Complex Nurse Case Manager - Remote

This a Full Remote job, the offer is available from: United States, Austria The RN Case Manager plays a critical role in delivering Cigna’s whole‑person health strategy by serving as a trusted advocate and clinical partner for customers, families, and caregivers. This role focuses on care coordination, customer engagement, and health navigation to improve outcomes and deliver exceptional customer experience. The Case Manager demonstrates Cigna’s Care Solutions cultural beliefs, acting with accountability, collaboration, compassion, and innovation in support of both customer needs and business objectives. How You’ll Make an Impact

• Partner with customers to assess needs, develop individualized care plans, and document interventions and outcomes in Cigna medical management systems.
• Collaborate with customers and providers to establish goals, interventions, and evidence‑based plans of care.
• Apply motivational interviewing, behavior change strategies, and shared decision‑making to drive engagement and improved health outcomes.
• Empower customers to effectively navigate the healthcare system and communicate with providers.
• Coordinate care across customers, caregivers, providers, and internal partners via phone and digital channels (email, text, chat).
• Collaborate with interdisciplinary teams—including pharmacists, nutritionists, behavioral clinicians, Medical Directors, and Medical Management programs—to support whole‑person health.
• Track, analyze, and document daily activity, volume, and outcomes to support performance and quality goals.
• Follow established policies, procedures, and Case Management performance measures.
• Efficiently navigate multiple systems and applications in a fast‑paced, customer‑focused environment.
• Complete required training and maintain clinical knowledge, licensure, and certifications.

Required Qualifications

• Active, unrestricted Registered Nurse (RN) license in your state of residency.
• Minimum of two (2) years of full‑time direct patient care experience as an RN.

Preferred Qualifications

• Specialty case management experience, with COMPLEX experience preferred for specialty roles.
• Ability to obtain a URAC‑recognized Case Management certification within four (4) years of hire.
• Strong clinical judgment with the ability to assess risk, prioritize care, and act decisively.
• Excellent verbal and written communication skills across phone and digital platforms.
• Proficiency in Microsoft Word, Excel, Outlook, and online research tools.
• Demonstrated ability to resolve conflict, collaborate across teams, and interact with diverse populations.
• Strong organizational skills, adaptability, and comfort managing multiple complex cases simultaneously.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 77,500 - 129,100 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. 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 need a reasonable accommodation to complete the online application process, please email [email protected] for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. This offer from "The Cigna Group" has been enriched by Jobgether.com and got a 82% flex score.