Cigna Nurse Case Manager – Portuguese or French Required Jobs in Kenya
Cigna is one of the world’s leading providers of health care, expatriate employee benefits, life, accidental and supplemental health insurance. Headquartered in the US and listed in NYSE, the Company operates in countries across the Americas, Europe, Africa and Asia Pacific.
Cigna Global Health Benefits (CGHB) is an integral part of Cigna’s growing international businesses. Product types include Medical, Dental, Vision, Life, AD&D, Disability, Travel, etc. sold to groups and individuals. We have approximately 1 million medical members around the world.
Join us in driving growth and improving lives in our growing team in Nairobi.
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 assigned
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.
How to Apply
For more information and job application details, see; Cigna Nurse Case Manager – Portuguese or French Required Jobs in Kenya
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