Aetna Field Case Mgr-Medical in Ft Wayne, Indiana

Req ID: 57304BR

POSITION SUMMARY

Candidates must be located in Northern Indiana.

The Case Manager uses a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and

advocacy for options and services to meet an individuals and familys comprehensive health needs through

communication and available resources to promote quality, cost effective outcomes.

Fundamental Components:

Acts as a liaison with member/client /family, employer, provider(s), insurance companies, and healthcare personnel as

appropriate. Implements and coordinates all case management activities relating to catastrophic cases and chronically ill

members/clients across the continuum of care that can include consultant referrals, home care visits, the use of

community resources, and alternative levels of care. Interacts with members/clients telephonically or in person. May be required to meet with members/clients in their homes, work-sites, or physicians office to provide ongoing case management services. Provides educational and prevention information for best medical outcomes. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes, as well as opportunities to enhance a members/clients overall wellness through integration. Monitors member/client progress toward desired outcomes through assessment and evaluation.

BACKGROUND/EXPERIENCE:

RN licensure required

5+ years clinical experience required

1+ years case management OR home health required

Ability to travel within a designated geographic area for in-person case management activities

Managed care experience preferred

CCM preferred

Excellent analytical and problem solving skills

Effective communications, organizational, and interpersonal skills.

Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications.

Effective computer skills including navigating multiple systems and keyboarding

EDUCATION

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

LICENSES AND CERTIFICATIONS

Nursing/Registered Nurse is required

Nursing/Certified Case Manager (CCM) is desired

FUNCTIONAL EXPERIENCES

Functional - Nursing/Case Management/1+ Years

TECHNOLOGY EXPERIENCES

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

Telework Specifications:

Full-Time Telework (WAH)

ADDITIONAL JOB INFORMATION

Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while

promoting wellness activities. Develops, implements and supports Health Strategies, tactics, policies and programs that

ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work.

Services and strategies, policies and programs are comprised of network management, clinical coverage, and policies.

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.