The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, weāre dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.
The Registered Nurse will perform medical necessity reviews for Initial and Concurrent authorization requests for Home Health services.
Minimum Education and Licensure Requirement: Current unrestricted Registered Nurse licensure. Associate degree or Bachelor Degree in Nursing preferred. Multistate license preferred. Must hold license in state of residence. Minimum Experience required Minimum 2 years clinical experience. Acute care, Home Health, SNF and/or Rehab experience desired. Medicare/Medicaid managed care knowledge preferred. The position is telephonic/Work at Home. Hours: Monday - Friday; 8a-5p in current time zone; Position is full-time during core business hours with the ability to work any shift between 7 am and 7 pm CST. Availability for weekend rotation, on-call rotation, and holiday rotation required. The ability to sit at a desk 50% of the time and utilize the computer, telephone, and other office equipment, throughout the entire work day; walking and standing. Ability to perform dependable and reliable work schedule is essential. Required Skills: Time-management: Ability to effectively manage oneās time and resources to ensure that work is completed efficiently Excellent organizational skills. Communication: Ability to provide clear verbal and written information via in-person, email, and phone to customers, co-workers, and leadership. Critical-Thinking/Decision-making: Ability to choose a course of action or developing appropriate solutions by identifying and understanding issues, problems, and opportunities. Autonomy: Ability to work independently with little to no supervision. Proficient in computer literacy skills with ability to use and troubleshoot Microsoft Word, Excel, Outlook, and PowerPoint with the ability to type 30 wpm preferred. Experience using videoconferencing systems such as WebEx. 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.
Medical Necessity Review for Initial and Concurrent Review authorization requests. Development, evaluation and coordination of an individualized plan of care for each patient. Monitor progress toward desired care outcomes; review the care plan in conjunction with the direct care providers. Facilitate a timely and safe discharge.
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Telehealth
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