Position Scope

Hours for the position: Must be able to work an 8-hour-shift between the business hours of 9a-9p EST. Flexibility is required to meet business needs. Must be open to work evenings.

Role Summary:
The Nurse Case Manager serves as a customer advocate, partnering with members, families, and providers to coordinate care and support navigation of the healthcare system. This role focuses on whole-person health, behavior change, and delivering high-quality, customer-centered outcomes aligned with Care Solutions cultural beliefs.

Key Responsibilities:

• Partner with customers to develop, implement, and document individualized care plans.
• Use motivational interviewing, behavior change strategies, and shared decision-making to support health goals.
• Coordinate care with providers, caregivers, and internal clinical partners to support whole-person health.
• Engage customers through telephonic, digital, and written communication channels.
• Track and document activities, outcomes, and progress in medical management systems.
• Follow standard operating procedures and meet defined case management performance measures.
• Maintain clinical expertise through required training and continuing education.

Required Qualifications:

• Active, unrestricted Registered Nurse (RN) license in a U.S. state or territory.
• Minimum of two (2) years of full-time direct patient care experience as an RN.
• Nursing degree from an accredited nursing program.
• Ability to work an 8-hour shift between 9:00 a.m. and 9:00 p.m. EST, including evenings as business needs require.
• Strong communication skills across telephonic and digital platforms.
• Proficiency with Microsoft Word, Excel, Outlook, and clinical documentation systems.

Preferred Qualifications:

• Case management certification (URAC-recognized) obtained within four (4) years of hire.
• Experience working in remote, telephonic, or digital care management environments.
• Strong organizational skills with the ability to manage multiple priorities in a fast-paced setting.
• Demonstrated ability to work effectively with culturally diverse populations.
• Flexibility to support non-standard shifts or occasional on-site meetings or audits

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.