Aetna Field Case Manager-Medical CA in Thousand Oaks, California
Req ID: 37661BR
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 an active state license in good standing in California required
Minimum 2 years clinical nursing background preferred
Prior case management and workers' compensation experience preferred
Ability to multitask in a fast paced work environment
Strong computer skills with experience in Microsoft Office Products, including Word, Outlook, and Excel
Sign on bonus for candidates bilingual with Spanish
The highest 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
Nursing/Certified Case Manager (CCM) is desired
Full Time WAH but with daily travel out in the field. Candidate should live in the Valenica/Santa Clarita, CA area.
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.
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