[Hiring] Concurrent Review Care Coordinator @Cigna Healthcare

Role Description

The UM Clinical Reviewer Senior Analyst is responsible for concurrent review, care coordination, and utilization management activities across post-acute care settings. The role applies clinical judgment, evidence-based guidelines, and organizational policies to support quality outcomes, cost-effective care, and member experience.

• Implement, evaluate, and coordinate individualized plans of care for assigned members.
• Conduct utilization and concurrent reviews in alignment with medical necessity criteria and regulatory requirements.
• Collaborate with providers, Medical Directors, and interdisciplinary teams to support transitions of care.
• Identify gaps or deviations in care plans and intervene appropriately to support desired outcomes.
• Document clinical decisions, determinations, and communications accurately and timely in designated systems.
• Ensure compliance with The Cigna Group policies, accreditation standards, and confidentiality requirements.
• Participate in meetings, audits, and quality improvement initiatives as assigned.

Qualifications

• Current, unrestricted Registered Nurse (RN) license in state of residence; multistate license preferred.
• Associate or Bachelor’s degree in Nursing preferred.

Requirements

• Minimum of 2 years of clinical nursing experience.
• At least 2 years of utilization management or care management experience preferred.
• Experience in home health, skilled nursing, rehabilitation, or managed care environments preferred.
• Knowledge of Medicare and Medicaid managed care programs preferred.

Required Skills & Competencies

• Strong time management and organizational skills.
• Clear and professional written and verbal communication abilities.
• Critical thinking and sound clinical decision-making.
• Ability to work independently with minimal supervision.
• Proficiency with Microsoft Office tools (Word, Excel, Outlook, PowerPoint) and virtual meeting platforms.

Work Environment & Conditions

• This is a remote, full-time position during core business hours, with flexibility to work shifts between 7:00 a.m. and 7:00 p.m. CST.
• Availability for weekend, on-call, and holiday rotation may be required.
• The role requires the ability to sit for extended periods, utilize computer and telephone equipment, and perform occasional walking or standing.

Benefits

• Hourly rate of 31 - 52 USD / hourly, depending on relevant factors, including experience and geographic location.
• Eligible to participate in an annual bonus plan.
• Comprehensive range of health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
• 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.

Compliance Statement

This job description is intended to comply with The Cigna Group Job Description Requirements and applicable employment, accreditation, and regulatory standards. Duties and responsibilities may be adjusted to meet business needs.