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 10Mbps download/5Mbps 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 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 Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. 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.