Cigna (RN) Inpatient Nurse Case Manager (California) in Work From Home Jobs, United States
(RN) Inpatient Nurse Case Manager (California)
This is a work at home role in the Glendale or Visalia, CA area.
Plans, implements, and evaluates appropriate health care services in conjunction with the physician treatment plan.
Handles more complex, high acuity cases, and/or account sensitive cases involving largest reserves. Utilizes clinical skills to assess, plan, implement, coordinate, monitor and evaluate options and services in order to facilitate appropriate healthcare outcomes for members.
Ensures that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained. Performs prospective, concurrent, and retrospective reviews for inpatient acute care, rehabilitation, referrals, and select outpatient services.
May review initial liability disability claims to determine extent and impact of insured's medical condition, medical restrictions and limitations and expected duration. Performs leadership role on team when implementing new tools or case management programs/initiatives and acts s resource to others.
RN with current unrestricted state licensure required.
Must reside in CA near Glendale or Visalia office
Three to five years clinical practice experience required
Utilization management experience required
2 years case management experience strongly preferred
May require experience with short or long term disability and knowledge of workers' compensation regulations.
Excellent communication and interpersonal skills.
Excellent time management, organization and negotiation skills.
Strong research and analytical skills.
Ability to assess complex issues, recommend changes and resolve problems. Knowledge of managed care preferred.
Works independently, receiving direction from manager for new or unprecedented situations.
Manages own caseload and coordinates all assigned cases.
Primary Location: California-California
Other Locations: United States-California-Glendale, United States-Work From Home Jobs, United States-California-Visalia
Work Locations: 400 North Brand Blvd Glendale 91203
Job: Med Mgt--Case Management
Employee Status: Individual Contributor
Job Type: Full-time
Job Level: Day Job
Job Posting: Dec 7, 2018, 2:16:41 PM
Qualified applicants will be considered for employment without regard to age, race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status. Need an accommodation? Email: SeeYourself@cigna.com