RN - Maternity Nurse Case Manager - Remote

1w1 week ago

The Cigna Group

Pittsburgh, US · Full-time · $80,000 – $105,000

About this role

Case managers are healthcare professionals who serve as customer advocates to coordinate, support, and guide care for customers, families, and caregivers navigating the healthcare journey. They adopt and demonstrate Care Solutions cultural beliefs, role modeling Customer Strong, Me to We, Own It, Evolve and Adapt, Be Bold, and Take Care for personal accountability and results.

In daily responsibilities, collaborate with customers to create and document care plans in the medical management system. Partner to establish goals and interventions using motivational interviewing, behavior change, and shared decision making to achieve optimal health.

Interface telephonically, via email, text, and chat with customers, families, providers, nutritionists, pharmacists, behavioral clinicians, Medical Directors, and internal partners for whole-person health support. Track activities, follow standard operating procedures, and toggle between multiple systems while prioritizing work aligned with organizational goals.

Demonstrate continuing education to maintain clinical expertise and certification. Adhere to Case Management performance measures and complete required training within communicated time limits to deliver key results and evolve with business needs.

Requirements

Active unrestricted Registered Nurse (RN) license in state or territory of the United States
Minimum of two years full-time direct patient care as an RN
Experience in Maternity specialty preferred
Within four years of hire, possess a URAC-recognized certification in case management
Excellent communication skills including telephonic and digital messaging
Strong computer skills in Microsoft Word, Excel, Outlook, and internet research
Ability to recognize, address, and resolve conflicts professionally
Demonstrates sensitivity to culturally diverse situations

Responsibilities

Collaborate with customer in creation of care plan and document plan in medical management system
Partner with each customer to establish goals and interventions to meet the customer’s needs
Utilize motivational interviewing, behavior change, and shared decision making to help customers achieve optimal health
Interface with customer, family members/caregivers, providers, and internal partners via telephonic, email, text, and chat
Collaborate with nutritionist, pharmacist, behavioral clinician, Medical Director, and customer's provider for whole-person support
Track daily activities to trend volume and outcomes
Research relevant topics in health promotion and disease prevention as required