Case Manager Specialist

Description Plans, implements, and evaluates appropriate health care services in conjunction with the physician treatment plan. Handles more complex, high acuity cases and/or account sensitive cases. Performs prospective, concurrent, and retrospective reviews for inpatient acute care, rehabilitation, referrals, and select outpatient services including DME (durable medical equipment). Ensures that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained. Performs leadership role on team when implementing new tools or case management programs/initiatives. Excellent communication and interpersonal skills. Excellent time management, organization and negotiation skills. Strong research and analytical skills. Ability to assess complex issues, recommend changes and resolve problems. Knowledge of managed care preferred. Works independently, receiving direction from manager or team leader for new or unprecedented situations. Manages own caseload and coordinates all assigned cases. Acts as a resource to others. RN with active license required, B.S. preferred. Three to five years clinical practice experience and 2 years case management experience. If in Behavioral Health, requires RN with current state licensure or a Master's Degree in a mental health field with current licensure; requires at least five years of varied experience in psychiatric settings; and at least one year as a Care Manager in behavioral health environment..

Requirements Ideal candidate will offer:

Working knowledge of motivational strategies, materials development, training and consultation required.

Thorough knowledge and understanding of health behavior change theories and their application.

Proven administrative abilities, with strong computer and software application skills.

Excellent interpersonal skills and the ability to work in a team environment

Demonstrated ability to set priorities

A high energy level and excellent written and oral communication skills are essential.

Passion for health improvement of members

A minimum of three (3) years experience in health promotion

Experience in telephonic counseling preferred

Certified Health Education Specialist certification preferred (from the National Commission for Health Education Credentialing).

Bachelors degree in Health Education, Health Promotion or related discipline required.

Experience with direct member communication (written and verbal).

Experience in health education and wellness coaching

Masters degree preferred

Registered Dietician required.

CIGNA offers a competitive compensation and comprehensive benefits package including health and wellness benefits, 401k plan, and work/life balance programs, as well as opportunities for career growth and development.

At CIGNA, we are committed to providing our customers with employee benefits, expertise and services that improve the health, well-being and productivity of their employees. CIGNA's people are the key to our success in a changing and increasingly competitive marketplace. The collective skills, behaviors and work experiences of all CIGNA employees enable us to make a real difference in the lives of our members. We seek the most talented and creative minds in the industry to develop innovative solutions our customers value and consumers expect.