Aetna Field Case Mgr-Medical in South Portland, Maine

Req ID: 43601BR

POSITION SUMMARY

In the Field Case Manager position, you will function as central coordinator of care for post-acute members identified as having chronic disease processes, implementing and coordinating all case management activities. Responsible for developing and executing implementation plans to help reduce risk of readmission to acute care facility. Uses computer-based systems in daily work activities.

Fundamental Components include, but are not limited to:

  • Responsible for comprehensive members of members post acute care discharge.

  • Responsible for early identification and assessment of members telephonically, in their home and possibly in provider office or facility.

  • Conducts regular discussions and updates with member, physician, and Multi-Disciplinary Team.

BACKGROUND/EXPERIENCE desired:

  • 5 years clinical practice experience with 3 years in acute; Required

  • 2 years of case management experience; Preference

  • 2 years of home care/hospice experience; Preferred Bilingual in English and Spanish; preferred

  • Certified Case Manager; Preferred

  • Ability to travel within a designated geographic area for in-person case management activities around 50 miles; Required

EDUCATION

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

LICENSES AND CERTIFICATIONS

Nursing/Registered Nurse (RN) is required

Healthcare Management/Case Manager Society of America (CMSA) is desired

FUNCTIONAL EXPERIENCES

Functional - Nursing/Case Management/1-3 Years

Functional - Nursing/Discharge Planning/4-6 Years

Functional - Nursing/Home Health Care Ambulatory Nursing/1-3 Years

TECHNOLOGY EXPERIENCES

Technical - Desktop Tools/Microsoft Outlook/1-3 Years/End User

Technical - Remote Access/WAH (Work at Home)/1-3 Years/End User

Telework Specifications:

Telework is a requirement for this position (no physical office location)

ADDITIONAL JOB INFORMATION

Exceptional case management of Medicare members. Collaboration with MDT- Nurse Case Manager, Medical Director, Social Worker, Pharmacist, Behavioral Health. State-of-the-are electronic documentation system. Creativity in developing case plan with traditional and non-traditional resources. Educational opportunities to meet both personal and professional goals. Culture of value-driven team

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