How Cigna Healthcare Clinical Case Management Works — and When to Use It

When employees face serious or complex health situations, having medical coverage alone is often not enough. What matters just as much is trusted guidance — someone who can help make sense of treatment plans, navigate the healthcare system, and provide continuity during moments of uncertainty.

That’s where Cigna Healthcare’s Clinical Case Management comes in.

What is Clinical Case Management?

Clinical Case Management is a dedicated support service provided by Cigna Healthcare to help members navigate complex, serious, or ongoing health conditions.

It goes beyond administrative processes to focus on coordination, clarity, and advocacy, ensuring members are supported throughout their care journey — from diagnosis through treatment and recovery.

This support is delivered by a dedicated team of medical professionals who work closely with members and, where appropriate, their providers.

What does Cigna Healthcare’s Clinical Case Management support?

Cigna Healthcare’s Clinical Case Management focuses on four core areas:

1. Coordinating treatment plans
   When care involves multiple providers, stages, or decisions, clinical case management helps bring everything together. The team supports members by helping them understand their treatment plans and navigate next steps across different points of care.
2. Accessing global medical expertise
   For complex or serious conditions, members may benefit from additional medical perspectives. Clinical Case Management can help coordinate access to global medical experts to provide advice and guidance where appropriate.
3. Supporting second opinions
   Making treatment decisions can feel daunting — especially when outcomes are uncertain. Clinical Case Management supports members who wish to explore second medical opinions, helping them understand options and feel confident in their decisions.
4. Supporting chronic and serious conditions
   For members managing long-term or serious health conditions, Clinical Case Management provides continuity of support across the care journey — not just at a single point in time.

When should Clinical Case Management be used?

Clinical Case Management is typically most helpful when a member is:

• Facing a serious or complex diagnosis
• Undergoing major treatment or surgery
• Managing a chronic condition
• Considering treatment options or second opinions
• Experiencing uncertainty or difficulty navigating the healthcare system

In these situations, having a consistent point of contact can make the journey feel more manageable.

What does this mean for employers and HR leaders?

For organisations, Clinical Case Management provides confidence that employees are supported beyond coverage alone.

It helps:

• Reduce stress and uncertainty for employees during vulnerable moments
• Support informed decision making and continuity of care
• Reinforce a people centred approach to employee wellbeing

By providing structured, professional support, Clinical Case Management helps employers care for their people while maintaining trust and confidence in their healthcare benefits.

What does this mean for members?

For members, Clinical Case Management means not navigating complex healthcare decisions alone.

It offers:

• Clear guidance when care feels overwhelming
• Reassurance during difficult or uncertain moments
• Support across the full care journey, not just one interaction

The goal is to help members feel informed, supported, and confident in the decisions they make about their health.

This article describes Cigna Healthcare’s Clinical Case Management program. Availability and support may vary based on clinical appropriateness and plan design.

Read about how our clinical case management team have helped members with their healthcare journey with us here:

• Supporting Families in High Stress Moments: How Clinical Case Management Brings Calm and Continuity
• When Care Plans Change Suddenly: How Clinical Case Management Supports Provides Clarity and Confidence
• Enabling Informed Decisions: How Clinical Case Management Supports Confidence in Complex Care

Learn more about Cigna Healthcare’s plans

Find out how Cigna Healthcare can support your health. Our group health plans and individual health plans provide comprehensive health coverage to look after your well-being.