Pre-Service RN Care CoordinatorRole SummaryThe Pre-Service RN Care Coordinator supports clinical and operational activities for post-acute care services, including transition of care, care coordination, and case management. This position helps ensure members receive medically appropriate services and equipment ordered by their physician while supporting timely communication between members, providers, and internal partners.
Responsibilities- Support clinical and operational processes related to transition of care, care coordination, and case management for post-acute care services, including home health, durable medical equipment, and related care management needs.
- Review physician-ordered services and equipment to help coordinate timely, appropriate member care.
- Collaborate with members, providers, caregivers, and internal teams to support continuity of care and resolve service coordination issues.
- Apply clinical judgment and established guidelines to support appropriate care coordination decisions.
- Document case activities accurately and timely in accordance with clinical, operational, regulatory, and compliance requirements.
- Maintain productivity, quality, and service expectations while managing assigned work in a remote environment.
Minimum Qualifications- Active, unrestricted Registered Nurse license in state of residence.
- Minimum of 2 years of clinical RN experience.
- Ability to work Monday through Friday, 9:00 a.m. to 6:00 p.m. Central Time, with flexibility to work any shift between 7:00 a.m. and 7:00 p.m. Central Time based on business needs.
- Availability for weekend, on-call, and holiday rotation as business needs require.
- Ability to use a computer, telephone, and standard office equipment throughout the workday.
- Ability to maintain a dependable and reliable work schedule.
Preferred Qualifications- Bachelor of Science in Nursing.
- Compact or multistate RN license.
- 2 or more years of utilization management experience.
- Experience in home health, skilled nursing facility, rehabilitation, post-acute care, or care coordination.
- Experience with Medicare and/or Medicaid managed care programs.
Work Environment- This is a remote position.
- This role requires prolonged use of a computer, telephone, and other standard office equipment throughout the workday.
- This position may require sitting for extended periods, with occasional walking and standing.
Skills and Competencies- Strong time management and organizational skills, with the ability to manage priorities and meet deadlines.
- Effective verbal and written communication skills with members, providers, coworkers, and leadership.
- Critical thinking and problem-solving skills, including the ability to evaluate information and determine appropriate next steps.
- Ability to work independently with minimal supervision while meeting performance expectations.
- Proficiency with Microsoft Word, Excel, Outlook, and PowerPoint.
- Experience using virtual collaboration tools such as Webex, Microsoft Teams, or similar platforms.
- Typing speed of 30 words per minute preferred.
For this position, we anticipate offering an hourly rate of 31 - 52 USD / hourly, 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, youll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, youll 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.
