Coordinate and manage member care in participating provider practices:
Under general supervision, responsible for identifying medium/ high risk members by utilizing predictive modeling reports for the assigned physician or health system practices.

Identify gaps in care and document compliance. Initiate contact with member/family, physician, and health care providers/suppliers to discuss the alternative treatment plans.

Greet members at on-site visits and assess members that need an ECC visit to assure coordination where prohibited.

Perform telephonic outreach to member in need of care coordination. Monitors and evaluates inpatient admissions and discharge census and follows through for post discharge appointments and needs.

Partner with in-office Point-of-Contact(s) to ensure member compliance and practice success:

Coordinate real-time performance measure management by communicating any updates to member health care.

Ensure that participating practices and are driving improvement on Star performance measures at the contract level.

Review data for those members that are frequent users of healthcare resources to ensure they are receiving the proper care.

Develop and maintain a process to ensure that all members in participating practices receive the screenings and services needed within the given timeframe.  

Maintain detailed understanding of P4Q Program and HEDIS/STAR performance measures. 

Once permitted, role will travel to doctor's offices. The role will also work a portion of the week from home.

Minimum Requirements:

Unrestricted LPN license in applicable state.

At least 3-5 years of related experience in a healthcare environment.

Experience working within a complex hospital health system, or large multi-specialty practice.

Excellent written and oral communication skills; excellent problem solving skills; highly organized and proactive; ability to handle multiple tasks and set priorities; detailed oriented; works independently with minimum of supervision. Ability to travel to and work at participating practices. Reside in AL/Birmingham area but work majority of time at home.

Requires wired-broadband high-speed internet.

Preferred Requirements: Minimum five years clinical practice experience in a providers’ office, hospital setting.  Experience working with Microsoft office applications, electronic medical records and similar databases strongly preferred. Knowledge of Stars and Hedis guidelines.

This position is not eligible to be performed in Colorado.

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you’ll enjoy meaningful career experiences that enrich people’s lives. What difference will you make?

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.