Aetna Clinical Case Manager BH in Boston, Massachusetts

Req ID: 55042BR

This is a full-time telework role anywhere in the US.

POSITION SUMMARY

Utilizes advanced clinical judgment and critical thinking skills to perform case management duties for complex patient populations requiring a high level of clinical experience. Serves to promote effective utilization of available resources and optimal, cost-effective member outcomes.

Fundamental Components:

Telephonic clinical case management with Medicare population. Uses Motivational Interviewing and engagement interventions to optimize member participation. Will document in clinical systems to support legacy Aetna and Coventry membership. Provides BH consultation and collaboration with Aetna partners. Active participation in clinical treatment rounds. Active participation in team activities focused on program development. Innovative thinking expected.

BACKGROUND/EXPERIENCE desired:

3+ 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 is required

Must be comfortable working over the computer throughout the day

Case management and discharge planning experience preferred

Managed care/utilization review experience preferred.

Crisis intervention skills preferred

EDUCATION

The minimum level of education desired for candidates in this position is a Master's degree.

LICENSES AND CERTIFICATIONS

Mental Health/Licensed Independent Social Worker is required

OR

Mental Health/Licensed Professional Counselor is required

OR

Mental Health/Licensed Psychologist is required

OR

Mental Health/Licensed Clinical Social Worker

OR

Nursing/Psychiatric and Mental Health Nurse is required

FUNCTIONAL EXPERIENCES

Functional - Clinical / Medical/Direct patient care (hospital, private practice)/1+ Years

FunctionalExperience/FunctionalFocus/1+ Years

TECHNOLOGY EXPERIENCES

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

Technical - Desktop Tools/Microsoft Word/1+ Years/End User

Technical - Desktop Tools/Microsoft SharePoint/1+ Years/End User

REQUIRED SKILLS

Benefits Management/Understanding Clinical Impacts/ADVANCED

General Business/Communicating for Impact/FOUNDATION

Leadership/Collaborating for Results/MASTERY

DESIRED SKILLS

Benefits Management/Encouraging Wellness and Prevention/ADVANCED

Benefits Management/Interacting with Medical Professionals/ADVANCED

Benefits Management/Maximizing Healthcare Quality/ADVANCED

Telework Specifications:

Potential for Full-Time (WAH) Telework.

Considered only for current internal teleworkers (in any area), but if candidate has unique circumstances, telework will be considered.

ADDITIONAL JOB INFORMATION

Annual monetary bonus based on productivity. Telephonic Case Management: no "queue" requirements, telework potential.

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 candidates'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

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.