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(RN) Nurse Case Manager — Premium Solutions – Remote
Position Scope
Hours for the position: Must be able to work an 8-hour-shift between the business hours of 9a-9p EST. Flexibility is required to meet business needs. Must be open to work evenings.
Role Summary:
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.
Key Responsibilities:
- 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.
Required Qualifications:
- 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.
Preferred Qualifications:
- 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.
About Cigna Healthcare
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.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 seeyourself@thecignagroup.com 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.
Additional Information
Company: Cigna Healthcare
Location: Pennsylvania
Salary: $77,500 - $129,100 per year
Job ID:
Specialties: Case Manager, Care Manager, Telephonic Nurse
Required Licenses: RN
Experience Level: 1-3 years
