(RN) Nurse Case Manager -- Premium Solutions - Remote

The Nurse Case Manager serves as a customer advocate, partnering with members, families, and providers to coordinate care and support navigation of the healthcare system. This role focuses on whole-person health, behavior change, and delivering high-quality, customer-centered outcomes aligned with Care Solutions cultural beliefs.

• Partner with customers to develop, implement, and document individualized care plans.
• Use motivational interviewing, behavior change strategies, and shared decision-making to support health goals.
• Coordinate care with providers, caregivers, and internal clinical partners to support whole-person health.
• Engage customers through telephonic, digital, and written communication channels.
• Track and document activities, outcomes, and progress in medical management systems.
• Follow standard operating procedures and meet defined case management performance measures.
• Maintain clinical expertise through required training and continuing education.

• Active, unrestricted Registered Nurse (RN) license in a U.S. state or territory.
• Minimum of two (2) years of full-time direct patient care experience as an RN.
• Nursing degree from an accredited nursing program.
• Ability to work an 8-hour shift between 9:00 a.m. and 9:00 p.m. EST, including evenings as business needs require.
• Strong communication skills across telephonic and digital platforms.
• Proficiency with Microsoft Word, Excel, Outlook, and clinical documentation systems.

• Case management certification (URAC-recognized) obtained within four (4) years of hire.
• Experience working in remote, telephonic, or digital care management environments.
• Strong organizational skills with the ability to manage multiple priorities in a fast-paced setting.
• Demonstrated ability to work effectively with culturally diverse populations.
• Flexibility to support non-standard shifts or occasional on-site meetings or audits

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.

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.