Aetna Care Management Associate in Allentown, Pennsylvania
Req ID: 53605BR
The Care Mgmt Associate (CMA) role supports medical services including precert intake and sending to clinical and discharge verifications along with outreach calls to members.
Responsible for initial entry of precert cases
Screens medical services incoming calls
Outgoing calls for entry of appropriate discharge date and disposition
Identifies triggers for referral to CM and or and other Specialty Programs
Utilizes eTUMS and other Aetna systems to build, research and enter member information, as needed
Performs non-medical research pertinent to maintenance and closure of open cases
Provides support services to team members by answering telephone calls, taking messages, researching information and assisting in solving problems
Making outreach calls to members to explain programs
2-4 years experience in a medical setting or customer service setting
The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.
LICENSES AND CERTIFICATIONS
Customer Service/ is desired
Office Support/ is desired
Medical/ is desired
Sales & Service/ is desired
Service/Demonstrating Service Discipline/FOUNDATION
Service/Working Across Boundaries/FOUNDATION
Service/Handling Service Challenges/FOUNDATION
Service/Creating a Differentiated Service Experience/ADVANCED
ADDITIONAL JOB INFORMATION
Hiring shift could be 12:30 t 9 pm. Coverage on Saturdays and or holidays by rotation basis.
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 candidates'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