Quality Manager overseeing the execution of strategic quality plans in a manufacturing setting. Ensure compliance with internal and external quality standards while managing a quality department in Farwell, Michigan.
About the role
- Case Manager (Registered) role supporting Aetna’s LTSS team in Virginia, conducting assessments and developing care plans. Requires 50-75% travel in the Richmond region.
Responsibilities
- Assessing, planning, coordinating, and implementing comprehensive case management services to support members’ medical, functional, and social needs.
- Conducting holistic assessments using clinical tools, data review, and member interviews to determine needs, benefit eligibility, and care coordination requirements.
- Developing individualized care plans to address medical, behavioral, and social factors impacting member health.
- Identifying risk factors, barriers, and opportunities to improve wellness and reduce health complications.
- Collaborating closely with internal and external partners to support seamless transitions into Aetna programs and services.
- Reviewing claims history and clinical information to guide care decisions and evaluate potential case management impact.
- Presenting complex cases in multidisciplinary conferences and consulting with supervisors to overcome barriers to goals.
- Ensuring compliance with company policies, regulatory requirements, and case management standards.
- Using effective interviewing and engagement techniques to understand member needs and encourage active participation in their care plan.
Requirements
- Must reside to the West of Richmond Virginia, including areas such as Ashland, Glen Allen, Henrico and Tuckahoe.
- Reliable transportation and willingness to travel 50–75% of the time (mileage reimbursement provided per company policy).
- Current, unrestricted Virginia LPN, RN, or Behavioral Health license.
- Minimum 3 years of clinical experience (ideally in Medical‑Surgical, Behavioral Health, Long‑Term Care, or related settings).
- 1+ year of Managed Care experience.
- Proficiency in navigating multiple computer systems, strong keyboarding skills, and ability to work in a technology‑driven environment.
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.
- Paid time off
- Flexible work schedules
- Family leave
- Dependent care resources
- Colleague assistance programs
- Tuition assistance
- Retiree medical access
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