Concurrent Review Care Coordinator

The Cigna Group

. Implement, evaluate, and coordinate individualized plans of care for assigned members .

Posted 11/4/2026full-timeRemote • United StatesJuniorMid-Level💰 $31 - $52 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in implementing and coordinating individualized care plans, conducting utilization management, and ensuring compliance with regulatory requirements. Proficient in clinical decision-making and effective communication within interdisciplinary teams to enhance member experience and quality outcomes.

Highest-signal resume keywords

Registered Nurse (RN) LicenseUtilization Management ExperienceClinical Nursing ExperienceCritical ThinkingMicrosoft Office Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical Decision-MakingCare CoordinationUtilization ReviewQuality ImprovementRegulatory ComplianceCare ManagementDocumentation SkillsTime ManagementOrganizational SkillsMember Experience Enhancement

Soft Skills

Clear CommunicationProfessional WritingIndependent WorkCollaborationProblem-Solving

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft OutlookMicrosoft PowerPointVirtual Meeting Platforms

Certifications & Qualifications

Registered Nurse (RN) License

Industry Keywords

MedicareMedicaidManaged CareHome HealthSkilled NursingRehabilitationAccreditation StandardsConfidentiality RequirementsQuality OutcomesCost-Effective Care

About the role

Key responsibilities & impact

Implement, evaluate, and coordinate individualized plans of care for assigned members
Conduct utilization and concurrent reviews aligned with medical necessity criteria and regulatory requirements
Collaborate with providers, Medical Directors, and interdisciplinary teams to support transitions of care
Identify gaps or deviations in care plans and intervene appropriately to support desired outcomes
Document clinical decisions, determinations, and communications accurately and timely in designated systems
Ensure compliance with The Cigna Group policies, accreditation standards, and confidentiality requirements
Participate in meetings, audits, and quality improvement initiatives as assigned
Work remotely full time during core business hours with shifts between 7:00 a.m. and 7:00 p.m. CST
Support post-acute care utilization management, care coordination, quality outcomes, cost-effective care, and member experience

Requirements

What you’ll need

Current, unrestricted Registered Nurse (RN) license in state of residence; multistate license preferred
Associate or Bachelor’s degree in Nursing preferred
Minimum of 2 years of clinical nursing experience
At least 2 years of utilization management or care management experience preferred
Experience in home health, skilled nursing, rehabilitation, or managed care environments preferred
Knowledge of Medicare and Medicaid managed care programs preferred
Strong time management and organizational skills
Clear and professional written and verbal communication abilities
Critical thinking and sound clinical decision-making
Ability to work independently with minimal supervision
Proficiency with Microsoft Office tools (Word, Excel, Outlook, PowerPoint) and virtual meeting platforms
Availability for weekend, on-call, and holiday rotation may be required
Ability to sit for extended periods, utilize computer and telephone equipment, and perform occasional walking or standing
Home internet through cable broadband or fiber optic service with at least 10 Mbps download/5 Mbps upload
Must reside in the United States and hold an unrestricted RN license in the state of residence

Benefits

Comp & perks

Annual bonus plan eligibility
Medical, vision, and dental benefits starting on day one
Well-being and behavioral health programs
401(k)
Company-paid life insurance
Tuition reimbursement
Minimum of 18 days of paid time off per year
Paid holidays
Leaves of absence
Remote work arrangement
Flexible shifts between 7:00 a.m. and 7:00 p.m. CST