SNP Case Manager is responsible for working with our dual eligible (Medicare/Medicaid) membership and completing the model of care requirements around Health Risk Assessments (HRA), High Risk Care Planning and Interdisciplinary Care Team meetings. Case Managers will make outreach to the member following our work aides and complete a HRA with the customer, create the appropriate Care Plan (CP), sending letters and documenting in Medical House of Knowledge (MHK).

Responsible for educating and motivating customers to participate in wellness programs. Support health promotion and disease prevention and care management services. Ensures that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained. Manages own caseload and coordinates all assigned cases. The Health Risk Assessments are physical health risk assessments for a Managed Medicare Population completed by the customer with case management support.

Ideal candidate would have previous case management experience with the Medicare/Medicaid population specifically focusing on Special Needs Plan Model of Care documentation requirements, care coordination working with hospital settings and Primary Care Physician offices. Knowledge of community resources is also helpful.

Qualifications

• Must have active Texas nursing License (CANNOT CONSIDER LPNs) Compact license a plus
• Requires two to four years clinical practice experience or certification in case management with managed care and Special Needs Population (SNP) population experience at professional level.
• Excellent verbal and written communication and interpersonal skills.
• Ability to learn new processes and systems quickly.
• Strong time management and organization skills.
• Ability to prioritize the work. Strong research and analytical and problem solving skills.
• Ability to work independently and knowledge of managed care preferred.
• Effective coaching/education skills.
• Ability to work in rapidly changing environment.
• Experience in senior population with chronic conditions.
• Ability to work with people with significant educational and or socioeconomic barriers impacting their health.

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.