RN Team Lead (Premium) - Evernorth Health Services - Remote

RN Team Lead -Premium Solutions

Responsibilities

• Build collaborative relationships with members, families, physicians, providers, and other partners to understand medical history, current health status, treatment plans, and opportunities for improved outcomes.
• Obtain informed verbal consent and complete required steps to secure written consent when appropriate.
• Assess health status, identify gaps or barriers to care, and develop documented, patient-centered case management plans with measurable outcomes, follow-up needs, and criteria for closure.
• Implement, coordinate, monitor, and evaluate case management plans while maintaining timely communication among all involved parties.
• Educate and advocate for members to help them make informed health and care decisions.
• Serve as a proactive liaison among members, accounts, families, physicians, facilities, agencies, and other care partners.
• Coordinate appropriate services and, when applicable, negotiate the level, intensity, duration, quality, and cost of care with providers.
• Maintain accurate and timely documentation of case management interventions, outcomes, cost-benefit information, savings, and required data.
• Provide utilization review services for members in active case management when appropriate.
• Practice within the scope of licensure and certification while following quality standards, case management policies and procedures, accreditation requirements, and applicable state and federal regulations.
• Participate in team and enterprise training and maintain the continuing education needed to support clinical expertise and applicable certification.
• Work effectively with people from diverse backgrounds and engage care coordination partners to support customer needs.
• Based on experience, provide leadership, preceptor or mentoring support, and coverage for other case management staff.
• Demonstrate The Cigna Group’s cultural beliefs through personal accountability, collaboration, and a focus on organizational results.

Required qualifications

• Active, unrestricted Registered Nurse license in state of residency
• At least three years of full-time, direct clinical care experience.
• Experience in a current Team Lead role
• Acute care clinical experience
• Strong time management, organization, research, analytical, negotiation, interpersonal, verbal communication, and written communication skills.
• Strong computer 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 77,500 - 129,100 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.

At The Cigna Group, 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), 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 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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com 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.