Job Summary

At Cigna, we are committed to helping people improve their health, well-being, and peace of mind. As a Medicare Clinical Operations LPN/LVN Case Management Analyst, you will be a vital part of our Clinical Operations team. This role is focused on supporting case management functions through medical review, care coordination, member outreach, and administrative processing for Medicare-eligible members. You will collaborate with Case Managers and other clinical and non-clinical staff to ensure high-quality, cost-effective healthcare services are delivered.

Key Responsibilities

• Conduct telephonic outreach to Medicare members to assess health needs, provide education, and coordinate care.

• Support case management activities by collecting clinical data, documenting interactions, and updating care plans.

• Assist in identifying members who require complex case management or additional resources.

• Review clinical documents and provide administrative support in authorizations and follow-up communications.

• Monitor member progress and report clinical status to the Case Manager or RN Supervisor.

• Maintain accurate and up-to-date documentation in the care management system.

• Ensure compliance with Medicare guidelines and organizational protocols.

• Work collaboratively with internal departments such as Utilization Management, Social Work, and Provider Services.

Required Skills and Qualifications

• Current and unrestricted LPN (Licensed Practical Nurse) or LVN (Licensed Vocational Nurse) license in the U.S.

• Knowledge of Medicare Advantage and CMS (Centers for Medicare & Medicaid Services) regulations.

• Strong customer service and communication skills—both written and verbal.

• Computer proficiency including EHR systems, Microsoft Office Suite, and case management software.

• Ability to multitask and work in a fast-paced, remote healthcare environment.

• Exceptional attention to detail and organizational abilities.

Experience

• Minimum 2–3 years of experience in clinical nursing, preferably in case management, utilization review, or managed care.

• Previous experience working with Medicare populations is highly desirable.

• Experience with virtual or telephonic patient communication preferred.

Working Hours

• Full-Time, 40 hours per week.

• Monday to Friday, typically between 8:00 AM – 5:00 PM (local time).

• Occasional flexibility may be required based on member needs or project deadlines.

Knowledge, Skills, and Abilities

• Solid understanding of medical terminology, clinical processes, and chronic condition management.

• Ability to engage with diverse member populations with empathy and professionalism.

• Familiarity with HIPAA and healthcare compliance standards.

• Critical thinking and problem-solving skills with a solution-oriented mindset.

• Team player who is self-motivated and can work independently in a remote setting.

Benefits

• Competitive base salary and annual performance incentives.

• Comprehensive medical, dental, and vision insurance.

• 401(k) with company match and retirement planning resources.

• Paid time off (PTO), holidays, and volunteer time.

• Continuing education and professional development programs.

• Employee wellness and mental health resources.

• Work-from-home flexibility and supportive team culture.

Why Join Cigna?

Joining Cigna means making a difference in the lives of millions of people. We offer a purpose-driven career, exceptional growth opportunities, and a collaborative work environment where innovation and compassion thrive. Our commitment to inclusion, integrity, and employee development makes us a top employer in the healthcare industry. Be part of something bigger—help us shape the future of healthcare.

How to Apply

Interested candidates should submit their application via Cignas official careers page.
Search for Medicare Clinical Operations LPN/LVN Case Management Analyst and apply online. Include an updated resume and cover letter outlining your relevant experience.