Case Management Senior Analyst - Allegiance - Work at Home

The job profile for this position is Case Management Senior Analyst, which is a Band 3 Senior Contributor Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. Case Management Senior Analyst (RN Case Manager) As a Case Management Senior Analyst, you will guide complex cases across the full care journey. You will connect members, providers, and plan partners to the right care at the right time—improving outcomes, reducing avoidable costs, and making the experience feel human. If you like solving tough problems with compassion and data, you’ll thrive here.

Responsibilities

Lead complex case planning from intake through resolution, aligning clinical needs, benefits, and community resources to support safe, timely care. Partner with members, families, providers, and internal teams to set clear short- and long-term goals and track progress toward better health outcomes. Reduce fragmentation by coordinating services across settings (inpatient, rehab, outpatient, preventive) and adjusting plans as needs change. Use utilization review and strong documentation to ensure services meet criteria, benefits are maximized, and care is both effective and cost-aware. Coach members on their condition, treatment options, and next steps so they can make informed choices and stay engaged in their care. Escalate quality-of-care or complex clinical questions to the Medical Director and help drive timely, well-informed decisions. Strengthen team performance by supporting quality reviews, leading risk meetings as needed, and mentoring new team members.

Qualifications

Required Active RN license (state-appropriate) with an associate degree in nursing (ASN) or higher. Compact license preferred. Minimum 3 years of recent clinical practice experience. Strong skills in care planning, care coordination, and patient advocacy across the continuum of care. Clear, respectful communication (written and verbal) with members, families, providers, and business partners. Comfort using a PC and common tools (Windows and Word) and ability to learn new systems as they change. Preferred Previous case management experience in a health plan, employer, or clinical setting. Certified Case Manager (CCM) credential (or ability to obtain within 12 months of hire). Experience interpreting benefit plan documents and applying guidelines to real member situations. Quality improvement or training/mentorship experience (QA programs, risk reviews, onboarding). If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 57,600 - 96,000 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Apply To This Job