Aetna Care Management Associate in Richfield, Ohio

Req ID: 45604BR

Please note that this position has a weekly shift rotation. Employees will be required to work an 8-hour shift within the business hours of 7:30 AM and 6:00 PM

POSITION SUMMARY

Support comprehensive coordination of medical services including Care Team intake, screening and supporting the implementation of care plans to promote effective utilization of healthcare services. Promotes/supports quality effectiveness of Healthcare Services

FUNDAMENTAL COMPONENTS

As part of the Patient Management team, your daily functions include: answering incoming calls from providers or members regarding precertification or registration for surgical procedures, coordinating care with appropriate nurses; verifying eligibility, referring/transferring callers to appropriate clinical staff; and providing excellent customer service. You will use software programs to enter data, research information and document your activities. The job responsibilities require the ability to learn multiple processes and complete them consistently, efficiently and in compliance with detailed procedures. A high school education. 1 year of telephonic customer service experience, computer literacy (Microsoft Word, Excel, and Outlook) and knowledge of medical terminology are essential for achieving success as a Care Management Associate. Two to four years experience as a medical assistant or office assistant along with knowledge of managed care concepts are preferred.

BACKGROUND/EXPERIENCE

2-4 years of call center experience required

1-3 years of member/customer service experience required

1-3 years of Healthcare/Medical experience preferred

2-4 years experience as a medical assistant, office assistant preferred

EDUCATION

The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.

FUNCTIONAL EXPERIENCES

Functional - Administration / Operations/Telephone / Receptionist/1-3 Years

TECHNOLOGY EXPERIENCES

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

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

REQUIRED SKILLS

General Business/Communicating for Impact/ADVANCED

General Business/Maximizing Work Practices/ADVANCED

Technology/Leveraging Technology/FOUNDATION

DESIRED SKILLS

Leadership/Driving a Culture of Compliance/ADVANCED

Service/Creating a Differentiated Service Experience/ADVANCED

Service/Demonstrating Service Discipline/FOUNDATION

ADDITIONAL JOB INFORMATION

As part of the Patient Management team, your daily functions include: answering incoming calls from providers or members regarding precertification or registration for surgical procedures, coordinating care with appropriate nurses; verifying eligibility, referring/transferring callers to appropriate clinical staff; and providing excellent customer service. You will use software programs to enter data, research information and document your activities. The job responsibilities require the ability to learn multiple processes and complete them consistently, efficiently and in compliance with detailed procedures. A high school education. 1 year of telephonic customer service experience, computer literacy (Microsoft Word, Excel, and Outlook) and knowledge of medical terminology are essential for achieving success as a Care Management Associate. Two to four years experience as a medical assistant or office assistant along with knowledge of managed care concepts are preferred.

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