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Must live in California to be considered for this position. This is a Work-at-Home position. Monday-Friday

Responsibilities

The Transplant Case Manager interacts with benefit specialist and claims staff for claim payment direction to ensure correct interpretation of transplant contracts and to apply payments accurately.

Assists in service marketing and/or account management functions for service center-based customers, as assigned.

Assists Sales Account Executive in communicating status and/or resolving issues for service center-based customers, as assigned.

Participates on committees, task forces and other company projects, as assigned.

Supports training initiatives or audits of case files, as assigned.

Demonstrates sensitivity to culturally diverse situations, clients and customers.

Any other assigned tasks as deemed necessary to meet business needs.

Additionally the candidate will be responsible for the adoption and demonstration of the Consumer Health Engagement cultural beliefs. They will be responsible for role modeling the six cultural beliefs to drive personal accountability and organizational results.

Qualifications

CA Unencumbered RN licensure required

Minimum of three years clinical experience required

MUST RESIDE in California

Clinical experience in case management strongly preferred

Transplant specific experience strongly preferred

Certification within a catastrophic specialty program preferred

Demonstrated ability as a case manager and ability to assist supervisor with sales/training/account service management.

Excellent time management, organizational, research, analytical, negotiation, communication (verbal and written) and interpersonal skills.

Expert knowledge of the insurance industry and claims processing.

This role is WAH which allows work to be performed at home. Employees must be fully vaccinated if they choose to come onsite. Currently we are encouraging all employee to remain working from home and all onsite meetings require a virtual option. Are you willing and able to comply with our policy?

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 40 - 66 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.

We want you to be healthy, balanced, and feel secure. That’s why 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) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group .

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 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.

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.