Aetna Clinical Case Manager in Blue Bell, Pennsylvania

Req ID: 40905BR

POSITION SUMMARY

Utilizes advanced clinical judgment and critical thinking skills to perform case management duties for complex patient populations, requiring a higher level of clinical experience. Services to promote effective utilization of available resources and optimal, cost-effective member outcomes.

Fundamental Components:

Telephonic clinical case management with commercial population. Uses Motivational Interviewing and engagement interventions to optimize member participation. Will document in clinical systems to support legacy Aetna membership Provide BH consultation and collaborate with Aetna partners. Active participation in clinical treatment rounds. Active participation in team activities focused on program development. Innovative thinking expected.

BACKGROUND/EXPERIENCE desired:

3-5 years of direct clinical practice experience post masters degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility

Case management and discharge planning experience preferred

Managed care/utilization review experience preferred

Advanced Crisis intervention skills

EDUCATION

The highest level of education desired for candidates in this position is a Master's degree.

LICENSES AND CERTIFICATIONS

Licensed Independent Social Worker is desired

Licensed Professional Counselor is desired

Licensed Psychologist is desired

Nursing/Psychiatric and Mental Health Nurse is desired

FUNCTIONAL EXPERIENCES

Functional - Clinical / Medical/Direct patient care (hospital, private practice)/1-3 Years

FunctionalExperience/FunctionalFocus/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

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

REQUIRED SKILLS

Benefits Management/Understanding Clinical Impacts/ADVANCED

General Business/Communicating for Impact/FOUNDATION

Leadership/Collaborating for Results/MASTERY

DESIRED SKILLS

Encouraging Wellness and Prevention/ADVANCED

Interacting with Medical Professionals/ADVANCED

Benefits Management/Maximizing Healthcare Quality/ADVANCED

Telework Specifications:

Potential for Full-Time (WAH) Telework

Considered only for current internal teleworkers (in any area), but if candidate has unique circumstances, telework will be considered.

ADDITIONAL JOB INFORMATION

Annual monetary bonus based on productivity; Telephonic Case Management; no "queue" requirements, telework potential

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