Aetna RN Field Case Mgr-Medical Palm Desert & Palm Springs, CA in Riverside, California
Req ID: 48600BR
Responsible for assessing and analyzing an injured employee to evaluate the medical and vocational needs required to facilitate the patients appropriate and timely return to work. Acts as a liaison with patient/family, employer, provider(s), insurance companies, and healthcare personnel.
Assesses and analyzes an injured employees medical and vocational status; develops a plan of care to facilitate the patients appropriate and timely return to work. Interviews patients in their homes, work-sites, or physicians office to provide ongoing case management services. Monitors patient progress toward desired outcomes through assessment and evaluation. Communicates both in-person and telephonically with patient, medical providers, attorneys, employers and insurance carriers; prepares all required documentation of case work activities. May arrange referrals, consultations and therapeutic services for patients; confers with specialists concerning course of care and treatment. Develops and administers educational and prevention programs. Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources. Testifies as required to substantiate any relevant case work or reports. Daily travel in the field.
Registered Nurse (RN) with active state license in good standing in the state of California where job duties are performed required.
Case management experience preferred
2 years clinical nursing practice experience required
Ability to travel within a designated geographic area for in-person case management activities required
Knowledge of laws and regulations governing delivery of rehabilitation services.
Job-specific technical knowledge, (e.g., knowledge of workers compensation and disability industry for workers compensation case managers or case management).
Excellent analytical and problem solving skills
Effective communications, organizational, and interpersonal skills.
Ability to work independently (may require working from home).
Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications.
Effective computer skills including navigating multiple systems and keyboarding
The minimum level of education desired for candidates in this position is a Associate's degree or equivalent experience required
LICENSES AND CERTIFICATIONS
Nursing/Registered Nurse (RN) is required
Nursing/Certified Case Manager (CCM) is desired
Functional - Nursing/Medical-Surgical Care/1-3 Years
Full time WAH with daily local travel in the field up to 75%, home each evening and weekends & holidays. Candidates should live in the Palm Desert/Palm Springs.
ADDITIONAL JOB INFORMATION
High initiative, challenging position that utilizes critical thinking and effective communication skills while working with injured workers, employers, claims examiners, attorneys, and treatment providers to improve patient outcomes. Evaluates injured workers' medical and vocational needs to develop a specialized plan of care that promotes successful return to work while assisting in the coordination of therapeutic services. Monitors injured workers' progress toward desired outcomes in a variety of environments, including the home, work site, and physician office settings. Opportunity to make a positive impact in the life of an injured worker. Aetna benefits package.
Mileage reimbursement is provided per the IRS rate. The position is salaried at a competitive rate with a monthly bonus available for work completed above minimum expectations. All major holidays are paid time off, vacation and sick time off is accrued. Full benefits offered including 401(k) and many corporate discounts available. Employees are reimbursed for fees to maintain licensure as well as free CEU s to maintain licensure. Continuing Education credits are available/provided for RN and a various industry certifications. Work from home with in-state travel. In addition to annual salary, position has potential for a quarterly monetary bonus. Coventry provides laptop, IPhone, fax/scanner/printer, as well as office supplies.Benefit eligibility may vary by position. Click here to review the benefits associated with this position. All employees are expected to embody our values of Excellence, Integrity, Caring and Inspiration in all that they do as an employee. The overall responsibility of the Field Case Manager is to ensure the injured worker receives the best possible care in a timely and efficient manner towards full rehabilitation and return to work.
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.
Job Function: Health Care