Aetna Case Manager RN in New Albany, Ohio
Req ID: 50020BR
This position is for the Mercer Health Advantage In Touch Care Program. The hours of operation are 8:00 am to 10:00 pm EST. It requires an Evening Shift rotation 1:30 pm to 10:00 pm) 1-2 times per month. The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individuals benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Requires an RN with unrestricted active license.
Fundamental Components related to Aetna In Touch Care Program include but are not limited to: - Utilizes influencing/motivational interviewing skills to ensure maximum member engagement to achieve optimal outcomes, Utilizes assessment techniques to determine members level of health literacy, technology capabilities, and/or readiness to change. - Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health. - Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
BACKGROUND/EXPERIENCE: 3-5 years of Clinical Practice experience; RequiredHospital Medical Surgical experience; PreferredStrong computer and typing skills; RequiredExperience with Patient Education/Discharge planning; PreferredEDUCATION
The minimum level of education required for candidates in this position is a Associate's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Registered Nurse License RN; is Required
Nursing/Certified Case Manager (CCM) is Preffered
Functional - Nursing/Case Management/1-3 Years
Functional - Nursing/Medical-Surgical Care/1-3 Years
Functional - Nursing/Concurrent Review/discharge planning/1-3 Years
Functional - Nursing/Disease management/1-3 Years
Technical - Desktop Tools/Microsoft Outlook/1-3 Years/End User
Technical - Desktop Tools/Microsoft Word/1-3 Years/End User
Technical - Aetna Applications/Aetna Total clinical View/1-3 Years/End User
Technical - Operating Systems/Windows/1-3 Years/End User
Benefits Management/Understanding Clinical Impacts/FOUNDATION
General Business/Applying Reasoned Judgment/ADVANCED
Service/Providing Solutions to Constituent Needs/ADVANCED
Benefits Management/Supporting Medical Practice/FOUNDATION
General Business/Consulting for Solutions/ADVANCED
Leadership/Collaborating for Results/ADVANCED
ADDITIONAL JOB INFORMATION
We are looking for a Case Manager to join the New Albany Dedicated Unit. Aetna In Touch Care model will be a combined case management and disease management focus. In this CM/DM role we are looking for a candidate who will assist with health care coordination, member satisfaction, and financial outcomes using targeted customer strategies and initiatives. The CM will provide telephonic member outreach for key educational and situational opportunities for increased case management and disease management identification and engagement. We will provide decision support and guidance for members and their families along with coordination of healthcare services. The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individuals benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Requires an RN with unrestricted active license. Minimum 3 to 5 years of recent experience. Strong knowledge of major health behavior models including Motivational Interviewing preferred. Must possess strong verbal, written communication skills, computer and keyboarding skills
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.
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Job Function: Health Care