Job Summary:

Cigna is seeking a dedicated and compassionate LPN/LVN (Licensed Practical Nurse / Licensed Vocational Nurse) to join our Medicare Clinical Operations team as a Case Management Analyst. This role plays a pivotal part in managing the healthcare needs of our Medicare members by providing high-quality case management services and ensuring comprehensive care coordination. The ideal candidate will be responsible for assessing, evaluating, and assisting members in accessing the most appropriate healthcare resources, all while maintaining a focus on improving health outcomes and reducing care gaps.

Key Responsibilities:

• Conduct initial assessments and ongoing evaluations of Medicare members healthcare needs.
• Develop individualized care plans in collaboration with members, healthcare providers, and interdisciplinary teams.
• Facilitate the coordination of medical services, ensuring that members receive the appropriate care in a timely manner.
• Monitor the effectiveness of care plans and adjust interventions as necessary to meet member needs and optimize health outcomes.
• Educate members and their families about available healthcare resources and services, helping them navigate the healthcare system.
• Document case management activities, care plans, and progress reports in the system in compliance with regulatory requirements and Cignas policies.
• Provide telephonic or in-person case management support to high-risk and complex cases.
• Work closely with medical directors, physicians, and other healthcare professionals to manage care transitions and ensure a seamless experience for members.
• Maintain current knowledge of healthcare trends, Medicare regulations, and case management best practices to inform clinical decisions.

Required Skills and Qualifications:

• Current, active LPN/LVN license in the state of employment.
• Minimum of 3 years of clinical experience in a healthcare setting (hospital, clinic, or case management environment).
• Previous experience working with Medicare patients or in a managed care environment preferred.
• Strong communication and interpersonal skills with the ability to interact effectively with members, providers, and interdisciplinary teams.
• Ability to work independently and as part of a team, managing multiple cases efficiently.
• Proficient in Microsoft Office Suite (Word, Excel, PowerPoint) and case management software.
• Strong attention to detail and organizational skills with a focus on quality care.
• Knowledge of Medicare regulations, policies, and clinical guidelines.

Experience:

• A minimum of 3 years of clinical nursing experience, preferably in case management, discharge planning, or a similar setting.
• Experience in a Medicare/Managed Care setting is highly preferred.
• Familiarity with case management tools and processes.
• Experience working in a telephonic case management environment is a plus.

Working Hours:

• Full-time position.
• Typical working hours are Monday to Friday, 8:00 AM – 5:00 PM (flexible scheduling may be available).
• Occasional evenings or weekends may be required based on member needs or project timelines.

Knowledge, Skills, and Abilities:

• In-depth understanding of case management processes and healthcare delivery systems.
• Proficient in using Electronic Health Records (EHR) and case management software.
• Ability to effectively manage a caseload and prioritize tasks based on clinical urgency and member needs.
• Strong problem-solving skills with the ability to develop creative solutions for complex member needs.
• Excellent organizational skills with the ability to manage multiple priorities and deadlines.
• Ability to educate and empower members to make informed decisions about their healthcare.
• Demonstrated commitment to improving health outcomes and providing high-quality care.

Benefits:

• Competitive salary and performance-based bonuses.
• Health, dental, and vision insurance plans for you and your family.
• 401(k) with company matching and financial planning assistance.
• Paid time off (PTO), including vacation, sick days, and holidays.
• Opportunities for professional growth and continuing education.
• Employee assistance program (EAP) for personal support.
• Work-life balance initiatives, including flexible scheduling options.

Why Join Cigna?

Cigna is committed to helping people improve their health, well-being, and sense of security. As a leading global health service company, we offer our employees meaningful work and the opportunity to make a real difference in the lives of our members. By joining our Clinical Operations team, you will be part of a dynamic organization that values collaboration, innovation, and a commitment to providing high-quality care to those who need it most.

How to Apply:

To apply for the Cigna Medicare Clinical Operations LPN/LVN Case Management Analyst position, please submit your resume and cover letter through our online application portal. Include details of your nursing experience and any relevant certifications. Qualified candidates will be contacted for an interview.

Cigna is an equal-opportunity employer. We encourage individuals of all backgrounds to apply and join us in making a difference in the lives of our members.