Aetna Case Manager in Blue Bell, Pennsylvania

Req ID: 41880BR

POSITION SUMMARY

Our department is fast paced unit and we have the ability to frequently change direction to focus on the needs of the unit. Our primary mission is focused on Healthy Outcomes for our members, Medicare STARS measures and closing those gaps.

Fundamental Components:

The telephonic case manager functions as a nurse educator role with our Medicare members. They must be able to engage our members to promote healthy lifestyles. This is a rewarding, exciting and fast-paced environment.

BACKGROUND/EXPERIENCE desired:

4-5 years years clinical practice experience. Case Management Experience preferred. Geriatric experience preferred.

EDUCATION

The highest level of education desired for candidates in this position is a Associate's degree or equivalent experience.

LICENSES AND CERTIFICATIONS

Nursing/Registered Nurse (RN) is REQUIRED

FUNCTIONAL EXPERIENCES

Functional - Nursing/Case Management/1-3 Years

Functional - Nursing/Concurrent Review/discharge planning/1-3 Years

Functional - Learning/Preceptor - Nurse/1-3 Years

TECHNOLOGY EXPERIENCES

Technical - Desktop Tools/Microsoft Outlook/1-3 Years/End User

Technical - Desktop Tools/Microsoft Word/1-3 Years/End User

REQUIRED SKILLS

Benefits Management/Maximizing Healthcare Quality/FOUNDATION

Benefits Management/Understanding Clinical Impacts/FOUNDATION

DESIRED SKILLS

General Business/Turning Data into Information/FOUNDATION

Telework Specifications:

Looking for Blue Bell, PA and Newark, DE in office. No opportunity for telework at this time.

ADDITIONAL JOB INFORMATION

The Case Manager utilizes a collaborative process of assessment, planning, implementation and evaluation, to engage, educate, and promote/influence members decisions related to achieving and maintaining optimal health status. Requires an RN with unrestricted active license. Responsibilities include but are not limited to: member outreach for support and education, provider outreach for education and data gathering, member referrals to and collaboration with other Aetna teams for case management, social service needs and provider collaboration nurse involvement. This position is within the Aetna Medicare STARS Engagement team.

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

Together we will empower people to live healthier lives.

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Job Function: Health Care