Complex Nurse Case Manager - Remote

Cigna Healthcare

$77K — $129K *
US-AnywhereRemote in United States
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Active, unrestricted RN license in your state of residency.
  • Minimum of two years of full-time direct patient care experience as an RN.
  • Specialty case management experience preferred, especially with complex cases.
  • Ability to obtain URAC-recognized Case Management certification within four years of hire.
  • Strong clinical judgment for assessing risk and prioritizing care.
  • Excellent verbal and written communication skills across multiple platforms.
  • Proficiency in Microsoft Office and online research tools.

Responsibilities

  • Partner with customers to assess needs and develop individualized care plans.
  • Collaborate with providers to establish goals and evidence-based plans of care.
  • Apply strategies like motivational interviewing to improve engagement and health outcomes.
  • Empower customers to navigate the healthcare system and communicate effectively with providers.
  • Coordinate care across various stakeholders via phone and digital channels.
  • Work with interdisciplinary teams to support whole-person health initiatives.
  • Document daily activity and outcomes to meet performance and quality standards.

Benefits

  • Comprehensive health-related benefits starting on day one, including medical, vision, and dental coverage.
  • Well-being and behavioral health programs available.
  • 401(k) retirement plan offered.
  • Company-paid life insurance for employees.
  • Tuition reimbursement support for continuing education.
  • Minimum of 18 days of paid time off per year plus paid holidays.
  • Available leaves of absence.
Full Job Description
The RN Case Manager plays a critical role in delivering Cigna's whole-person health strategy by serving as a trusted advocate and clinical partner for customers, families, and caregivers. This role focuses on care coordination, customer engagement, and health navigation to improve outcomes and deliver exceptional customer experience.

The Case Manager demonstrates Cigna's Care Solutions cultural beliefs, acting with accountability, collaboration, compassion, and innovation in support of both customer needs and business objectives.

How You'll Make an Impact
  • Partner with customers to assess needs, develop individualized care plans, and document interventions and outcomes in Cigna medical management systems.
  • Collaborate with customers and providers to establish goals, interventions, and evidence-based plans of care.
  • Apply motivational interviewing, behavior change strategies, and shared decision-making to drive engagement and improved health outcomes.
  • Empower customers to effectively navigate the healthcare system and communicate with providers.
  • Coordinate care across customers, caregivers, providers, and internal partners via phone and digital channels (email, text, chat).
  • Collaborate with interdisciplinary teams-including pharmacists, nutritionists, behavioral clinicians, Medical Directors, and Medical Management programs-to support whole-person health.
  • Track, analyze, and document daily activity, volume, and outcomes to support performance and quality goals.
  • Follow established policies, procedures, and Case Management performance measures.
  • Efficiently navigate multiple systems and applications in a fast-paced, customer-focused environment.
  • Complete required training and maintain clinical knowledge, licensure, and certifications.


Required Qualifications
  • Active, unrestricted Registered Nurse (RN) license in your state of residency.
  • Minimum of two (2) years of full-time direct patient care experience as an RN.


Preferred Qualifications
  • Specialty case management experience, with COMPLEX experience preferred for specialty roles.
  • Ability to obtain a URAC-recognized Case Management certification within four (4) years of hire.
  • Strong clinical judgment with the ability to assess risk, prioritize care, and act decisively.
  • Excellent verbal and written communication skills across phone and digital platforms.
  • Proficiency in Microsoft Word, Excel, Outlook, and online research tools.
  • Demonstrated ability to resolve conflict, collaborate across teams, and interact with diverse populations.
  • Strong organizational skills, adaptability, and comfort managing multiple complex cases simultaneously.


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 annual salary of 77,500 - 129,100 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

At The Cigna Group, 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), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.

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