- Assess medical necessity, appropriateness, and cost-effectiveness of proposed treatments and therapies.
- Source and articulate relevant guidelines for moderately-complex local to global level cases.
- Complete day-to-day Case Management tasks with minimal supervision.
- Use clinical knowledge to assess diagnosis and treatment plans, identifying gaps in care or risks for readmission or complications.
- Establish patient-centric goals and interventions to meet member needs.
- Coordinate care and interface with members, family members/caregivers, and healthcare teams.
- Develop documented patient-centric case management plans involving all relevant parties.
- Work with Cigna physicians to evaluate complex cases and receive clinical expertise.
- Deliver clinical programs, including case management, chronic condition management, and lifestyle coaching.
- Maintain accurate workflow and process documents.
- Adhere to professional practice standards and case management policy and procedures.
- Participate in unit and corporate training initiatives and continuing education.
- Participate in clinical projects to enhance customer health and wellbeing.
- Play an active role in Cigna's digital transformation.
- Serve as clinical liaison to clients.
- Balance business needs with patient advocacy.
- Demonstrate sensitivity to emotionally distressed and culturally diverse situations.
- Manage/coordinate an active volume of cases in a multicultural population.
- Coordinate care with other Cigna Case Managers around the world.
- Gain experiences and knowledge within the insurance and healthcare industry.
- Broad exposure to all aspects of business operations and leadership/general management skills.
- Continue to utilize and enhance healthcare knowledge while out of clinical setting.
- Bachelor's degree in Nursing.
- Clinical knowledge to assess diagnosis and treatment plans and goals.
- Knowledge and experience in relevant Health Insurance fields.
- Necessary licenses and certifications for quality assurance standards and case management policy and procedures.
- Strong organizational and leadership skills.
- Strong interpersonal and communication skills.
- Demonstrates problem-solving and analytical skills.
- Ability to build excellent working relationships with staff, matrix partners, customers, and providers.
- Ability to act as an advocate for the customer while complying with internal policies and procedures.
- Strong time management and prioritization skills.
- Enthusiastic with a positive attitude.
- Ability to operate computer, proficient with Microsoft office products, and various software.
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Case Manager - Singapur, Singapore - The Cigna Group
Description
Job Summary: Manage complex medical cases, coordinate care, and develop patient-centric plans to improve health outcomes.
Key Responsibilities:
Key Challenges:
Developmental Value:
Requirements:
Personal Competencies:
About The Cigna Group:
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the healthcare system, empowering them with the information and insight they need to make the best choices for improving their health and vitality.
