Aetna Case Manager RN in Richfield, Ohio

Req ID: 55463BR

POSITION SUMMARY

This is an in-office position open to Allentown, PA or Richfield, OH.

We help our member's live fuller and happier lives while delivering financial results to our plan sponsors. Through integrity, compassion and commitment to best in class service. We educate members, facilitate treatment plans and partner with constituents to create innovative service models.

Fundamental Components:

Responsible for the review and evaluation of clinical information and documentation. Reviews documentation and interprets data obtained from clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and or provider issues. Requires an RN with unrestricted active license. Excellent communication skills and attention to details.

BACKGROUND/EXPERIENCE:

RN licensure required

3+ years clinical experience required

Case management experience preferred

Managed care experience preferred

EDUCATION

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

LICENSES AND CERTIFICATIONS

Nursing/Registered Nurse (RN) is required

FUNCTIONAL EXPERIENCES

Functional - Nursing/Medical-Surgical Care/1+ Years

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

TECHNOLOGY EXPERIENCES

Technical - Operating Systems/Windows/1+ Years/Power User

REQUIRED SKILLS

Benefits Management/Maximizing Healthcare Quality/FOUNDATION

Benefits Management/Understanding Clinical Impacts/FOUNDATION

Technology/Leveraging Technology/FOUNDATION

ADDITIONAL JOB INFORMATION

We value leadership, creativity, and initiative. If you share these values and commitment to excellence and innovation, consider a career with our company. Aetna is about more than just doing a job. This is our opportunity to reshape healthcare for America and across the globe.

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.