Transplant Nurse Case Manager

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

📋 Description

• Evaluate customer needs, create tailored care plans, and document interventions and outcomes within Cigna medical management systems.

• Work alongside customers and providers to set goals, interventions, and evidence-based care plans.

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

• Empower customers to effectively navigate the healthcare system and communicate with their providers.

• Coordinate care among customers, caregivers, providers, and internal partners through both phone and digital channels.

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

• Monitor, analyze, and document daily activities, volume, and outcomes to support performance and quality objectives.

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

• Navigate various systems and applications in a dynamic, customer-centric environment.

• Complete mandatory training and maintain clinical expertise, licensure, and certifications.

⛳️ Requirements

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

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

• Preferred experience in specialty case management; transplant experience is a plus for specialized roles.

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

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

• Exceptional verbal and written communication skills across both phone and digital platforms.

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

• Ability to resolve conflicts, collaborate across teams, and engage with diverse populations.

• Strong organizational skills, adaptability, and comfort in managing multiple complex cases concurrently.

• For home-based roles, necessary cable broadband or fiber optic internet service with a minimum of 10Mbps download and 5Mbps upload.

🏝️ Benefits

• Eligibility for annual bonus plan.

• Comprehensive medical benefits.

• Vision benefits.

• Dental benefits.

• Access to well-being and behavioral health programs.

• 401(k) retirement plan.

• Company-sponsored life insurance.

• Tuition reimbursement opportunities.

• A minimum of 18 days of paid time off annually.

• Paid holidays.

• Leaves of absence available.

• Remote work options.