Aetna RN Field Case Mgr-Medical Registered Nurse Travel Houston, TX in Pasadena, Texas
Req ID: 49224BR
Responsible for assessing and analyzing an injured employee to evaluate their needs & required to facilitate the patient's appropriate and timely return to work. Patient/Family, employer, provider(s), insurance companies and healthcare liaison.
Fundamental Components but not limited to the following:
The Field Case Manager works from home, has a flexible work schedule, travels to appointments in the greater Houston area to meet with their clients, and documents all work activities. This position will have a caseload that is mostly persons who are injured at work and are receiving workers comp benefits. The Field Case Manager is responsible for assessing, analyzing, and problem solving an injured employees medical and vocational needs. The Field Case Manager then develops, implements, and tracks the progress of goals to help the injured worker through the rehabilitation process and return to work.
The Field Case Manager is a liaison with the injured worker, their family, employer, provider(s), and insurance companies. This includes attending provider appointments during regular business hours, confirm the diagnosis and ensure the treatment plan is within clinical protocols. We ensure the rehab plan is communicated to and understood by all parties involved in the claim. We also provide the injured worker with educational resources using various media to help ensure understanding of the medical challenges.
Documentation of services provided and timely communication with all customers a key focus of the position. We provide the technology necessary to provide this service including a laptop with proprietary software, a smartphone with specialized apps, and a printer/scanner. The ability to proficiently use this technology is required. All technology hardware, software, and office supplies are provided with no cost to the employee. IT support provided 24/7/365.
The Field Case Manager must be available regular business hours during the work week to meet with the injured worker and their providers. At least half the work day is spent traveling to and participating in provider appointments. The remainder of the day is spent coordinating care and documentation by making phone calls, creating and sending emails, letters and reports. The position requires effective communication and organization skills, along with the ability to use contemporary smart phones and software programs such as MS Word, Outlook and Excel.
Must have a National Certification such as CCM, COHN, CRRN, CDMS
Minimum of three years case management experience required.
5 years RN clinical practice experience required.
Ability to travel within a designated geographic area for in-person case management activities up to 50-75% travel
Knowledge of laws and regulations governing delivery of rehabilitation services.
Job-specific technical knowledge, (e.g., knowledge of workers compensation and disability industry for workers compensation case managers or case management).
Excellent analytical and problem solving skills
Effective communications, organizational, and interpersonal skills.
Ability to work independently (may require working from home).
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 desired for candidates in this position is a Associate's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Nursing/Certified Case Manager (CCM, COHN, CRRN, CDMS) one is required
Registered Nurse required
Functional - Nursing/Case Management/1-3 Years
Technical - Desktop Tools/Microsoft Outlook/4-6 Years/End User
Technical - Desktop Tools/Microsoft Word/4-6 Years/End User
Technical - Desktop Tools/Microsoft Explorer/4-6 Years/End User
ADDITIONAL JOB INFORMATION
We offer you:
Home every night, weekend and holiday!
All major holidays are paid time off, vacation and sick time off is accrued. Full benefits offered including 401(k) and many corporate discounts available. Employees are reimbursed for fees to maintain licensure as well as free CEU s to maintain licensure. Continuing Education credits are available/provided for RN and a various industry certifications too. Work from home with in-state travel. In addition to annual salary, position has potential for a monthly monetary bonus. Mileage reimbursement is provided per the IRS rate. Coventry provides laptop, IPhone, fax/scanner/printer, as well as office supplies.Benefit eligibility may vary by position. Click here to review the benefits associated with this position. All employees are expected to embody our values of Excellence, Integrity, Caring and Inspiration in all that they do as an employee. The overall responsibility of the Field Case Manager is to ensure the injured worker receives the best possible care in a timely and efficient manner towards full rehabilitation and return to work.
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.
Job Function: Health Care