Aetna Case Manager RN in Allentown, Pennsylvania
Req ID: 48365BR
Please note: Training hours will be 8AM-4:30PM for a period of 8-12 weeks. Once completed, required shift is 1:30PM - 10PM, Monday - Friday.
This Case Management position is for the Public and Labor Program. The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individuals benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.
Requires an RN with unrestricted active license.
Fundamental Components related to Aetna In Touch Care Program include but are not limited to:
Utilizes influencing/motivational interviewing skills to ensure maximum member engagement to achieve optimal outcomes, 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 and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
Requires an RN with unrestricted active license.
3+ years Medical Surgical experience is required
Strong computer and typing skills are required
Must be comfortable with navigation through multiple systems and dual monitors and must be able to touch type at efficient speed.
Experience with patient education and Discharge planning is preferred
Bilingual in English and Spanish is preferred.
Disability case management experience preferred .
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 is required
Nursing/Certified Case Manager (CCM) is preferred
Functional - Nursing/Medical-Surgical Care/3+ Years
Functional - Nursing/Case Management/1+ Years
Technical - Desktop Tools/Microsoft Outlook/1+ Years/End User
Technical - Desktop Tools/Microsoft Explorer/1+ Years/End User
Technical - Aetna Applications/Aetna Total clinical View/1+ Years/End User
General Business/Consulting for Solutions/ADVANCED
Leadership/Collaborating for Results/ADVANCED
Benefits Management/Maximizing Healthcare Quality/FOUNDATION
ADDITIONAL JOB INFORMATION
We are looking for a Case Manager to join the Allentown Dedicated Unit. Aetna In Touch Care model will be a combined case management and disease management focus. In this CM/DM role we are looking for a candidate who will assist with health care coordination, member satisfaction, and financial outcomes using targeted customer strategies and initiatives. The CM will provide telephonic member outreach for key educational and situational opportunities for increased case management and disease management identification and engagement. We will provide decision support and guidance for members and their families along with coordination of healthcare services. The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individuals benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Requires an RN with unrestricted active license. Minimum 3 to 5 years of recent experience. Strong knowledge of major health behavior models including Motivational Interviewing preferred. Must possess strong verbal, written communication skills, computer and keyboarding skills.
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