Aetna Field Case Mgr-Medical in Woodbury, New York
Req ID: 54383BR
This is a full time, field Case Management position that would include face-to-face visits with members in their home or provider offices. Focus is the Medicare population in the Northeast region. Requires an RN with unrestricted active license who resides within the Westchester/Rockland area.
Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. Utilizes case management processes in compliance with regulatory and company policies and procedures. Thinks through the treatment paradigm (versus the service episode) and identifies intervention/needs necessary to improve patient outcomes Utilizes Motivational Interviewing techniques to develop patient centered care plans
Minimum of 3+ years case management experience (required for NCM role, preferred for all other areas).
5 years clinical practice experience (required for NCM role only).
Ability to travel within a designated geographic area for in-person case management activities
Knowledge of laws and regulations governing delivery of rehabilitation services.
Job-specific technical knowledge, (e.g., 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
Effective computer skills including navigating multiple systems and keyboarding
The minimum level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
LICENSES AND CERTIFICATIONS:
Active unrestricted RN license in NY required
Functional - Nursing/Case Management/4+ Years
Functional - Nursing/Home Health Care Ambulatory Nursing/4+ Years
Functional - Nursing/Concurrent Review/discharge planning/1+Years
ADDITIONAL JOB INFORMATION:
Field Case Manager will work in the West Chester/Rockland and Nassau/Queens area
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.