Nurse Case Manager - Portuguese or French at Cigna

Cigna is a global health service company, dedicated to helping the people we serve improve their health, well-being and sense of security. Cigna has almost 40,000 employees who service over 80 million customer relationships around the world. Within its international division, a dedicated unit - headquartered in Belgium - focuses on the needs of International...

 

Nurse Case Manager - Portuguese or French

  • Job TypeFull Time
  • QualificationBA/BSc/HND
  • Experience3 - 5 years
  • LocationNairobi
  • Job FieldMedical / Healthcare 

MAJOR RESPONSIBILITIES

  • Manages an active caseload of case management cases for Cigna and provides one on one case management to customers to improve health status, reduce health risks and improve quality of life.
  • Uses clinical knowledge and Cigna approved guidelines and tools to assess diagnosis and treatment plans and goals and identifies gaps in care or risks for readmission or complications.
  • Works with a multicultural population and is constantly aware of the cultural differences among that population. 
  • Establishes patient centric goals and interventions to meet the member’s needs
  • Interfaces with the member, family members/caregivers, and the healthcare team, as well as internal matrix partners. 
  • Delivers clinical programs including case management, chronic condition management, hospital support program, etc.
  • Balances business needs with patient advocacy
  • Assesses member’s health status and treatment plan and identifies any gaps or barriers to healthcare. 
  • Visit providers to manage and coordinate care for customers by reviewing medical and claim information, ensure compliance with approved services and fees and discuss cases with hospital staff and physicians.
  • Establishes a documented patient centric case management plan involving all appropriate parties (client, physician, providers, employers, etc), identifies anticipated case results/outcomes, criteria for case closure, and promotes communication within all parties involved.
  • Work with Cigna physicians to evaluate complex cases and receive appropriate clinical expertise on diagnosis and treatment plans
  • Coordinate care with other nurses from other regions around the world when a need for local or regional expertise is important for better care or to comply with regulations
  • Maintains accurate workflow and process documents
  • Participates in unit and corporate training initiatives and demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate. 
  • Serve as clinical liaison to Clients
  • Other duties as assigne

REQUIREMENTS

  • Bachelor’s in nursing, 3-5 years of experience in international clinical management
  • Experience in the Africa region & International market
  • Fluent in English along with either Portuguese or French required
  • Demonstrated organizational and leadership skills
  • Strong interpersonal and communication skills
  • Demonstrates problem-solving and analytical skills.
  • Ability to act as an “advocate” for the customer while complying with internal policies and procedures and contractual/legal compliance requirements
  • Ability to operate personal computer, proficient with Microsoft office products, call center software, and a variety of software.
  • Experience with clinical guidelines solutions such as coverage policy and MCG guidelines
  • Ability to build solid working relationships with staff, matrix partners, customers and providers
  • Flexible to work on shifts/varying work schedules.

Method of Application

Interested and qualified? Go to Cigna on cigna.wd5.myworkdayjobs.com to apply

Comments

Post a Comment

Popular posts from this blog

Deputy Director Public Works at Turkana County Government

Turkana is the 2nd largest county in Kenya 77,000 sq.km. It is also the north-western most county in Kenya and is known mostly for its scenic landscapes and rich culture. Read more about this company   Deputy Director Public Works Job Type Contract Qualification BA/BSc/HND , MBA/MSc/MA Experience Location Turkana Job Field Building and Construction  , Engineering / Technical  REF: TUR/CPSB/057/2022/2023: DEPUTY DIRECTOR PUBLIC WORKS, JOB GROUP ‘Q’, ONE (1) POST. Deputizing the director Public works and assist on matters of buildings/construction management in the county. Duties and responsibilities:- formulating, implementing and reviewing buildings/construction development policies, strategies, procedures, plans, standards and guidelines; initiating review and dissemination of appropriate legislation and regulations on buildings/constructions development; facilitating designs, approval and implementation of buildings/construction development programmes facilitating implementation of s
Read more

Project Director at LVCT Health

LVCT Health is an indigenous Kenyan non-governmental and not-for-profit organization established in 2001. We are driving Kenya towards HIV prevention, with an ultimate goal of reducing HIV infections to zero. We offer integrated HIV services through development of models that are scaled up to the national models. We also carry out sexual and reproductive ...   Project Director Job Type Full Time Qualification MBA/MSc/MA Experience 7 - 10 years Location Kiambu Job Field Medical / Healthcare  Job purpose The Project Director will be responsible for providing overall strategic and technical oversight to the Dhibiti Project in Central region. This includes responsibility for the technical, monitoring and evaluation and financial and operations components of the project. S/he will work closely with the Program Director and other directors/managers to ensure adherence to technical and contractual requirements of the grant, achievement of targets and project alignment to institutional vision
Read more

School Office Administrative Officer (a female preferred) at Tamkeen Integrated Schools

School Office Administrative Officer (a female preferred) Job Type Full Time Qualification BA/BSc/HND , Diploma Experience 3 - 5 years Location Nairobi Job Field Administration / Secretarial  Tamkeen Integrated Schools (TIS), is a private school in Kileleshwa providing the revered Cambridge System from Kindergarten to A-levels with a strong emphasis on STEM, Islamic Education, and Coding Programs. Our holistic approach integrates spiritual enrichment, recreation, and specialized teaching in Islamic Values, Arabic, and Quran memorization, fostering student ownership of learning in a modern Islamic education system. Tamkeen Integrated Schools is actively seeking a highly skilled Administrative Officer to join our team. The ideal candidate will bring a wealth of experience in school office administration, with a specific focus on the Cambridge system and academic matters. Exceptional organizational skills and a strong commitment to customer service and problem solving are essential. Key R
Read more