The Cigna Group
Clinical Waste & Abuse Nurse Lead position at Evernorth, responsible for identifying waste and abuse trends, coaching peers, and shaping review practices. Provides clinical expertise and thoughtful judgment to protect patients and strengthen payment integrity.
Requirements
- Experience and strong proficiency in Clinical Waste and Abuse
- Active, unrestricted RN license
- Minimum of 2 years of recent acute clinical nursing experience
- Demonstrated ability to independently manage complex clinical reviews and escalations
- Strong clinical judgment, problem-solving, and decision-making skills
- Knowledge of healthcare reimbursement principles and utilization review concepts
- Ability to communicate clearly and effectively across clinical and non-clinical audiences
Benefits
- 401(k)
- Company paid life insurance
- Tuition reimbursement
- Minimum of 18 days of paid time off per year
- Paid holidays
- Medical
- Vision
- Dental
- Well-being and behavioral health programs
Originally posted on Himalayas
To apply for this job please visit himalayas.app.
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