Registered Nurse

Fairfax, VA
Feb 15, 2018
Feb 16, 2018
Healthcare, Other
Full Time
**Description:**Role is onsite at Inova Fairfax hospital location//.**SIGN ON BONUS//- $5,000//!**Primary Duties:As a normal course of business, Cigna maintains relationships with hospitals and hospital systems across the country as part of our product offerings//. Hospital participation status in Cigna's networks differs by product and by hospital//. This role s primary focus is the customers in products where a hospital is non//-participating//. This role is an offsite clinical role that works within hospitals in a given geography//. Although it s anticipated that most work will be done within a single hospital, there may also be some travel to the other facilities within the market, as needed//.The In//-House Nurse will be responsible for collaborating with the hospital s staff and supporting customers through the transfer process//. The objective of this role is to simplify the customer experience//. After a treating physician determines a patient is appropriate for transfer, the Cigna In//-House Nurse will be responsible to initiate and orchestrate a transfer to a participating facility, as well as to communicate and educate the customer about the transfer//.Key responsibilities include, but are not limited to:Identify Connect and SureFit Network plan customers who are in the Emergency Room or are admitted to an out of network facility//. Collaborate with the hospital physicians to determine if customer is clinically stable enough to move and confirm needed services can be provided in a participating facility//.Facilitate transfer by collaborating with both the non//-participating and participating facility and informing the customer about the process//.Interface and educate customers regarding hospital participation status//. In addition, provide information on participating network options, both facilities and providers//. Explain benefits of transferring to a participating facility and support the collaboration between the non//-participating hospital and the participating hospital//.Act as a resource for the primary, secondary facilities, and others as needed//.Partner with urgent care facilities to educate and assist with transfers to participating hospital ERs//.Outreach to customers post discharge from non//-participating hospital to provide education around networks, INN/OON benefits and Cigna programs//.Ensure the customers have a PCP and that the PCP is aware of the customer s recent clinical event//.Coordinate with Cigna clinical teams as appropriate //(IPCM, Case Mgmt//) to support needs of customer, including referring to Cigna programs as appropriate//.Communicate with hospital personnel as appropriate to support needs of customer and day to day work activities//.Demonstrate sensitivity to culturally diverse situations, clients and customers//.Participate in unit and corporate training initiatives and demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate//.Role is an in//-house position in Inova Fairfax hospitalTravel may be required to the other Inova facilities infrequentlyMonday//-Friday schedule, no Holidays/Weekends**Qualifications:**Requirements:At a minimum, this position requires a RN with an active license, B//.S//. preferred, CCM preferred//.A minimum of 3 years of clinical experience requiredStrong computer and communication skills requiredA minimum of 2 years UM or CM experienceFulfill hospital s requirements for in house staff //(vaccinations, drug screen, etc//.//)Flexible, problem//-solving aptitudeQualifications:Strong written and verbal communication skills in order to effectively communicate with members, physicians, providers and operations peers//.Understanding of medical insurance productsStrong prioritization, time management, organizational, research, analytical, and customer service skillsAbility to work with ambiguity**Primary Location:** Virginia//-Virginia**Work Locations: Job:** Med Mgt//-//-Case Management**Schedule:** Regular**Shift:** Standard**Employee Status:** Individual Contributor**Job Type:** Full//-time**Job Level:** Day Job**Travel:** Yes, 50 % of the Time**Job Posting:** Jan 30, 2018, 6:46:50 AM

Similar jobs

More searches like this