[Hiring] Complex Case Management Team Lead @Cigna Healthcare

Role Description

The Telephonic Case Manager Team Lead supports clinical case management operations by mentoring team members, promoting quality outcomes, and helping the team deliver a consistent customer experience. This full-time, work-at-home role requires employees to conduct business in a secure, private area of the home where confidential conversations cannot be overheard.

• Support team performance related to clinical outcomes, total cost of care, stakeholder experience, and operational goals.
• Partner with the Clinical Supervisor to support employee engagement, retention, coaching, and development.
• Train, mentor, and support new and existing team members in partnership with leadership.
• Promote collaboration across clinical disciplines and help identify development opportunities at the individual and team level.
• Guide team members toward evidence-based actions that support quality outcomes and appropriate medical cost management.
• Participate in workgroups, committees, team meetings, and special projects as needed.

Additional Responsibilities

• Complete chair-side assessments in Verint to support adherence to standard operating procedures and clinical quality expectations.
• Assist the Clinical Supervisor with audits, including NCQA, calendar, and account-specific audits.
• Support clinical rounds in partnership with Medical Directors.
• Resolve escalated issues referred by internal teams or customers.
• Serve as a clinical case management subject matter expert.
• Support new hire orientation in partnership with Workforce Development.
• Assist with day-to-day team operations, including team meetings, coaching support, call-off support, and monitoring team communication spaces.
• Maintain a case management workload equal to approximately 50% of the team average, including customer-facing and medical management cases.

Qualifications

• Active, unrestricted RN license in good standing in state of residence.
• Clinical nursing experience with demonstrated ability to apply clinical judgment in a case management setting.
• Experience in complex case management.
• Ability to provide coaching, feedback, and mentoring to team members.
• Ability to work from home in a secure, private workspace that supports confidential conversations.

Preferred Qualifications

• Strong administrative, computer, and software application skills.
• Effective interpersonal, written, and verbal communication skills.
• Ability to work collaboratively in a team environment.
• Strong clinical acumen, sound decision-making skills, and ability to analyze quantitative and qualitative data.
• Demonstrated ability to prioritize work, manage time, and delegate when appropriate.
• Ability to resolve internal and external concerns in a professional, customer-focused manner.
• Experience communicating directly with customers by phone and in writing; telephonic coaching or counseling experience is helpful.

Benefits

• Comprehensive health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
• 401(k) plan.
• Company paid life insurance.
• Tuition reimbursement.
• A minimum of 18 days of paid time off per year and paid holidays.
• Annual salary range of 77,500 - 129,100 USD, depending on relevant factors.
• Eligibility to participate in an annual bonus plan.