Aetna Field Case Mgr-Medical in Ft Wayne, Indiana
Req ID: 57304BR
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.
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.
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
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
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 - Nursing/Case Management/1+ Years
Technical - Desktop Tools/Microsoft Outlook/1+ Years/End User
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.