Job Description

Primary Duties and Responsibilities:

* Conducts a comprehensive F2F (Nursing Facility assessments) 4 times per year with Members residing in a Skilled Nursing Facility.
* Attends and actively participates in Nursing Facility care plan meetings for assigned Members to collaborate with nursing facility staff to mitigate barriers to care and prevent hospitalizations.
* Collaborates and coordinates member transition needs to create a viable discharge plan for members expressing desire to return to the community through MFP process.
* Leads interdisciplinary team meetings necessary to collaborate member needs with internal and external partners
* Works with member, members family, nursing facility and providers to develop a comprehensive

Individualized service plan.

* Uses clinical judgment to identify physical and behavioral health needs and works with the member and caregiver to establish an appropriate plan of care to ensure needs are met.
* Works with member to close functional, clinical, and pharmacy gaps.
* Acts as a liaison and facilitates the coordination of benefits, resources, healthcare providers, and institutions.
* Completes and files all assessments within the timelines outlined by the state.
* Maintains a maximum weekly face to face visit schedule of twelve members with average caseload of 120.
* Candidate must reside in one of the service areas listed . (Wood, Rains, Hopkins, Delta, Franklin, Hunt) (Tyler , Texas County )

Required Qualifications:

* Must be a Registered Nurse with a current, unrestricted Texas License with 3- 5 years RN experience.
* Strong organizational and time management skills
* Must have strong computer skills using MS office products including Word, Excel, and Outlook
* Excellent verbal and written communication skills
* Must have reliable transportation, a valid and unrestricted drivers license and proof of insurance.
* The ability to travel to members homes, and other locations within the service delivery area.
* Travel 80% of the time.

Preferred Qualifications:

* Previous STAR+PLUS experience.
* Home Health Case Management experience with Medicare or Medicaid beneficiaries
* CCM certification preferred not required.
* Experience managing members with chronic and complex disease
* Experience working with community resource organizations preferred
* Experience with care management software applications preferred.

About Cigna

Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. We offer an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products. Together, with our 74,000 employees worldwide, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation.

When you work with Cigna, youll enjoy meaningful career experiences that enrich peoples lives while working together to make the world a healthier place. What difference will you make? To see our culture in action, search TeamCigna on Instagram.

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 require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.