Aetna Case Manager in San Antonio, Texas

Req ID: 41038BR

Join our growing team in the San Antonio, TX office!

POSITION SUMMARY

The Case Manager facilitates the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities. Develops, implements and supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work. Services and strategies, policies and programs are comprised of network management, clinical coverage and policies.

Fundamental Components:

Utilizes clinical tools and information/data reviews, conducts an evaluation of member's needs and benefit plan and facilitates integrative functions as well as smooth transition through levels of care. Utilizes assessment techniques and interviewing skills to ensure maximum member engagement. Consults with the supervisor and others to overcome barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to overall management of the member's needs.

BACKGROUND/EXPERIENCE:

3-5+ years clinical practice experience (Required) Nursing/Registered Nurse (RN) (Required)Certification in Case Management and prior experience (Preferred) Proficiency with computer skills which includes navigating through multiple systems and keyboarding. Effective communication skills, both verbal and written. Bilingual preferred but not required.

EDUCATION

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

LICENSES AND CERTIFICATIONS

Nursing/Registered Nurse (RN)

FUNCTIONAL EXPERIENCES

Functional - Nursing/Case Management/1-3+ Years

FunctionalExperience/FunctionalFocus/1-3+ Years

TECHNOLOGY EXPERIENCES

Technical - Desktop Tools/Documentum/1-3+ Years/End User

REQUIRED SKILLS

Benefits Management/Maximizing Healthcare Quality/FOUNDATION

Benefits Management/Understanding Clinical Impacts/FOUNDATION

Leadership/Collaborating for Results/ADVANCED

DESIRED SKILLS

General Business/Applying Reasoned Judgment/ADVANCED

Leadership/Driving a Culture of Compliance/FOUNDATION

Service/Providing Solutions to Constituent Needs/ADVANCED

ADDITIONAL JOB INFORMATION

Excellent potential for professional growth.

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 and affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status.

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