Transplant Nurse Case Manager

This is a fully remote position, open to applicants in California.

📋 Description

• Evaluate customer requirements, create personalized care plans, and record interventions and results in Cigna's medical management systems.

• Partner with customers and healthcare providers to set objectives, interventions, and evidence-based care plans.

• Utilize motivational interviewing, behavior modification techniques, and shared decision-making to enhance engagement and health outcomes.

• Assist customers in navigating the healthcare system and facilitate communication with providers.

• Coordinate care among customers, caregivers, providers, and internal stakeholders via phone and digital platforms.

• Work in collaboration with interdisciplinary teams, including pharmacists, nutritionists, behavioral clinicians, Medical Directors, and Medical Management programs.

• Monitor, assess, and document daily activities, volumes, and outcomes.

• Adhere to established policies, procedures, and Case Management performance standards.

• Manage multiple systems and applications in a dynamic, customer-centric environment.

• Complete necessary training and uphold clinical knowledge, licensure, and certifications.

⛳️ Requirements

• Current, unrestricted Registered Nurse (RN) license in your state of residence.

• A minimum of two (2) years of full-time direct patient care experience as an RN.

• Preferred experience in specialty case management; transplant experience is desirable for specialty roles.

• Capability to acquire a URAC-recognized Case Management certification within four (4) years of employment.

• Strong clinical judgment with the ability to assess risk, prioritize care, and make decisive actions.

• Outstanding verbal and written communication skills across phone and digital channels.

• Proficient in Microsoft Word, Excel, Outlook, and online research tools.

• Skill in conflict resolution, collaboration across teams, and engagement with diverse populations.

• Excellent organizational abilities, adaptability, and competence in managing multiple complex cases simultaneously.

• Home internet access, while working remotely, through cable broadband or fiber optic service with a minimum of 10 Mbps download and 5 Mbps upload speeds.

🏝️ Benefits

• Eligibility for an annual bonus plan.

• Comprehensive medical benefits.

• Vision benefits.

• Dental benefits.

• Well-being and behavioral health programs.

• 401(k) retirement plan.

• Company-paid life insurance.

• Tuition reimbursement assistance.

• At least 18 days of paid time off annually.

• Paid holidays.

• Leaves of absence.