Science Communication Manager for MERKUR GROUP driving evidence - based initiatives on player protection. Involves analysis, research, publications, and public affairs collaboration.
About the role
- Case Manager Registered Nurse role focused on assessing and coordinating case management activities for member wellness. Field-based position within Aetna’s Long-Term Services and Supports team.
Responsibilities
- Nurse Case Manager is responsible for assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness
- Develops a proactive course of action to address issues presented to enhance the short and long- term outcomes as well as opportunities to enhance a member’s overall wellness through integration
- Conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans
- Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues
- Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality
- Reviews prior claims to address potential impact on current case management and eligibility
- Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management
- Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation
Requirements
- Candidate must reside in Bowling Green/Ashland region of Virginia
- Must possess reliable transportation and be willing and able to travel up to 50-75% of the time
- RN/BH with current unrestricted Virginia state licensure required
- 3 years Clinical Experience (Preferably in Medical-Surgical Nursing, Behavioral Health, Long term Care, etc.)
- 1+ years Managed Care experience
- Proficiency with computer skills which includes 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
- Paid time off
- Flexible work schedules
- Family leave
- Dependent care resources
- Colleague assistance programs
- Tuition assistance
- Retiree medical access
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