Aetna Clinical Care Manager in Charleston, West Virginia

Req ID: 42709BR

POSITION SUMMARY

Nurse Case Manager is responsible for telephonically assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical and behavior needs of the member to facilitate the members overall wellness. The care manager 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 members overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies.

Fundamental Components include but are not limited to:

Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding

Effective communication skills, both verbal and written.

Ability to multitask, prioritize and effectively adapt to a fast paced changing environment

Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.

Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.

Typical office working environment with productivity and quality expectations

Fundamental Components:

Nurse Case Manager is responsible for telephonically assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical and behavior needs of the member to facilitate the members overall wellness. The care manager 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 members overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies.

LICENSES AND CERTIFICATIONS

Nursing/Registered Nurse is required

Nursing/Certified Case Manager is preferred

BACKGROUND/EXPERIENCE desired:

3+ years clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care preferred.

Case management and discharge planning experience preferred

Managed Care experience preferred

Crisis intervention skills preferred

EDUCATION

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

FUNCTIONAL EXPERIENCES

Functional - Nursing/Case Management/1+ Years

Functional - Clinical / Medical/Disease management/1+ Years

TECHNOLOGY EXPERIENCES

Technical - Desktop Tools/Microsoft Outlook/1+ Years/

Technical - Desktop Tools/Microsoft SharePoint/1+ Years/

Technical - Desktop Tools/Microsoft Word/1+ Years/

Technical - Desktop Tools/

ADDITIONAL JOB INFORMATION

In-office position, option for telework will be evaluated after a certain period of employment.

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.

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