RN Care Coordinator - Evernorth - Remote (Finance)

Evernorth Workplace Care offers health care delivery services along with population health and health coaching solutions, conducted in person or virtually. Our mission is to deliver proactive, personalized, and holistic patient care and coaching by acting on health data and insights to improve the overall health and wellness of our clients' employees, and those they care about most, by providing access to high quality, affordable services where they work and live.

Our Evernorth Workplace Care solution isn't a one-size-fits-all model. Using data-driven insights, we'll customize a solution that addresses your organization's most pressing needs-creating a more affordable, predictable, and simple health care experience.

Evernorth Workplace Care - Personalized Care Where You Are

Role & Responsibilities:

The Registered Nurse (RN) Care Coordinator (RN CC) is an integral member of Evernorth's health team supporting our customers in their journey to better health. The RN CC functions as an employer-based clinical liaison to coordinate complex care among all available client health resources, Cigna in-network resources, community programs and other third-party employer wellness benefits. The goal of the RN Care Coordinator role is to improve care delivery of the aligned population through identification of risk and opportunity, collaboration and coordination with clinical and administrative partners, and promotion of availableprograms.

This role will be a clinical liaison and resource to the customer population, employer, clinic staff, provider and other clinical matrix partners to identify and coordinate customer care.

The RN Care Coordinator will identify and address the health care needs of their customers which may include, but not limited to the following:

• Identifies and refers appropriate customers to eligible programs within their Health Plan and all eligible client specific health and wellness programs.

• Provides one on one health and wellness coaching for customers with select chronic conditions, select at-risk conditions, or lifestyle coaching.
• May work with health center staff to Identify and refer appropriate customers to eligible programs within Cigna Healthcare (CHC) and all eligible client specific health and wellness programs.
• Supports Care Coordination of the individual customer. Coordinates the care of the high-risk targeted population in an appropriate, efficient, high-quality and cost-effective manner. Refers to appropriate clinical partners (i.e. complex case management and / or Specialty Case management)
• Partners, and functions as central conduit among employer, provider (e.g., Primary Care Provider, Onsite Health Center Clinician) and all available Cigna programs and resources.
• Supports established process and procedures that ensures thorough review of patient level actionable data and reports used to support identification of customers for outreach and engagement.
• Assure and maintains timely, compliant, efficient documentation and information exchange to drive appropriate outreach, engagement and positive clinical outcomes with aligned population.
• Communicates clearly with all matrix partners and refers to appropriate internal and external programs to support outcomes.
• Identifies cases appropriate for complex case management and follows process for referral.
• Works effectively with Cigna's internal team to support coordination of care and data analysis.
• Identifies and builds effective relationships with local network providers. Provides steerage to high quality network providers and referrals to the onsite health center.
• Identifies gaps in care and works with providers and/ or local community resources to close gaps in care.
• Establishes and maintains a positive, professional, and collaborative relationship with customer/employee, employer, providers of care, and Cigna partners to support improved outcomes (clinical, quality and cost) of aligned employee population.
• Partners and coordinates with health management matrix partners for additional engagement and promotion opportunities
• Acts as resource to direct customers with specific non-clinical questions to the appropriate resource.

Qualifications

• RN with current unrestricted state licensure required
• At least three or more years of clinical practice experience
• Case Management experience is preferred
• Behavioral Health experience is strongly preferred
• Health Coaching experience is strongly preferred
• A high energy level with excellent oral and written communication skills.
• Excellent Computer skills including Microsoft Office Suite
• Excellent interpersonal skills. Must be able to work in a team environment and exhibit flexibility and enthusiasm in learning new information and developing new skills quickly.
• Comfortable communicating with multiple clinical partners (direct care, Workplace Care, and telephonic coaching and case management teams).
• Clinical Expertise in one or more of the following areas desired: Musculoskeletal, Metabolic/Diabetes, Oncology, Maternity/Fertility, Mental Health)
• Experience in project development and working in a matrix environment preferred.
• Self-directness and the ability succeed in an independent role.
• Passion for assisting member with health improvement and navigation of the Health Care System. Must have strong problem solving skills

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 76,600 - 127,600 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.

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.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.