RN Care Coordinator- Evernorth- Maitland, FL

About the position

Evernorth Direct Health is an industry-leading business that provides custom care delivery and wellness services across four key business lines: Wellness Centers, Health Coaching, Wellness Events, and COVID-19 solutions. The organization is built on the recognition that health makes progress possible, and its services are designed to redefine healthcare as we know it. The Care Coordinator role is pivotal in this mission, as it involves identifying and referring customers to eligible programs within CIGNA Healthcare and other client-specific health and wellness programs. The Care Coordinator supports the care coordination of individual customers, particularly focusing on high-risk populations, ensuring that care is delivered in an appropriate, efficient, high-quality, and cost-effective manner. In this role, the Care Coordinator acts as a central conduit between employers, providers (such as Primary Care Physicians and Onsite Health Clinics), and all available Evernorth programs and resources. This position requires a thorough review of patient-level actionable data and reports to identify customers for outreach and engagement. The Care Coordinator is responsible for maintaining timely, compliant, and efficient documentation and information exchange to drive appropriate outreach, engagement, and positive clinical outcomes. Clear communication with all matrix partners is essential, as is the ability to refer customers to appropriate internal and external programs to support their health outcomes. The Care Coordinator will also identify cases suitable for complex case management and follow the established referral processes. Building effective relationships with local network providers is crucial, as is providing guidance to high-quality network providers and referrals to onsite health centers. The role involves identifying gaps in care and collaborating with providers and local community resources to close these gaps. Establishing and maintaining positive, professional, and collaborative relationships with customers, employers, providers of care, and Evernorth partners is key to supporting improved clinical, quality, and cost outcomes for the aligned employee population. The Care Coordinator will also partner with health management matrix partners for additional engagement and promotion opportunities, acting as a resource for customers with specific non-clinical questions.

Responsibilities
? Identify and refer appropriate customers to eligible programs within CIGNA Healthcare and client-specific health and wellness programs.
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? Support care coordination of individual customers, particularly high-risk populations.
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? Coordinate care in an efficient, high-quality, and cost-effective manner.
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? Refer to appropriate clinical partners and function as a central conduit between employers, providers, and Evernorth resources.
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? Ensure thorough review of patient-level actionable data and reports for customer outreach and engagement.
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? Maintain timely, compliant documentation and information exchange to drive outreach and positive clinical outcomes.
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? Communicate clearly with matrix partners and refer to internal and external programs to support outcomes.
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? Identify cases appropriate for complex case management and follow referral processes.
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? Work effectively with Evernorth's internal team to support care coordination and data analysis.
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? Build effective relationships with local network providers and provide steerage to high-quality network providers.
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? Identify gaps in care and work with providers and community resources to close these gaps.
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? Establish and maintain positive relationships with customers, employers, providers, and Evernorth partners to support improved outcomes.
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? Partner and coordinate with health management matrix partners for engagement and promotion opportunities.
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? Act as a resource for customers with specific non-clinical questions.

Requirements
? Current unrestricted RN state licensure within home state.
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? Three or more years of clinical practice experience.
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? Preferred case management experience.
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? High energy level with excellent oral and written communication skills.
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? Excellent computer skills, specifically in Word and Excel.
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? Strong interpersonal skills and ability to work in a team environment.
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? Commitment to ongoing education is preferred.
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? Comfortable communicating with multiple clinical partners.
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? Experience working with high-risk patients is preferred.
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? Experience in project development and working in a matrix environment is preferred.
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? Self-directed with the ability to succeed in an independent role.
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? Current BLS/CPR/AED Certification.
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? Passion for assisting members with health improvement and navigation of the healthcare system.
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? Strong problem-solving skills.

Nice-to-haves
? CHES certification.
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? Health coaching experience including chronic disease management.
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? Dynamic presentation skills.
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? Positive role model in demonstrating healthy behaviors.

Benefits
? Health insurance coverage.
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? 401k retirement savings plan.
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? Paid holidays and vacation time.
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? Flexible scheduling options.
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? Professional development opportunities.

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