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

Use this summary to align your resume positioning with the role.

Demonstrates expertise in care coordination, utilization management, and clinical decision-making within post-acute care settings. Proficient in compliance with regulatory requirements and effective communication with interdisciplinary teams.

Highest-signal resume keywords

Registered Nurse (RN) LicenseUtilization Management ExperienceClinical Nursing ExperienceKnowledge of Medicare and MedicaidProficiency with Microsoft Office

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care CoordinationUtilization ManagementClinical Decision-MakingTime ManagementOrganizational Skills

Soft Skills

Clear CommunicationCritical ThinkingAbility to Work Independently

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft OutlookMicrosoft PowerPointVirtual Meeting Platforms

Certifications & Qualifications

Registered Nurse (RN) License

Industry Keywords

Post-Acute CareHome HealthSkilled NursingRehabilitationManaged 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
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
Perform concurrent review, care coordination, and utilization management across post-acute care settings

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 connection through cable broadband or fiber optic service with speeds of at least 10Mbps download/5Mbps upload

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 shift scheduling between 7:00 a.m. and 7:00 p.m. CST