Aetna Case Management Coordinator in Kalamazoo, Michigan
Req ID: 50621BR
This is a telework role. Qualified applicants must live within 50 miles of Kalamazoo, MI.
25-50% of travel is required.
Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources.
The minimum of an LBSW is required
Experience working with either the Medicaid or Medicare population is required
1 year of case management experience is required
Experience within behavioral health is required
Strong computer skills are required
Managed Care experience preferred
Discharge planning experience preferred
The minimum level of education desired for candidates in this position is a Associate's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Healthcare Management/Case Manager Society of America (CMSA) is desired
Functional - Medical Management/Medical Management - Non-profit Community Health Center/1-3 Years
Functional - Medical Management/Medical Management - Disease management/4-6 Years
Functional - Medical Management/Medical Management - Case Management/1-3 Years
Technical - Desktop Tools/Microsoft Outlook//End User
Technical - Aetna Applications/QNXT//End User
Technical - Aetna Applications///
Benefits Management/Understanding Clinical Impacts/FOUNDATION
General Business/Applying Reasoned Judgment/ADVANCED
General Business/Communicating for Impact/FOUNDATION
Benefits Management/Encouraging Wellness and Prevention/ADVANCED
Benefits Management/Interacting with Medical Professionals/ADVANCED
Leadership/Driving a Culture of Compliance/FOUNDATION
Considered for any US location; training period in the office may be required
ADDITIONAL JOB INFORMATION
Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate. Assist members improve healthy outcomes.
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