Nurse (RN) Case Management Lead Analyst - (Fluent in Dari/ Pashto) - Evernorth Health Services - Remote (Open) at The Cigna Group

About the position

The Bilingual Nurse Case Management Lead Analyst is responsible for managing healthcare needs through effective case management practices. This role involves obtaining consent, establishing collaborative relationships with clients and healthcare providers, and implementing care plans to achieve quality outcomes. The analyst will document findings, act as a liaison among various stakeholders, and ensure compliance with legal and ethical standards while advocating for members' needs. The position requires fluency in Dari or Pashto and offers the opportunity to work remotely while managing a high volume of calls in a fast-paced environment.

Responsibilities
?? Obtain informed verbal and written consent from clients.
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?? Identify, support, and resolve customer healthcare needs promptly.
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?? Establish collaborative relationships with clients, families, and healthcare providers to assess care needs.
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?? Set short-term and long-term goals for case management and involve all relevant parties.
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?? Promote quality, cost-effective outcomes through effective communication and education.
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?? Implement, coordinate, monitor, and evaluate the case management plan.
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?? Document findings clearly and accurately in the case management system.
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?? Act as a liaison between clients, families, and healthcare facilities.
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?? Build strong working relationships with internal team members and across the organization.
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?? Maintain accurate records of case management interventions and outcomes.
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?? Adhere to quality assurance standards and case management policies.
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?? Demonstrate sensitivity to culturally diverse situations and clients.
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?? Ensure member privacy, confidentiality, and safety are maintained.
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?? Provide leadership and mentorship to other case management staff as needed.
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?? Comply with all accreditation and regulatory mandates.
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?? Participate in training initiatives to maintain clinical expertise.

Requirements
?? Active Unrestricted Registered Nurse (RN) license in the United States.
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?? Minimum of two years full-time direct patient care experience as an RN.
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?? Fluency in Dari or Pashto, with excellent verbal and written communication skills.
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?? Strong time management, organizational, research, analytical, and negotiation skills.
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?? Proficiency in using multiple computer systems, including Windows-based applications.
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?? Good clinical acumen with experience in managing patients with acute and complex medical conditions.
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?? A quiet and confidential home office space without distractions during work hours.
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?? Access to high-speed broadband internet.

Nice-to-haves
?? Experience in PDN (Private Duty Nursing).
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?? Case Management certification.
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?? Familiarity with TruCare and ICMS systems.
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?? Possession of a URAC-recognized certification in case management within four years of hire.
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?? Strong computer skills in Microsoft Word, Excel, and Outlook.
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?? Ability to manage conflicts professionally and collaboratively.
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?? Demonstrated flexibility and organizational skills to meet business needs.

Benefits
?? Remote work opportunity
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?? Flexible working hours
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?? Competitive hourly rate based on experience
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?? Continuing education support
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?? Professional development opportunities

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