Aetna Clinical Case Manager (RN)- Registered Nurse in Blue Bell, Pennsylvania
Req ID: 40907BR
In the Clinical Case Manager position you will direct contact with members to provide comprehensive behavioral and medical assessments of needs and utilization of motivational interviewing skills.
Work with the member to formulate an integrated member centric treatment plan for better health.
Fundamental Components include, but are not limited to:
The Case Management role identifies cases that may benefit from intervention by direct member telephone contact to offer and engage the member in the program. Once engaged a telephonic comprehensive behavioral and medical assessment of needs and evaluation of barriers is completed to determine where intervention is indicated to improve the quality of results. Deliver an integrated, holistic approach to care management to allow for early intervention and education. Support wellness and prevention programs and coaching to support healthy lifestyles via monthly telephonic contact for the 4-6 month duration of the program. Multi-tasks to accomplish workload efficiently between outreach, initial assessments, follow up, behavioral health consultation to medical colleagues and weekly multidisciplinary rounds. Models integrity and ethical behavior in all situations. Adapts quickly to new and changed situations.
3-5 years of direct clinical practice experience post RN or post masters degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility; Required Case management and discharge planning experience; Preferred Managed care/utilization review experience; Preferred Strong medical background; Required Crisis intervention skill; Preferred
The minimum level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
LICENSES AND CERTIFICATIONS (1 of the 3)
Nursing/Registered Nurse (RN) is required
Mental Health/Licensed Social Worker (LSW) + Master Degree is required
Mental Health/Licensed Psychologist is required
Functional - Nursing/Mental Health/1-3 Years
Functional - Clinical / Medical/Direct patient care (hospital, private practice)/1-3 Years
Functional - Clinical / Medical/Disease management/1-3 Years
Technical - Desktop Tools/Microsoft Word/1-3 Years/End User
Technical - Desktop Tools/Microsoft Outlook/1-3 Years/End User
Benefits Management/Encouraging Wellness and Prevention/ADVANCED
Benefits Management/Interacting with Medical Professionals/ADVANCED
Benefits Management/Understanding Clinical Impacts/ADVANCED
General Business/Applying Reasoned Judgment/ADVANCED
General Business/Communicating for Impact/FOUNDATION
General Business/Consulting for Solutions/ADVANCED
Telework is a requirement for this position (no physical office location)
ADDITIONAL JOB INFORMATION
Work with a diverse member population and a highly challenging job. Ability to work from home. member of a high performing team and organization.
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.
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.
Job Function: Health Care