The Nurse will:
- Deliver professional activities in the Case Management job family.
- Coordinate enrollee care needs across the continuum for assigned members who are medically stable but require primary psychosocial support and acute intermittent medical support.
- Interview members and relatives to obtain social history relevant to medical problems and care planning.
- Assist members with environmental difficulties that interfere with obtaining maximum benefits from medical care.
- Serve as a liaison between primary care team, members, relatives and appropriate outside agencies.
- Apply standard techniques and procedures to routine instructions that require professional knowledge in specialist areas.
- Provide standard professional advice and creates initial reports/analyses for review.
- Provide guidance, coaching, and direction to more junior members of the team in Case Management
Responsibilities include:
- Responsible for the effective and sufficient support of all Case Management activities to include review of inpatient and outpatient medical records for appropriateness of case management resources.
- Uses an established set of criteria to evaluates and approve the ...
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Cigna-Evernorth Services Inc.
A global health company with a mission to improve the health and vitality of those they serve.
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