Aetna Clinical Case Manager in Blue Bell, Pennsylvania
Req ID: 40905BR
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.
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.
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
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 - Clinical / Medical/Direct patient care (hospital, private practice)/1-3 Years
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
Benefits Management/Understanding Clinical Impacts/ADVANCED
General Business/Communicating for Impact/FOUNDATION
Leadership/Collaborating for Results/MASTERY
Encouraging Wellness and Prevention/ADVANCED
Interacting with Medical Professionals/ADVANCED
Benefits Management/Maximizing Healthcare Quality/ADVANCED
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