Aetna Field Case Manager - Medical in Parsippany, New Jersey
Req ID: 56724BR
The RN case manager utilizes a collaborative process of assessment, planning, facilitation, and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. The RN case manager will work closely with a provider collaboration group to focus on population health management of Aetna members attributed to the physician groups. The RN case manager will need to live in close proximity to the provider collaboration group in northern NJ.
The RN case manager will identify potential barriers to care and develop an individualized care management plan using a holistic approach to assist members with achieving their identified health goals. Utilizing data to assist in identifying trends or issues with a focus on STARS measures within the physician group such as readmission risk, diabetes treatment adherence.
RN with current, unrestricted New Jersey license. Minimum 3-5 years clinical (acute and/or post-acute) experience; CCM certification and/or experience preferred. Ability to utilize data to as a tool to assist in tracking and trending outcomes and clinical information.
5 years clinical practice experience
Ability to travel within a designated geographic area for in-person case management activities
Excellent analytical and problem solving skills
Effective communications, organizational, and interpersonal skills.
Ability to work independently (may require working from home on occasion)
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 highest level of education desired for candidates in this position is a Associate's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Nursing/Registered Nurse is desired
Nursing/Certified Case Manager (CCM) is desired
Functional - Nursing/Medical-Surgical Care/4-6 Years
Functional - Nursing/Case Management/1-3 Years
Functional - Nursing/Home Health Care Ambulatory Nursing/1-3 Years
Functional - Nursing/Discharge Planning/1-3 Years
Technical - Desktop Tools/Microsoft Outlook/4-6 Years/End User
Technical - Desktop Tools/Microsoft Explorer/4-6 Years/End User
Technical - Desktop Tools/Microsoft Word/1-3 Years/End User
Technical - Desktop Tools/Microsoft PowerPoint/1-3 Years/End User
Office-based schedule (must live near provider office location in Flemington, NJ). This is an embedded (onsite) position. Work at home would only be allowed if weather or extenuating circumstances, as approved by supervisor, prevent candidate from getting into assigned office.
ADDITIONAL JOB INFORMATION
This position will be home based and will require travel for face-to-face case management assessment of members, as well as occasional travel for provider meetings. A unique opportunity to work collaboratively with our physician partners. Time management and organizational skills along with the ability to manage changing priorities are key to this position. Strong verbal and written communication skills plus proficiency with computers, navigating in multiple systems and web-based applications, including use of mouse and solid keyboarding skills.
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.