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Aetna Case Manager RN in Bethlehem, Pennsylvania

Req ID: 58986BR

Job Description

Office-based position in Bethlehem, PA or Richfield, OH

Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate physical and behavioral healthcare and social services for members through assessment and member-centered care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources, optimal member functioning, and cost-effective outcomes

Fundamental Components included but are not limited to:

The candidate has the ability to exercise independent and sound judgment, has strong decision-making skills and well-developed interpersonal skills. Ability to manage multiple priorities, effective organizational and time management skills along with strong teamwork skills. Managed Care experience and prior experience within a telephonic customer service center type of environment is preferred. Candidate must possess good computer skills. Fundamental components related to the Care Management Unit include but are not limited to; 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, education and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.

Qualifications Requirements and Preferences:

RN licensure required

3+ years clinical experience required

Case management experience preferred

Managed care experience preferred

CCM certification preferred

Excellent communication skills

Additional Job Information:

Typical office working environment with productivity and quality expectations

Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.

Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.

Ability to multitask, prioritize and effectively adapt to a fast paced changing environment

Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding

Effective communication skills, both verbal and written.

Benefit Eligibility

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Job Function: Health Care

Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.

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