Pre-Service RN Care Coordinator - EviCore

Position: Pre-Service RN Care Coordinator - EviCore - Work at Home
*
* Hours:

Monday - Friday; 9a-6p Central Time Zone;
Position is full-time during core business hours with the ability to work any shift between 7 am and 7 pm CST.*
* ** Pre-Service RN Care Coordinator*
* ** Job Summary*
* The Pre-Service RN Care Coordinator is responsible for clinical and operational processes related to transition of care, care coordination, and case management for post-acute care services. This role helps ensure members receive services and equipment ordered by their physician and supports coordination between members, providers, and internal partners.

** Responsibilities*
* + Perform clinical and operational activities related to transition of care, care coordination, and case management for post-acute care services, including home health, durable medical equipment, and related care management services.

+ Review and coordinate services or equipment ordered by the physician to support timely, appropriate member care.

+ Collaborate with providers, members, and internal teams to support continuity of care and resolve service coordination needs.

+ Document activities accurately and follow established clinical, operational, and compliance guidelines.

** Minimum Qualifications*
* + Active, unrestricted Registered Nurse license in state of residence.

+ Minimum of 2 years of clinical RN experience.

+ Ability to work Monday through Friday, 9:00 a.m.

-6:00 p.m. Central Time, with flexibility to work any shift between 7:00 a.m. and 7:00 p.m. Central Time based on business needs.

+ Availability for weekend, on-call, and holiday rotation as needed.

+ Ability to use a computer, telephone, and other standard office equipment throughout the workday.

+ Ability to maintain a dependable and reliable work schedule.

** Preferred Qualifications*
* + Bachelor of Science in Nursing.

+ Multistate RN license.

+ 2 or more years of utilization management experience.

+ Experience in home health, skilled nursing facility, rehabilitation, post-acute care, or care coordination.

+

Experience with Medicare and/or Medicaid managed care programs.

** Work Environment*
* + This is a remote position.

+ This role requires prolonged use of a computer, telephone, and other office equipment throughout the workday.

+ The position may require sitting for extended periods, as well as occasional walking and standing.

** Required Skills*
* +  
** Time management and organization:
** Ability to manage time and resources effectively to complete work efficiently and meet deadlines.

+  
** Communication:
** Ability to communicate clearly and professionally with members, providers, coworkers, and leadership through verbal and written channels.

+  
** Critical thinking and decision-making:
** Ability to identify issues, evaluate information, and develop appropriate solutions.

+  
** Autonomy:
** Ability to work independently with minimal supervision while meeting role expectations.

+  
** Technology proficiency:
** Proficiency with Microsoft Word, Excel, Outlook, and PowerPoint; ability to type 30 words per minute preferred.

+  
** Virtual collaboration:
** Experience using videoconferencing tools such as Webex or similar platforms.

** About The Cigna Group*
* At The Cigna Group, we are committed to improving the health and vitality of those we serve. Our employees help make a meaningful difference for our customers, clients, and communities through innovative solutions, collaboration, and a commitment to service.

** Equal Opportunity Employer*
* The Cigna Group is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other characteristic protected by applicable law.

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 10

Mbps download/5

Mbps upload.

For this position, we anticipate offering an hourly rate of 31 - 52 USD / hourly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in…