Nurse Case Management Supervisor - Evernorth Health Services -Remote

Role Summary

Provides high-level oversight, day-to-day guidance, coaching team members, resolving escalated issues, managing conflict resolution, and supporting the consistent achievement of performance goals.

This role is accountable for team performance, quality, customer satisfaction, and the delivery of high-quality case management and coaching services. The supervisor provides day-to-day guidance, coaching, conflict resolution, and support for escalated issues while helping the team consistently achieve performance goals.

The supervisor partners with internal teams and external stakeholders—including customers, providers, vendors, claims payors, and insurance professionals—to support business initiatives, resolve service delivery concerns, and advance operational goals. Success in this role requires sound judgment, strong relationship-building skills, and intermediate technical proficiency.

Key Responsibilities

Team Leadership and Performance Management

• Lead, coach, and develop direct reports, including case managers, health coaches, and other clinical team members.
• Manage day-to-day team activities and provide guidance, feedback, conflict resolution, and support for escalated issues.
• Monitor and evaluate performance against established key performance indicators, quality standards, financial targets, and applicable accreditation requirements, including URAC and NCQA.
• Conduct regular performance discussions and support compensation decisions through the performance evaluation process.
• Promote career development through coaching, mentoring, continuing education, and succession planning.

Operational Excellence and Strategic Alignment

• Drive operational results by using available tools and resources to improve service delivery, outcomes, and team effectiveness.
• Collaborate with matrix partners to develop work plans, remove barriers, and implement corrective actions to meet business objectives.
• Align team priorities with the Strategic Business Plan and support corporate, customer, product, and business initiatives.
• Lead or participate in projects, work groups, national teams, and committees; communicate progress, risks, and barriers to leadership.

Customer and Stakeholder Engagement

• Serve as a liaison and escalation point between frontline staff, customers, and internal matrix partners.
• Resolve service delivery concerns, respond to customer requests, and ensure adherence to customer-specific requirements.
• Support customer meetings, presentations, visits, and audits for current and prospective clients.
• Build and maintain productive relationships with internal teams and external stakeholders.

Quality, Compliance, and Talent Development

• Maintain clinical knowledge and provide coaching informed by clinical expertise.
• Partner with quality teams to identify improvement opportunities and implement appropriate actions.
• Support corporate and national quality and certification initiatives, including URAC and NCQA.
• Communicate changes in customer requirements, service delivery protocols, and business processes to staff.
• Recruit and hire qualified case managers, health coaches, and other team members.
• Demonstrate inclusive leadership and cultural sensitivity across diverse teams and customer populations.

Minimum Qualifications

• Active, unrestricted Registered Nurse (RN) license in a U.S. state or territory.
• High-performing candidate with current proven track record in a supervisor role.
• Intermediate technical proficiency and sound judgment are required
• Knowledge of case management and health coaching programs.
• Excellent written and verbal communication skills.
• Demonstrated leadership ability, strategic thinking, and sound judgment in decision-making.
• Working knowledge of quality management principles, standards, and continuous improvement processes.
• Ability to collaborate across teams and build effective relationships with internal and external stakeholders.

Preferred Qualifications

• One to two years of leadership or management experience in clinical operations, care management, or healthcare services.
• Experience partnering with sales teams and external consultants to support client relationships or business development.
• Experience supporting or participating in clinical audits, customer presentations, or client visits.
• Experience with staff training, onboarding, professional development, or succession planning.
• Knowledge of benefit plan design, insurance operations, claims processing, or healthcare benefits.
• Strong analytical, organizational, research, negotiation, and time-management skills.
• Experience leading or contributing to process improvement initiatives.
• Ability to succeed in a fast-paced, changing business environment.

• Management Experience: Minimum of 1-2 years in a leadership or management role within clinical operations or healthcare services.
• Sales & Consultant Interaction: Experience engaging with sales teams and external consultants to support business development and client relationships.
• Clinical Audits: Proven experience conducting and responding to clinical audits to ensure compliance and quality standards.
• Training & Development: Skilled in staff training, onboarding, and professional development initiatives.
• Communication & Analysis: Strong communication, interpersonal, and analytical skills, with the ability to convey complex information clearly.
• Benefit Plan Knowledge: Understanding of benefit plan design and the ability to align services with customer needs.
• Organizational Skills: Excellent time management, organizational, research, and negotiation capabilities.
• Insurance Industry Expertise: In-depth knowledge of insurance operations, including claims processing and healthcare benefits.
• Technical Proficiency: Proficient in Microsoft Word, Excel, and PowerPoint for reporting, presentations, and data analysis.
• Adaptability: Ability to thrive in a fast-paced, dynamic business environment.
• Relationship Building: Demonstrated ability to build and maintain strong working relationships with staff, customers, and providers.
• Process Improvement: Experience leading or contributing to process improvement initiatives to enhance operational efficiency and outcomes.

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 92,100 - 153,500 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, paid holidays, and leaves of absence. 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.