People want to be treated like individuals. At Cigna, we get that. That’s why we embrace and encourage peoples’ uniqueness, helping to give them the strength and confidence to show the world who they really are. The coverage, expertise and services we provide are at the very core of how we help people achieve their full potential – and ultimately, improve their health, well-being and sense of security.
But before we can accomplish any of that, we have to have the right people in place. People like you.
Skills, experience, talent and creativity like yours enables us to develop the meaningful, innovative solutions our customers value and expect. That’s why we’re committed to recruiting, motivating and nurturing the best and the brightest, whether you have industry experience or not. We’re growing a workforce as unique and diverse as the millions of customers we proudly serve around the world – one individual at a time.
Cigna strongly embraces the scientific evidence that the use of tobacco products is harmful to the health of the user, the user’s family, and the general public. Cigna's mission is to improve the health, well-being and security of the people we serve, which starts with our employees. Starting with job offers dated January 1, 2014, Cigna will no longer hire – where state law permits -- applicants who use tobacco products, including cigarettes, cigars and chewing or smokeless tobacco. Currently, these states are: AL, AK, AZ, AR, DE, FL, GA, HI, IA, ID, KS, MD, MA, MI, NE, OH, PA, TX, UT, VT and WA.
If you’re passionate about making a difference one individual at a time, and would like to join the Cigna team, you’ll be screened for nicotine as part of the pre-employment drug screen in states that allow the screening. If you test positive for nicotine, although we won’t be able to offer you employment, we encourage you to check with your medical provider to explore your options and resources for quitting. Once you’re tobacco-free, you may re-apply for jobs with Cigna in [six] months.
Cigna offers a Healthy Life Incentive for Cigna Medical Plan participants who live tobacco free. As a result, non-tobacco users pay a reduced premium for their Medical Plan coverage.
The Population Health Management (PHM) Health Service Manager is a member of the PHM Department who supports population-based studies and interventions. Populations are selected based upon their potential to support the strategic goals of CMG and CIGNA HealthCare of AZ. Interventions are designed to improve the health and financial outcomes for the population and the organization. The Health Services Manager assures implementation and continuous improvement with all direct reports and partners very closely with all matrix partners in the organization to assure positive outcomes.
Clinical Responsibilities and Essential Functions
- Translates organizational goals into population-based program solutions.
- Develops clinical programs that will result in improved metrics with the involvement of the appropriate persons and departments
- Develops and provides oversight of the implementation of streamlined effective processes supporting cost effective care for our patients.
- Manages/direct reports providing leadership and direction to align staff with CMG and Cigna Healthcare goals and objectives.
- Develops and ensures quality standards for nursing practice for selected patient populations, including, patients post-hospitalization, or with specific disease processes such as CHF, or COPD to name a few.
- Manages the implementation of new clinical programs and projects for the PHM department.
- Continuously evaluates the effectiveness, necessity, and efficiency of all PHM programs recommending changes and improvement to the PHM administration team.
- Educates self on the critical elements associated with the target population such as disease states, Medicare requirements, utilization patterns, clinical treatment guidelines, regulations, quality and availability.
- Creates tools that are useful to PHM and matrix partners such as reports or improved process.
- Communicates clearly verbally and in written form with all matrix partners.
- Develops metrics to measure performance of both identification methods and interventions.
- Educates and acts as a resource to all matrix partners in regards to PHM programs
- Leads mid-sized time-limited project or components of a larger project and directs one or more teams involved in the project to develop new procedures/processes/or policy solutions to address highly complex department or CMG needs.
- Determines requirements, plans projects, establishes priorities and monitors progress.
- Evaluates project status and resource utilization and implements changes to improve the team's effectiveness.
- Assists staff in going through change processes stressing an entrepreneurial/innovative approach in creating strong work teams.
- Provides effective leadership for all staff by establishing open communications, mentoring, training guidance, and articulating clearly defined goals and objectives that tie to PHM and CMG strategies.
- Specifically leads the clinical component of nursing functions within the PHM department.
- Is the nursing/clinical lead for nursing integration efforts with operational and Custom Care nursing staffs.
- Together with operations nursing leaders, develops and implements clinical improvement projects and ensures that PHM is properly integrated into CMG’s overall nursing operations.
