Case Manager

Cigna (Madrid, España) Publicado hace 5 horas
Are you looking for a new challenge in your career? Great! And you’re considering working at Cigna? Even better! You’ll have lots of questions. Here are some answers.
What does Cigna do?
We started over 200 years ago and we continued to innovate and expand ever since. Cigna Corporation is a global health service company dedicated to improving the health, well-being, and peace of mind of those we serve.
We deliver choice, predictability, affordability and access to quality care through connected, personalized solutions that advance whole person health, both in body and mind .
With more than 170 million customer and patient relationships in more than 30 countries and jurisdictions , we are able to harness actionable insights that drive better health care results.
Our global workforce of more than 74,000 employees are dedicated to living our mission and being champions of our customers and communities each and every day.
Cigna provides employee benefits around the world, amongst which health insurance services and life & protection solutions (LPS) like life & disability plans. We’re passionate about helping people improve their health, well-being, and piece of mind.
Cigna Europe has more than 60 years of experience in designing, implementing and managing international group health insurance and employee benefits programmes for domestic and international recruited staff from European corporations, International Organisations (IGO & NGO) and governments. We also provide healthcare for globally mobile individuals. To support its European and Global Segments customers, Cigna Europe has dedicated offices in the United Kingdom, Belgium, Spain, Kenya, Dubai, the United States and Malaysia. Over the years, we have acquired an in-depth understanding of the daily challenges faced by domestic and international organisations, and their staff members in managing their health and wellbeing.
We’re people-people. We are a human organization, where people come first. Whether it’s our customers, patients, clients, or colleagues, we aim to improve the health, well-being and peace of mind of everyone we can reach
What makes Cigna different from other employers?
We go further than just paying insurance claims. Solid customer relationships are our main goal. We also strongly believe in business ethics and continually strive to be cleaner, greener, and respectful of all.
We owe our success to the talent and dedication of our team. They’re the ones who make a difference in our customers’ lives. So we know that it’s important to go the extra mile for our employees. We make sure they have a good work-life balance and we offer many initiatives for health and well-being.
The Job
The Nurse Case Manager will assess, plan, implement, coordinate, monitor and evaluate options and services to meet an individual’s health needs. Assistance may include such activities as providing clinical information regarding medical conditions or treatments, identifying providers and coordinating complex care plans . The Nurse Case Manager will promote quality cost-effective outcomes managing care needs through education and health advocacy to members serviced. The Nurse Case manager is able to work independently and effectively communicate to internal and external customers by telephone, email or face to face with customers.
What are your main responsibilities?
Uses clinical knowledge to assess diagnosis and treatment plans and goals, and identifies gaps in care or risks for readmission or complications.
+ Manages/coordinates an active volume of cases by providing information, navigation and coordination to customers worldwide.
+ Works with a multicultural population and is constantly aware of the cultural differences among that population.
+ Establishes patient centric goals and interventions to meet the member’s needs
+ Interfaces with the member, family members/caregivers, and the healthcare team, as well as internal matrix partners.
+ Balances business needs with patient advocacy
+ Assesses member’s health status and treatment plan and identifies any gaps or barriers to healthcare.
+ Visit providers to manage and coordinate care for customers by reviewing medical and claim information, ensure compliance with approved services and fees and discuss cases with hospital staff and physicians.
+ Establishes a documented patient centric case management plan involving all appropriate parties (client, physician, providers, employers, etc), identifies anticipated case results/outcomes, criteria for case closure, and promotes communication within all parties involved.
+ Work with Cigna physicians to evaluate complex cases and receive appropriate clinical expertise on diagnosis and treatment plans
+ Responsible for delivering to customers clinical programs including case management, chronic condition management, lifestyle coaching, pre assignment assessment and any other program delivered by global clinical operations.
+ Coordinate care with other nurses from other regions around the world when a need for local or regional expertise is important for better care or to comply with regulations
+ Maintains accurate workflow and process documents
+ Adheres to professional practice within scope of licensure and certification quality assurance standards and all case management policy and procedures
+ Participates in unit and corporate training initiatives and demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate.
+ Demonstrates sensitivity to culturally diverse situations, clients and customers.
+ Serve as clinical liaison to Clients
+ Other duties as assigned
What skills do you need?
+ Bachelor in Nursing, 3-5 years of experience in international clinical management
+ Demonstrated organizational and leadership skills
+ Strong interpersonal and communication skills
+ Demonstrates problem-solving and analytical skills.
+ Ability to act as an “advocate” for the customer while complying with internal policies and procedures and contractual/legal compliance requirements
+ Ability to operate personal computer, proficient with Microsoft office products, call center software, and a variety of software.
+ Ability to build solid working relationships with staff, matrix partners, customers and providers
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, you’ll enjoy meaningful career experiences that enrich people’s 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:_ _SeeYourselfEMEA@cigna.com_ _for support. Do not email_ _SeeYourselfEMEA@cigna.com_ _for an update on your application or to provide your resume as you will not receive a response._
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