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Nurse Case Manager Senior Analyst
hace 2 semanas
**Europe Global Segments**: Mainly focusing Global Individual Health but supporting and collaborating with Global Employee Health and International Organizations Health
**Major responsibilities and desired results**:
Uses clinical knowledge to assess diagnosis and treatment plans and goals, and identifies gaps in care or risks for readmission or complications.
Manages/coordinates an active volume of cases by providing information, navigation and coordination to customers worldwide.
Works with a multicultural population and is constantly aware of the cultural differences among that population.
Establishes patient centric goals and interventions to meet the member’s needs
Interfaces with the member, family members/caregivers, and the healthcare team, as well as internal matrix partners.
Balances business needs with patient advocacy
Assesses member’s health status and treatment plan and identifies any gaps or barriers to healthcare.
Contact/collaborate with providers to manage and coordinate care for customers by reviewing medical and claim information, ensure compliance with approved services and fees and discuss cases with hospital staff and physicians.
Establishes a documented patient centric case management plan involving all appropriate parties (client, physician, providers, employers, etc), identifies anticipated case results/outcomes, criteria for case closure, and promotes communication within all parties involved.
Work with Cigna physicians to evaluate complex cases and receive appropriate clinical expertise on diagnosis and treatment plans
Responsible for delivering to customers clinical programs including case management, chronic condition management, lifestyle coaching, pre assignment assessment and any other program delivered by global clinical operations.
Coordinate care with other nurses from other regions around the world when a need for local or regional expertise is important for better care or to comply with regulations
Maintains accurate workflow and process documents
Adheres to professional practice within scope of licensure and certification quality assurance standards and all case management policy and procedures
Participates in unit and corporate training initiatives and demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate.
Demonstrates sensitivity to culturally diverse situations, clients and customers.
Serve as clinical liaison to Clients
Other duties as assigned
**Minimum requirements**:
Bachelor in Nursing, 3-5 years of experience in international clinical management
Very strong IT skills
Demonstrated organizational and leadership skills
Strong interpersonal and communication skills
Demonstrates problem-solving and analytical skills.
Ability to act as an “advocate” for the customer while complying with internal policies and procedures and contractual/legal compliance requirements
Ability to operate personal computer, proficient with Microsoft office products, call center software, and a variety of software.
Ability to build solid working relationships with staff, matrix partners, customers and providers
**Language requirements**:
English read, write and speak fluently
**Desirable**: German, French or any other language a plus
About Cigna
Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you’ll enjoy meaningful career experiences that enrich people’s lives. What difference will you make?
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.
