Job Summary:The Cigna Medicare Clinical Operations LPN/LVN Case Management Analyst will be responsible for providing high-quality case management services for Medicare members. This position will work closely with physicians, healthcare providers, and members to manage and coordinate care while ensuring adherence to clinical guidelines and Medicare policies. The ideal candidate will utilize their clinical expertise to drive patient outcomes, optimize care plans, and ensure that Cignas services meet the highest standards of care and compliance.

Key Responsibilities:

• Conduct comprehensive assessments of Medicare members healthcare needs.
• Develop and implement personalized care plans for members in collaboration with multidisciplinary teams.
• Monitor and track patient progress, adjusting care plans as necessary.
• Serve as a liaison between the patient, their family, and healthcare providers.
• Review medical records, insurance plans, and case data to ensure appropriate care and services are provided.
• Provide education to members regarding their conditions, treatments, and care options.
• Facilitate communication between internal teams, external providers, and health professionals.
• Ensure compliance with Cignas Medicare policies, procedures, and regulatory requirements.
• Participate in case reviews, audits, and quality improvement initiatives.

Required Skills and Qualifications:

• Active LPN (Licensed Practical Nurse) or LVN (Licensed Vocational Nurse) license.
• Certification in case management (preferred, or willingness to pursue).
• Strong clinical knowledge and experience in case management or care coordination.
• Ability to analyze and synthesize healthcare data to improve patient outcomes.
• Excellent communication skills, both written and verbal.
• Strong problem-solving and decision-making abilities.
• Ability to work independently and as part of a collaborative team.
• Familiarity with Medicare regulations and compliance requirements.
• Proficiency in using electronic medical records (EMR) and case management software.

Experience:

• Minimum of 2 years of clinical experience in a healthcare setting, preferably in case management or care coordination.
• Experience working with Medicare populations is highly desirable.
• Previous experience in a remote or virtual work environment is a plus.

Working Hours:

• Full-time position, Monday to Friday.
• Standard business hours (9:00 AM to 5:00 PM), with occasional flexibility based on workload.

Knowledge, Skills, and Abilities:

• In-depth understanding of Medicare programs and regulations.
• Knowledge of healthcare delivery systems and care coordination processes.
• Strong organizational and time-management skills.
• Ability to build rapport with patients, families, and healthcare professionals.
• Familiarity with healthcare analytics and reporting tools.

Benefits:

• Competitive salary and performance-based bonuses.
• Comprehensive health insurance, including dental and vision coverage.
• Retirement savings plan with employer match.
• Paid time off (PTO), including vacation, sick leave, and holidays.
• Professional development and continuing education opportunities.
• Work-from-home flexibility and remote team collaboration.

Why Join Cigna?At Cigna, we are committed to improving the health and well-being of the people we serve. As a Medicare Clinical Operations LPN/LVN Case Management Analyst, you will play a vital role in impacting the lives of our Medicare members, ensuring they receive personalized care that aligns with our mission to make healthcare more accessible and affordable. Join us to be part of a dynamic, collaborative team where your expertise is valued and your professional growth is supported.

How to Apply:Interested candidates should submit their resume along with a cover letter highlighting relevant experience and qualifications through Cignas career portal. Cigna is an equal-opportunity employer and encourages applicants from diverse backgrounds to apply.