Aetna Case Manager RN in Sunrise, Florida

Req ID: 52375BR

POSITION SUMMARY

This is an in-office position in Sunrise, FL.

The RN Case Manager utilizes a collaborative process of assessment, planning, implementation and evaluation, to engage, educate, and promote/influence members decisions related to achieving and maintaining optimal health status for our Americas International membership.

Fundamental Components:

Prior utilization review and case management experience is required, whether that be in a managed care, home health, or hospital environment. Applicants must be computer savvy, familiar with use of Excel spreadsheets, Word documents and research using the Internet. This is a wonderful opportunity to work with our Americas International membership.

BACKGROUND/EXPERIENCE:

3+ years of clinical experience required

RN licensure required

Bilingual in Spanish and English is required

Case management experience preferred

Managed care preferred

CCM (Certified Case Manager) 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 is required

Nursing/Certified Case Manager (CCM) is desired

Healthcare Management/ is desired

Insurance/ is desired

FUNCTIONAL EXPERIENCES

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

Functional - Clinical / Medical/Concurrent review / discharge planning/1+ Years

Functional - Clinical / Medical/Disease management/1+ Years

Functional - Nursing/Case Management/1+ Years

Functional - Medical Management/Medical Management - Hospital/1+ Years

TECHNOLOGY EXPERIENCES

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

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

Technical - Aetna Applications/Aetna Total clinical View/1+ Years/End User

Technical - Aetna Applications/DocFind/1+ Years/End User

REQUIRED SKILLS

Benefits Management/Maximizing Healthcare Quality/FOUNDATION

Benefits Management/Supporting Medical Practice/FOUNDATION

General Business/Applying Reasoned Judgment/ADVANCED

Telework Specifications:

In-office, no option for telework.

ADDITIONAL JOB INFORMATION

This is a new and exciting opportunity to work with Aetna International. The ideal candidate will be a professional Registered Nurse with an unrestricted, active license and support delivery of UM/CM services to Aetna International consumer members having excellent verbal and written communication skills, who is able to think independently and works as a team member, has strong organizational and time management skills, and can manage multiple and shifting priorities throughout the day. 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. Aetna is about more than just doing a job. This is our opportunity to re-shape 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.

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