Aetna Case Management Coordinator in Princeton, New Jersey
Req ID: 64211BR
Develop, implement, support, and promote Health Services strategies, tactics, policies, and programs that drive the delivery of quality healthcare to establish competitive business advantage for Aetna. Health Services strategies, policies, and programs are comprised of utilization management, quality management, network management and clinical coverage and policies. Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes
Fundamental Components included but are not limited to:
Position will require travel in Camden and surrounding counties and a training period working out of the Princeton office. Applicants must be comfortable traveling to both.
The Case Manager Coordinator is responsible for conducting face to face visits using comprehensive assessments of members enrolled in Managed Long-Term Services and Supports program (MLTSS). The Case Manager Coordinator is responsible to coordinate and collaborate care with member/authorized representative, PCP, and any other care team participant. The Case Manager Coordinator will attend interdisciplinary meetings and advocate on members behalf. The Case Manager Coordinator works with member and care team to develop care plan and will authorize services within the MLTSS benefit. The Case Manager Coordinator will also work with the member and care team to coordinate and assist with community resources. The Case Manager Coordinator is responsible for documenting accurately and timely in the electronic health record. This position requires the care manager to use critical thinking and be able to problem solve any issues related to assigned membership. While this position is telework the care manager must work normal business hours.
Qualifications Requirements and Preferences:
1+ years of Case management experience required.
Bachelor's Degree in Health Science or Social Work; Required
MSW, MPH, CSW; Preferred
Bilingual Fluency; Preferred
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.