Case Management Analyst - LPN - Work at Home

LPN Case Management Analyst

Bring your clinical judgment, compassion, and problem-solving skills to a role where every decision can improve a member’s care experience. As an LPN Case Management Analyst, you will help connect members with the right services, reduce gaps in care, and support thoughtful use of health care resources. You will join a team of ambitious and compassionate experts who learn together, adapt quickly, and focus on better outcomes.

Responsibilities

• Assess clinical information and identify members who may benefit from case management based on health changes, claims triggers, and clinical judgment.
• Conduct initial outreach and engagement activities to introduce programs, gather information, identify immediate needs, and facilitate referrals to appropriate case management, disease management, or community resources.
• Coordinate referral requests and apply clinical policies and guidelines to support timely, high-quality care decisions.
• Improve continuity of care through pre- and post-surgical planning, discharge follow-up, and referrals to chronic care or disease management programs.
• Serve as a trusted resource for referrals to specialized vendor partners while following client-specific requirements.
• Communicate clear, accurate information to members, providers, and internal partners, and document each interaction in the appropriate system.
• Meet quality assurance, protocol, and documentation standards while using sound judgment to solve problems and manage competing priorities.
• Strengthen team capability by sharing knowledge, supporting training, contributing to meetings or committees, and completing assigned improvement work.
• Build expertise in claims processes, benefit documents, and evolving technology to make accurate and consistent decisions.

Required Qualifications

• Active, unrestricted LPN or LVN license in your primary state of residence.
• Minimum of 1 year of clinical practice experience. Experience in Maternity Management, Pre/Post Surgical, Oncology preferred.
• Ability to review and apply clinical information, benefit documents, policies, and procedures to individual situations.
• Strong written, verbal, listening, organization, and follow-through skills.
• Ability to manage multiple priorities, meet deadlines, and make sound decisions with professionalism and patience.
• Basic computer skills, including Microsoft Windows and Word, with the ability to learn and adapt to new software.

Preferred Qualifications

• Experience in case management, care coordination, discharge planning, claims review, or a health plan setting.
• Knowledge of claims processing procedures and quality assurance requirements.
• Experience serving as a trainer, preceptor, subject matter expert, or committee contributor.

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 hourly rate of 24 - 37 USD / hourly, 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, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

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.

If you need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance.  Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.