Aetna Field Case Mgr-Medical in Parsippany, New Jersey

Req ID: 52691BR

Office-based schedule (must live near provider office location in Flemington, NJ).

POSITION SUMMARY

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 Hunterdon Healthcare Partners 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 Hunterdon Healthcare Partners office in Flemington, NJ.

Fundamental Components:

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.

BACKGROUND/EXPERIENCE:

RN with current, unrestricted New Jersey license - required

Minimum 5+ years clinical (acute and/or post-acute) experience - required

CCM certification and/or experience preferred.

Ability to utilize data to as a tool to assist in tracking and trending outcomes and clinical information.

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

Bilingual preferred

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

EDUCATION

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

LICENSES AND CERTIFICATIONS

Nursing/Registered Nurse is required

Nursing/Certified Case Manager (CCM) is desired

FUNCTIONAL EXPERIENCES

Functional - Nursing/Medical-Surgical Care/4+ Years

Functional - Nursing/Case Management/1+ Years

Functional - Nursing/Home Health Care Ambulatory Nursing/1+ Years

Functional - Nursing/Discharge Planning/1+ Years

TECHNOLOGY EXPERIENCES

Technical - Desktop Tools/Microsoft Outlook/4+ Years/End User

Technical - Desktop Tools/Microsoft Explorer/4+ Years/End User

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

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

Telework Specifications:

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 office based within Hunterdon Healthcare Partners. 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 hereto 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