Primary Care Nurse Specialist
5 days ago
About The Role
">The Cigna Group is seeking a highly skilled Primary Care Nurse Specialist to join our team in Houston, TX. This is a hybrid position that requires working from home and occasionally visiting clients.
">Job Description
">- ">
- We are looking for a compassionate and positive Registered Nurse who can serve as the key contact point for patients, coordinating and streamlining all services offered within Evernorth.">
- You will educate patients on healthcare options, provide patient education, and answer questions as they arise.">
- Your primary responsibility will be to work hand-in-hand with patients, other staff members, and providers to address any questions or concerns regarding schedules, appointments, orders, consults, etc.">
- You will be responsible for knowing where to look for all member information and directing and delegating tasks to team members as needed.">
- As a liaison between providers and patient panels, you will direct and delegate tasks to team members while ensuring seamless communication.">
- You will educate patients about their care options, make specific recommendations based on their goals, review paperwork to ensure it meets all requirements, explain test results, diagnoses, and medical outcomes, cover triage and transition of care for patients, improve health literacy, identify problems or gaps in care, offer opportunities for intervention, coordinate services and referrals, participate in patient education and outreach tied to HEDIS initiatives, and work to improve access to care while managing healthcare costs and utilization.">
- In this role, you will complete telephonic nursing assessments, social determinants of health screenings, post-hospital discharge screenings, triage, and other assessments assigned by providers.">
- You will assist in organizing and running chronic care and/or interdisciplinary care team rounds, participate in creating care plans for patients, maintain and update spreadsheets and documents provided by health plans, participate in weekly care coordination with health plan case management, track hospice consults, obtain pre-authorization for CT, MRI, Echo's ordered by providers, schedule patients, and serve as a guide for escalated orders and results clinically appropriate.">
- You will assess and triage immediate health concerns transferred to the nursing team by clinical support staff, provide telephonic nursing assessment and triage supported by triage protocols, initiate medication changes and other orders directed by providers in response to a triage call, monitor daily discharge lists, develop plans to schedule transition of care visits, complete telephonic post-discharge hospital visits, ask pertinent discharge triage questions, complete medication reconciliation, document findings, and make appropriate referrals to social work, pharmacy, case management, and engagement.">
Requirements
">- ">
- This position requires an active, unrestricted RN license in all states we provide services, ability to obtain compact license and/or additional state licensure as needed, 3+ years of experience as a Registered Nurse with experience in internal medicine or adult medicine, proficient level of experience with Microsoft Office applications, strong technical aptitude, EMR experience, and proficiency, BSN or ADN degree.">
- Prior experience working with the geriatric population/chronic condition experience, home health experience, triage experience, case management experience, previous customer service experience, previous experience in a telephonic role, highly organized self-directed worker with an ability to function in high volume environment, strong verbal and written communication skills, prior clinical experience in palliative care, end of life, hospice, oncology, ICU, geriatrics, skilled nursing facilities, home health, skilled nursing visits preferred, knowledge of STARS and HEDIS metrics a plus.">
- If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.">
About The Cigna Group
">Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers, and patients. We strive to create a culture of diversity, equity, and inclusion where everyone feels valued and respected.
">We welcome qualified applicants without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status, or any other characteristic protected by applicable equal employment opportunity laws.
">Estimated Salary: $83,000-$105,000 per year
">Location: Houston, TX
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