Strong communication skills across telephonic and digital platforms.
• Proficiency with Microsoft Word Excel Outlook and clinical documentation systems.

Preferred Qualifications:

• Case management certification (URAC-recognized) obtained within four (4) years of hire.
• Experience working in remote telephonic or digital care management environments.
• Strong organizational skills with the ability to manage multiple priorities in a fast-paced setting.
• Demonstrated ability to work effectively with culturally diverse populations.
• Flexibility to support non-standard shifts or occasional on-site meetings or audits

This role is also anticipated to be eligible to participate in an annual bonus plan.

At The Cigna Group youll enjoy a comprehensive range of benefits with a focus on supporting your whole health. Starting on day one of your employment youll 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 paid holidays and leaves of absence. For more details on our employee benefits programs click here.

About Cigna Healthcare

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 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.