Aetna Disability Behavioral Health Clinical Case Manager in Plantation, Florida
Req ID: 45186BR
Achieve high-caliber and comprehensive disability behavioral health case management to facilitate healthy return to work outcomes and/or appropriate claim resolution.
Conducts comprehensive evaluations of disability claimants functionality via functional assessments.
Independently reviews and interprets clinical information and utilizes established clinical guidelines and protocols.
Drives the crisis support initiative for the disability organization by assessing crisis situations and initiating the threat protocol process when deemed clinically appropriate.
Advises on highly complex claims at multidisciplinary clinical review roundtables to ensure optimal outcomes.
Determines when claims contain quality of care issues and escalates these through established channels.
BACKGROUND/EXPERIENCE:3-5 years of direct clinical practice experience post masters degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility; RequiredCase management and discharge planning experience; PreferredManaged care/utilization review experience; PreferredCrisis intervention skills; PreferredEDUCATION
The highest level of education desired for candidates in this position is a Master's degree.
LICENSES AND CERTIFICATIONS
One of these 2 licenses is Required
Mental Health/Licensed Mental Health Counselor
Mental Health/Licensed Clinical Social Worker
Functional - Clinical / Medical/Clinical claim review & coding/1-3 Years
Functional - Clinical / Medical/Concurrent review / discharge planning/1-3 Years
Technical - Desktop Tools/Microsoft Outlook/1-3 Years/End User
ADDITIONAL JOB INFORMATION
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 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