Aetna Inc. Denver , CO 80208
Posted 4 weeks ago
This RN Case Manager position is 100% remote and candidates can apply from any state, however, preference is for candidates in CST, MST or PST time zones and with Compact RN licensure.
Normal Working Hours: Monday through Friday between the hours of 8a-6pm CST for a scheduled 8-hour shift.
Weekends may be required per the needs of the department.
Employees will have an occasional evening shift rotation per the needs of the team.
Less than 10% travel may be required for on-site meetings, trainings, or system updates, or to meet licensure requirements e.g., finger printing.
The RN Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate overall wellness.
RN Case Manager:
Collaboratively develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness through integration.
Through the use of clinical tools and information/data review (e.g., assessments, claims, etc..) conducts an evaluation of member's needs and available benefits to collaborate and refer to programs offered by the plan sponsor.
Applies clinical judgment to reduce risk factors, address complex health issues and social indicators.
Utilizes case management processes in compliance with regulatory and company policies and procedures.
Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.
The typical pay range for this role is:
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
Must have an active and unrestricted RN license and, if located within the Nurse Licensure Compact jurisdiction, the ability to use their compact license without restriction
Willingness and ability to obtain additional state licenses upon hire (paid for by the company)
3+ years of acute care clinical experience as an RN (general medical, post-surgical, specialty including pediatrics, ICU, case management and discharge planning)
Ability to use a computer station with multiple screens, operate multiple programs simultaneously, and sit for extended periods of time
A private designated workspace free of distractions and high-speed internet
Employee that lives in CST, MST or PST Time Zone
Compact RN licensure
1+ years of case management experience
Certified Case Manager (CCM) certification
Strong customer service skills including attention to customers, sensitivity to certain issues and proactive identification/resolution of issues.
Experience with all types of Microsoft Office including PowerPoint, Excel, and Word
Strong telephonic communication skills
1+ years of experience utilizing computers and navigating multiple monitors while speaking with someone on the telephone.
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