Nurse Case Management Senior Analyst at Cigna

Job Summary: 

The Nurse Case Manager will assess, plan, implement, coordinate, monitor and evaluate options and services to meet an individual’s health needs. Assistance may include such activities as providing clinical information regarding medical conditions or treatments, identifying providers and coordinating complex care plans. 
The Nurse Case Manager will promote quality cost-effective outcomes managing care needs through education and health advocacy to members serviced. 

Responsibilities:

• Coordinate the delivery of medical care for clients, including communicating with healthcare providers, negotiating treatment plans, and ensuring that clients receive appropriate care.
• Conduct assessments of clients' medical conditions and develop care plans to ensure timely and effective treatment.
• Monitor clients' progress, adjust care plans as needed, and communicate updates to clients and healthcare providers.
• Facilitate communication and coordination between clients, healthcare providers, and insurance companies.
• Manage medical costs and negotiate cost-effective treatment options with healthcare providers.
• Ensure that clients receive the appropriate level of care, in accordance with company policies and procedures.
• Maintain up-to-date knowledge of medical trends and advancements, and apply this knowledge to the development of client care plans.
• Provide clients and their families with emotional support and information about their conditions and treatment options.

Requirements:

• Active nursing license in good standing.
• Bachelor's degree in Nursing.
• At least 3 years of nursing experience in a hospital and insurance environment. 
• Knowledge of medical terminology and medical conditions.
• Excellent communication and interpersonal skills.
• Fluent in English, with proficiency in Arabic, French, German, Spanish or Portuguese being an asset. 
• Ability to work independently and as part of a team.
• Ability to handle confidential and sensitive information with discretion.