Complexity and Scope
- Place the patient first in all you do to make each patient interaction a positive experience.
- Provide each patient with an exceptional customer experience by greeting them with a warm welcome and smile as they enter the healthcare setting. Maintain eye contact.
- Introduce yourself and role to the patient/customer with whom you are interacting.
- Maintain a professional appearance of self and the workplace at all times.
- Communicate with patients promptly and efficiently using words the patient understands; keep the patient informed of delays in service and/or clinician wait times.
- Take ownership and accountability for responding to patient questions, concerns, or complaints. Consistently seek assistance to help the patient if you are unable to resolve on your own.
- Provides immediate service recovery and work to exceed patient/customer expectations surrounding resolution of concerns.
- Anticipate patient’s stated and unstated needs. Talk with them in depth so you understand what the patient truly needs. Provides explanations and support to meet those needs.
- Consistently keep personal conversations private and out of the work environment.
- Patient information is consistently maintained in a private and secure manner, complying with HIPAA Guidelines at all times.
- Consistently thanks the patient for allowing Cigna Medical Group to provide their healthcare and ask if there is anything else we can do for them during their visit.
- Always leads by setting example of fostering a service environment through recruitment, coaching, training, and retention of employees.
- Consistently publicly recognizes employees that model the observed service behaviors.
- Consistently communicates employee service accomplishments in monthly team meetings.
Physical Demands/Environmental Factors
- This role is critical interface to all Population Health programs for CMG’s entire Medicare Advantage patient. (38,000 members)
- This role is critical interface for our PCMH contracts with two AHCCCS plans, CareFirst and Mercy Care. (30,000 members)
- This role is critical interface for our Collaborative Accountable Care program for our OAP commercial patient population. (19,000 members)
- Assists with development and implementation of new or improvement of existing Population Health Programs tailored to all of the above patient populations.
- This role is a critical interface across all of CMG to interface with all of the Operations leadership around critical patient care metrics in addition to staff that is housed across the valley in Health Care Centers.
- This role serves as a critical interface between PHM and Health Care Center, and Custom Care nursing clinical programs.
- Possess physical agility and adequate reaction time to respond quickly and appropriately to unexpected patient care needs.
- Needs adequate hearing and visual acuity, including adequate color vision to conduct Computer assisted meetings and training.
- Requires fine motor skills, adequate eye hand coordination, and ability to grasp and handle objects.
- Must be able to travel to manage a team with both onsite meetings and on-line meeting located across all Health Care Centers.
- May be required to lift 75 pounds.
- Must use standard precautions due to threat of exposure to blood and body fluids when in Health Care Centers.
- Needs to communicate effectively through reading, writing, and speaking in person or on telephone.
- Use of computers will be required.
Department Specific Requirements
- Registered Nurse with current AZ license.
- Graduate of an accredited school of nursing, Bachelor’s degree preferred or associated Healthcare degree.
- Minimum of 3-5 years’ supervisory/managerial experience in a clinical setting, ambulatory setting preferred.
- Superior organizational and time management skills.
- Excellent analytical, investigative, and detail orientation skills
Department Specific Qualifications
- Excellent oral and written communication skills.
- Demonstrates ability to build collaborative relationships in a heavily matrixed environment
- Proven ability to think innovatively to solve problems and promote optimal quality of care and service
- Demonstrates initiative in achieving individual, team and organizational goals and objectives
- Demonstrated skills in leadership, communication, quality improvement, team building, problem solving, and change management
- Ability to begin when all facts and full direction not finalized or unclear
Cigna offers a competitive compensation and comprehensive benefits package including health and wellness benefits, 401k plan, and work/life balance programs, as well as opportunities for career growth and development.
- Previous Care Coordination or Case Management experience preferred
- Experience working with high-risk patients preferred
- Ability to design and execute process improvements to meet customer service requirements.
- Must be willing and able to travel to all CMG HealthCare Centers
We encourage you to complete all questions on the candidate profile if you wish to be considered for this opportunity.
Cigna is an Equal Opportunity Employer
Cigna is a global health service company, dedicated to helping the people we serve improve their health, well-being and sense of security....