Case Manager Registered Nurse working with Aetna to enhance patient care for dual eligible populations. Collaborating with stakeholders to address comprehensive health needs and improve outcomes.
Responsibilities
Help elevate patient care to a whole new level
Join the Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models
Collaborate with members, providers, and community organizations to address the full continuum of health care and social determinant needs
Acts as a liaison with member/client /family, employer, provider(s), insurance companies, and healthcare personnel as appropriate
Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care
Interacts with members/clients telephonically or in person, may be required to meet with members/clients in their homes, worksites, or physician’s office
Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status and develops a plan of care
Communicates with member/client and other stakeholders, prepares all required documentation of case work activities as appropriate
Interacts and consults with internal multidisciplinary team to help member/client maximize best health outcomes
Provides educational and prevention information for best medical outcomes
Monitors member/client progress toward desired outcomes through assessment and evaluation
Requirements
Minimum 3-5 years clinical practical experience preference required
Minimum 2-3 years CM, discharge planning and/or home health care coordination experience
Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
Ability to travel within a designated geographic area for in-person case management activities as directed by Leadership and/or as business needs arise
Excellent analytical and problem-solving skills
Effective communications, organizational, and interpersonal skills
Ability to work independently
Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications
Efficient and Effective computer skills including navigating multiple systems and keyboarding
Benefits
Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Benefit solutions that address different needs and preferences of colleagues such as paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility
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