Cigna Clinical Account Manager (RN) - Mid-Atlantic in United States

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Role Summary

The Clinical Account Manager, as part of the Mid Atlantic Sales Organization, works cross-organizationally to support, influence and drive change that results in improved quality, affordability and satisfaction for our customers. The Clinical Account Manager is a clinical consultative role and represents Cigna internally and externally to enable the successful integration between sales, clients, brokers, provider partners, clinical operations and other stakeholders. The Clinical Account Manager’s clinical expertise enhances the sales account team and assists in driving membership growth and retention in the market.

Major Duties

  • Partners with clinical operations to maintain a working knowledge of all clinical, health advocacy and operational processes necessary to support clients and sales teams. Responsible to share key operations information with their respective sales team.

  • Facilitates integration and acts as clinical liaison between Mid Atlantic sales, clients, brokers, clinical operations teams, and other partners

  • Clinical subject matter expert for sales team related to clinical operations and policies, clinical products, utilization patterns, large claims analysis, population trends, customer engagement and non-standard clinical workflows

  • Effectively articulates and educates sales team, brokers, clients and other partners on clinical products and updates

  • Analyze large claim data and provide insight into clinical trends, identify participation in clinical programs and educate partners on Cigna interventions

  • Participate in monthly/quarterly client meetings including large claim analysis, clinical program participation, and provide recommendations related to wellness and communication strategy

  • Facilitate claims-based jumpstart process – chronic condition management and case management

  • Assist client manager in client discussions related to benefit and coverage issues, e.g. explain Coverage Position

  • Support escalated transition of care issues, e.g. special needs children

  • Investigate and resolve escalated clinical issues and provide client level explanation to sales team as needed

  • Coordinate clinical operations site visits for clients, brokers and providers

  • Educate client team on clinical programs, e.g. on-site clinic staff, school nurses

  • Clinical liaison/consultant between client, sales team, implementation manager and clinical operations when implementing clinical products

  • Facilitate client cultural training for clinical operations when clinical operations site visit is not possible

  • Facilitate case management and coaching referrals to appropriate clinical operations team

  • Coordinate coach support for client worksite engagement events

  • Clinical liaison between non-Cigna on-site clinics, e.g. referrals to Cigna clinical programs

  • Participate in client Lunch and Learns as relates to clinical programs, e.g. YHF, Personal Health Team

  • Participate in Mid Atlantic Wellness Council

  • Participate in client wellness retreat and strategic planning as related to clinical programs and information

  • Support RFP process and finalist meetings as requested

  • Participate in special projects as directed

  • Perform other duties as directed

Qualifications

  • Registered Nurse with a current active license

  • Bachelor’s degree preferred

  • Minimum of three (3) years of clinical practice experience

  • Industry experience required

  • 1 year of management experience strongly preferred

  • Knowledge and experience working with clinical programs (Cigna clinical programs preferred)

  • Skilled at research, organization, time management, and analytics

  • Demonstrates flexibility, consultative critical thinking and action planning

  • Proven administrative abilities with strong computer and software application skills

  • Excellent interpersonal skills

  • Ability to work independently toward established priorities

  • Ability to build strong relationships and influence diverse groups

  • Excellent written and oral communication skills

  • Ability to maintain confidentiality

  • Travel required

Qualified applicants will be considered for employment without regard to age, race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status.

If you require an accommodation based on your physical or mental disability please email: SeeYourself@cigna.com. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

We’re a global health service company dedicated to helping people improve their health, well-being and sense of security. We offer an integrated suite of health services, such as medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products that serve over 95 million customers around the world. When you work with us, you’ll enjoy a different kind of career - you’ll make a difference, learn a ton, and change the way people think about health insurance. To see our culture in action, search #TeamCigna on Twitter or Instagram.