Concurrent Review Care Coordinator - EviCore - Work at Home id-1895

December 20, 2024

Full Job Description

The Registered Nurse will perform clinical and operational processes related to transition/coordination of care and utilization/case management of Post-Acute Care services including but not limited to long-term acute care, skilled nursing and inpatient rehab facilities, home health care, care management, and utilization review. The Registered Nurse is responsible for the implementation, evaluation, and coordination of the plan of care for all assigned patients. Develops care plans and other case management tools by participating in meetings. Identifies progress toward desired care outcomes; intervenes to overcome deviations in the expected plan of care; reviews the care plan with patients in conjunction with direct care providers. Monitors delivery and utilization of care by completing patient rounds with Medical Directors.

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Minimum Education, Licensure and Professional Certification Requirements:

Current unrestricted Registered Nurse licensure.
Associate degree or Bachelor Degree in Nursing preferred
Multistate license preferred

Minimum Experience Required:

2+ years of clinical experience
2 + years experience in utilization management preferred.
Home health, SNF, and/or rehab experience desired
Medicare/Medicaid managed care programs preferred
Position is remote
Hours: Monday - Friday; 8a-5p Central or 8a-5p Mountain; Position is full-time during core business hours with the ability to work any shift between 7 am and 7 pm CST.
Availability for weekend rotation, on-call rotation, and holiday rotation.
Ability to sit at a desk 50% of the time and utilize the computer, telephone, and other office equipment, throughout the entire work day; walking and standing.
Ability to perform dependable and reliable work schedule is essential ••

Required Skills:

Time-management: Ability to effectively manage one’s time and resources to ensure that work is completed efficiently Excellent organizational skills
Communication: Ability to provide clear verbal and written information via in-person, email, and phone to customers, co-workers, and leadership
Critical-Thinking/Decision-making: Ability to choose a course of action or develop appropriate solutions by identifying and understanding issues, problems, and opportunities
Autonomy: Ability to work independently with little to no supervision
Proficient in computer literacy skills with the ability to use and troubleshoot Microsoft Word, Excel, Outlook, and PowerPoint with the ability to type 30 wpm preferred
Experience using videoconferencing systems such as WebEx

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 hourly rate of 27 - 41 USD / hourly, 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.

Concurrent Review Care Coordinator - EviCore - Work at Home id-1895

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