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.

POSITION SUMMARY

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.

BACKGROUND/EXPERIENCE

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

EDUCATION

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 EXPERIENCES

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

TECHNOLOGY EXPERIENCES

Technical - Desktop Tools/Microsoft Outlook//End User

Technical - Aetna Applications/QNXT//End User

Technical - Aetna Applications///

REQUIRED SKILLS

Benefits Management/Understanding Clinical Impacts/FOUNDATION

General Business/Applying Reasoned Judgment/ADVANCED

General Business/Communicating for Impact/FOUNDATION

DESIRED SKILLS

Benefits Management/Encouraging Wellness and Prevention/ADVANCED

Benefits Management/Interacting with Medical Professionals/ADVANCED

Leadership/Driving a Culture of Compliance/FOUNDATION

Telework Specifications:

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