Aetna Clinical Consultant-RN in Harrisburg, Pennsylvania
Req ID: 66111BR
Exciting opportunity to work in office in the Harrisburg, PA Engagement Hub!
Aetna s Corporate Care Management is expanding our Engagement Hub services. The Engagement Hubs located in Florida, Texas and Pennsylvania, are focused on driving member engagement into Aetna s Care Management programs, while delivering care services to members who do not need long term support but have immediate care needs.
The Clinical Consultant - RN (CC-RN) provides short-term care management supporting members through a collaborative process. The CC-RN provides health coaching, medical management support, and connects members to the resources and services, available at Aetna and in their own community, supporting the member s comprehensive health needs while promoting quality care and cost effective outcomes.
Fundamental Components included but are not limited to:
Responsible for short-term care management of Aetna members, to deliver comprehensive, community-based care management services focused on helping the member maximize best health outcomes
Responsible for providing clinical consulting support to non-clinicians who serve as the first point of contact for many of our programs
Interacts with members telephonically and eventually through technology-based interactions, including video, email, text, etc.
Conducts individualized surveys to identify problems and interventions with corresponding measurable outcomes that drive the content of the holistic, member centered care
Utilizes influencing and motivational interviewing skills to ensure maximum member engagement; promotes lifestyle and behavior changes to achieve optimum level of health
Helps members actively and knowledgeably participate with providers in healthcare decision-making; helps members actively and knowledgeably participate with community-based organizations able to support in meeting health goals
Conducts surveys for members discharged from an in-patient hospital or skilled nursing facility, supports post discharge plan of care for both members assigned within their case load and members outside of the case load but residing within their assigned area
Demonstrates proficiency managing email in an Outlook account, and using remote communication software such as Skype and WebEx; able to demonstrate proficiency with Word, Excel, and experience documenting within an electronic health record
Adheres to care management, privacy and confidentiality, and quality management processes in compliance with regulatory, accreditation guidelines, company policies and procedures
Other responsibilities as assigned
Qualifications Requirements and Preferences:
RN licensure required
3+ years clinical experience required
3+ years case/ care management experience required
Bachelor's degree or 3 years equivalent experience required
Community-based experience preferred
Experience in a call center or telephonic care management setting preferred
Health plan experience preferred
CCM certification preferred
Managed care experience preferred
Master's degree preferred
Nursing - Registered Nurse
Additional Job Information:
The Clinical Consultant-RN must work in an Engagement Hub located in Harrisburg, PA
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Job Function: Healthcare
Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.