Concurrent Review Care Coordinator, Evicore, Work At Home at The Cigna Group

Overview

Concurrent Review Care Coordinator Job Summary The Concurrent Review Care Coordinator is responsible for concurrent review, care coordination, and utilization management activities across post-acute care settings. The role applies clinical judgment, evidence-based guidelines, and organizational policies to support quality outcomes, cost-effective care, and member experience. Key Responsibilities Implement, evaluate, and coordinate individualized plans of care for assigned members.

Conduct utilization and concurrent reviews in alignment with medical necessity criteria and regulatory requirements. Collaborate with providers, Medical Directors, and interdisciplinary teams to support transitions of care. Identify gaps or deviations in care plans and intervene appropriately to support desired outcomes.

Document clinical decisions, determinations, and communications accurately and timely in designated systems. Ensure compliance with The Cigna Group policies, accreditation standards, and confidentiality requirements. Participate in meetings, audits, and quality improvement initiatives as assigned.

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 .
• About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality.
• We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people.
• 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.