RN Nurse Case Management Manager, Tyler, Texas( Smith, Wood, Upshur, Rusk Counties)
Company: Cigna
Location: Tyler
Posted on: January 11, 2021
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Job Description:
Summary Nurse Case Management Manager is responsible for
overseeing the functions of Service Coordination within the nursing
facilities to ensure contractual requirements for Cigna Star Plus
nursing facility members are met. The manager will be responsible
for managing the day to day operation for their assigned service
coordination team while providing assignment monitoring, evaluating
quality of coordination, coaching, and team leadership for their
service area. Essential Duties and Responsibilities: Leads,
directs, and monitors the delivery of all service coordination
functions. Implements procedures and policies established by Cigna
that enhance the quality of life for people receiving services.
Provides leadership and collaboration with other managers and
departments to assure compliance with local, state and federal
regulations, nursing practice standards as well as standard
operational structure across the Texas. Ensures effective and
efficient budget management in providing the best utilization of
resources. Provides effective staff management (hiring,
development, training, performance feedback, etc.) that assures
utilization of personnel to best meet the needs of the people
receiving supports and services. Supports training that assures the
best possible delivery of health related supports and services.
Ensures the completion of accurate service coordination
documentation to provide continuity of care and record storage.
Oversees caseload assignments/priorities Monitors monthly
productivity and goal status Assists with the implementation of
workflows; Monitoring processes to ensure adequate acknowledgement,
research and resolution to daily encounters for staff development
Coordinates and completes staff check ins and audits to provide
feedback to direct reports Attends applicable committees, as
assigned Holds team meetings no less than monthly Conducts staff
training in accordance with approved curriculum and approved
presentations and maintaining a training log of training provided
and attendance Conducts monthly staff meetings Keeps current on
regulatory and company-wide changes impacting complex case
management Attends required leadership meetings Travel 25% out of
service area This role will start off working from home in
Tyler,Texas and move to onsite TBD. Candidate must live in one of
the following counties: Smith, Wood, Upshur or Rusk. Required
Qualifications: Must be a Registered Nurse with a current,
unrestricted Texas License At least two years' experience in
management or administration Strong organizational and time
management skills Must have strong computer skills using MS office
products including Word, Excel, Power Point, and Outlook Excellent
verbal, written, communication and presentation skills Strong
knowledge of the Medicare/Medicaid Managed Care business Ability to
meet deadlines and manage multiple priorities Effectively adapt and
respond to complex, fast-paced, changing environment. Ability to
make decisions on what needs to be done based on clearly
established guidelines Experience managing process workflows.
Preferred Knowledge, Skills, Abilities: Bachelor's degree preferred
Previous STARPLUS experience. Home Health Case Management
experience with Medicare or Medicaid populations a plus Experience
managing members with chronic disease processes Experience working
with community resource organizations Experience with care
management software applications About Cigna Cigna Corporation
(NYSE: CI) is a global health service company dedicated to
improving the health, well-being and peace of mind of those we
serve. We offer an integrated suite of health services through
Cigna, Express Scripts, and our affiliates including medical,
dental, behavioral health, pharmacy, vision, supplemental benefits,
and other related products. Together, with our 74,000 employees
worldwide, 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 Cigna, you'll enjoy meaningful
career experiences that enrich people's lives while working
together to make the world a healthier place. What difference will
you make? To see our culture in action, search TeamCigna on
Instagram. 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: for support. Do not email
for an update on your application or to provide your resume as you
will not receive a response.
Keywords: Cigna, Tyler , RN Nurse Case Management Manager, Tyler, Texas( Smith, Wood, Upshur, Rusk Counties), Healthcare , Tyler, Texas
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