RN Team Lead -Premium SolutionsResponsibilities- Build collaborative relationships with members, families, physicians, providers, and other partners to understand medical history, current health status, treatment plans, and opportunities for improved outcomes.
- Obtain informed verbal consent and complete required steps to secure written consent when appropriate.
- Assess health status, identify gaps or barriers to care, and develop documented, patient-centered case management plans with measurable outcomes, follow-up needs, and criteria for closure.
- Implement, coordinate, monitor, and evaluate case management plans while maintaining timely communication among all involved parties.
- Educate and advocate for members to help them make informed health and care decisions.
- Serve as a proactive liaison among members, accounts, families, physicians, facilities, agencies, and other care partners.
- Coordinate appropriate services and, when applicable, negotiate the level, intensity, duration, quality, and cost of care with providers.
- Maintain accurate and timely documentation of case management interventions, outcomes, cost-benefit information, savings, and required data.
- Provide utilization review services for members in active case management when appropriate.
- Practice within the scope of licensure and certification while following quality standards, case management policies and procedures, accreditation requirements, and applicable state and federal regulations.
- Participate in team and enterprise training and maintain the continuing education needed to support clinical expertise and applicable certification.
- Work effectively with people from diverse backgrounds and engage care coordination partners to support customer needs.
- Based on experience, provide leadership, preceptor or mentoring support, and coverage for other case management staff.
- Demonstrate The Cigna Group's cultural beliefs through personal accountability, collaboration, and a focus on organizational results.
Required Qualifications- Active, unrestricted Registered Nurse license in state of residency
- At least three years of full-time, direct clinical care experience.
- Experience in a current Team Lead role
- Acute care clinical experience
- Strong time management, organization, research, analytical, negotiation, interpersonal, verbal communication, and written communication skills.
- Strong computer skills.
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.
