Aetna Case Manager RN in Santa Ana, California
Req ID: 53917BR
Telework opportunity for candidates across the US.
Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate physical and behavioral healthcare and social services for members through assessment and member-centered care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources, optimal member functioning, and cost-effective outcomes
The candidate has the ability to exercise independent and sound judgment, has strong decision-making skills and well-developed interpersonal skills. Ability to manage multiple priorities, effective organizational and time management skills along with strong teamwork skills. Managed Care experience and prior experience within a telephonic customer service center type of environment is preferred. Candidate must possess good computer skills. Fundamental components related to the Care Management Unit include but are not limited to; 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, education and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
RN licensure required
3+ years clinical experience required
Discharge planning/ Case management experience highly preferred
CCM certification preferred
Computer literacy and ability to toggle between multiple screens
Excellent communication skills
The minimum level of education required for candidates in this position is a Bachelor's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Nursing/Registered Nurse (RN) is required
Nursing/Certified Case Manager (CCM) is desired
Functional - Nursing/Medical-Surgical Care/1+ Years
Functional - Nursing/Case Management/1+ Years
Functional - Nursing/Discharge Planning/1+ Years
Technical - Desktop Tools/Microsoft Word/1+ Years/End User
Technical - Desktop Tools/Microsoft Outlook/1+ Years/End User
Technical - Desktop Tools/TE Microsoft Excel/1+ Years/End User
Benefits Management/Supporting Medical Practice/FOUNDATION
Benefits Management/Understanding Clinical Impacts/FOUNDATION
Leadership/Driving a Culture of Compliance/FOUNDATION
Benefits Management/Maximizing Healthcare Quality/FOUNDATION
ADDITIONAL JOB INFORMATION
This position offers the candidate the opportunity to join our Self Insured team in National Accounts. We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and clinical excellence. This Unit has a strong desire to deliver best-in-class service to the Member's we serve and we strive to do this as a TEAM. 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. Together we will empower people to live healthier lives.
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.
Aetna takes our candidates's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.
Job Function: Health Care
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.