Aetna Licensed Case Management (CM) Supervisor - MULTIPLE OPENINGS AVAILABLE! (VA MCD) in Chantilly, Virginia

Req ID: 43980BR


We currently have multiple Licensed Case Management (CM) Supervisor opportunities to join our growing Aetna Better Health of Virginia team in the greater Chantilly, VA area!

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.


The Licensed Case Management (CM) Supervisor is responsible for oversight of healthcare management staff including the organization and development of high performing teams. Works closely with functional area managers to ensure consistency in clinical interventions supporting our members. Accountable for meeting the financial, operational and quality objectives of the unit. Anticipated office location in Chantilly, VA.

Fundamental Components of the Licensed Case Management (CM) Supervisor include, but are not limited to:

Oversees the implementation of healthcare management services for assigned functional area Implements clinical policies & procedures in accordance with applicable regulatory and accreditation standards (e.g. NCQA, URAC, state and federal standards and mandates as applicable). Serve as a content model expert and mentor to the team regarding practice standards, quality of interventions, problem resolution and critical thinking. Ensure implementation and monitoring of best practice approaches and innovations to better address the member's needs across the continuum of care. May act as a liaison with other key business areas. May develop/assist in development and/review new training content. May collaborate/deliver inter and intra-departmental training sessions. Protects the confidentiality of member information and adheres to company policies regarding confidentiality. Manages resources responsible for identification of members, development and implementation of care plans, enhancement of medical appropriateness and quality of care and monitoring, evaluating and documenting of care Develop, initiate, monitor and communicate performance expectations. Ensures the team's understanding and use of information system capability and functionality. May have responsibility for their own case load work. May act as a single point of contact for the customer and the Account Team including: participation in customer meetings, implementation and oversight of customer cultural requirements, and support implementation of new customers. Participate in the recruitment and hiring process for staff using clearly defined requirements in terms of education, experience, technical and performance skills. Assesses developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teams. Establish an environment and work style that promotes the concept of teamwork, cross product integration, and continuum of care thinking that results in strong performance. Consistently demonstrates the ability to serve as an model change agent and lead change efforts. Create a positive work environment by acknowledging team contributions, soliciting input, and offering personal assistance, when needed. Accountable for maintaining compliance with policies and procedures and implements them at the employee level.


One of the following active and unrestricted state licenses required: Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), or Licensed Professional Counselor (LPC). 3 - 5+ years of professional experience in clinical area of expertise required. Ability to communicate effectively with Providers, Members, Staff and other Leaders both in oral and written formats. Ability to evaluate and interpret data, identify areas of improvement, and focus on interventions to improve outcomes. Ability to work with people in such a manner as to build high morale and group commitment to goals and objective.


The minimum level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.


One of the following active and unrestricted state licenses required: Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), or Licensed Professional Counselor (LPC).


Functional - Medical Management/Medical Management - Case Management/4-6 Years

Functional - Medical Management/Medical Management - Managed Care/Insurance Clinical Staff/4-6 Years

Functional - Clinical / Medical/Management: < 25 employees/1-3 Years


Technical - Desktop Tools/TE Microsoft Excel/4-6 Years/End User

Technical - Desktop Tools/Microsoft Word/4-6 Years/End User

Technical - Desktop Tools/Microsoft SharePoint/4-6 Years/End User

Technical - Desktop Tools/Microsoft Outlook/4-6 Years/End User


EDUCATION AND LICENSURE: Master's degree in behavioral health field; or Registered Nurse (BSN preferred): and Active unrestricted State Licensure in applicable functional area. (eg RN, LPC, LCSW) -1-3 years of CM experience is preferred; MLTSS experience strong desired. MCO experience is highly desired. Minimum of 1-3 years supervisory experience including previous staffing and hiring experience, new employee onboarding, mentoring and coaching staff. Reporting: ability to understand and create reports with productivity and service metrics; identify gaps May provide support to the sales staff & network staff via onsite customer visits and/or presentations) Computer literacy and advanced proficiency with Microsoft Excel, Word, and web-based applications and access databases is required Knowledge of community resources and provider networks Experience working with diverse teams and populations Ability to multitask, prioritize and effectively adapt to a fast paced changing environment. Field based travel with personal vehicle required. Must have dependable transportation, valid and active VA driver's license and proof of vehicle insurance.

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.

Aetna takes our candidate'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