Aetna RN Field Assessor in Middlesex County, New Jersey
Req ID: 63291BR
This is a full time RN Assessor who will conduct face to face visits to Aetna Members and completes needs assessments for personal care assistance services, Adult and pediatric medical day care services, and MLTSS clinical eligibility.
This position requires nursing clinical judgment, travel, In office training, and work at home computer data entry.
Fundamental Components included but are not limited to:
Position will require travel in Northern NJ and a training period working out of the Princeton office. Applicants must be comfortable traveling to both.
Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility. Assessments include the member s level of work capacity and related restrictions/limitations. Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.
Qualifications Requirements and Preferences:
2 + years clinical practice experience; Required
Knowledge of electronic health documentation and MS office products; Required
RN License in NJ active and unrestricted; Required
Experience in care management, discharge planning, and/or clinical assessments; Preferred
Bilingual Spanish Fluency; Preferred
Residency in Bergen, Passaic, Morris or Essex Counties; Preferred
Ability to travel to members homes in assigned counties to conduct assessments; Required
Ability to Train in Princeton office for approximately up to 6+ weeks; Required
Nursing - Registered Nurse
Nursing - Case Management
Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft Word
Additional Job Information:
Typical office working environment with productivity and quality expectationsWork requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.Ability to multitask, prioritize and effectively adapt to a fast paced changing environmentPosition requires proficiency with computer skills which includes navigating multiple systems and keyboardingEffective communication skills, both verbal and written.
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.