Aetna Care Management Associate in Seattle, Washington

Req ID: 44579BR

JOIN US AT OUR JOB FAIRS FOR THIS ROLE IN SEATTLE!Please bring an updated copy of your resume, and be prepared to interview. Ramada Tukwila Southcenter15901 W. Valley HwyTukwila, WA 98188Thursday, August 24 from 12pm to 7pmFriday, August 25 from 10am to 5:30pm Residence Inn by Marriott Bellevue/Downtown605 114th Ave SEBellevue, WA 98004Saturday, August 26 from 9a-2pm

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:

Performs intake calls from members, providers, facilities regarding services via telephone or fax - Screens requests for appropriate referral to medical services staff - Performs non0medical research pertinent to the establishes, maintenance and closure of open cases - Maintains accurate and complete documentation of required information that meets risk management, regulatory and accreditation requirements - Promotes communication both internally and externally to enhance effectiveness of medical management services - Protects the confidentiality of member information and adheres to company policies regarding such - Supports the administration of the precertification process in compliance with various laws and regulations, URAC and/or NCQA standards where applicable - Places outbound calls to providers under the direction of medical management nurses to obtain clinical information for approval of medical authorizations - Identifies triggers for referrals into Case Management, Disease Management and other Special Programs - May assist in the research and resolution of claims payment issues - Sedentary work involving significant periods of sitting, talking, hearing and keying - Work requires visual acuity to perform close inspection of written and computer generated documents as well as a PC monitor - Working environment includes typical office conditions

BACKGROUND/EXPERIENCE desired:

2-4 years experience as a medical assistant, office assistant. Strong customer service skills to coordinate service delivery, including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for customers Computer literacy Familiar with basic medical terminology

EDUCATION

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

TECHNOLOGY EXPERIENCES

Technical - Aetna Applications/Aetna Total clinical View/1-3 Years/End User

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

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

Telework Specifications:

Considered for any US location; training period in the office may be required

ADDITIONAL JOB INFORMATION

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