Case Manager RN

Aetna Inc. Orlando , FL 32801

Posted 3 weeks ago

Job Description:

This exciting role will sit in our Blue Bell, PA office!

Telework open for candidates located in Compact states (AZ, FL, GA, MD, MO, TN, TX, UT, VA, AK, DE, IA, ID, ME, MT, ND, SC, SD, WI, CO, KY, MS, NC, NE, NM, OK, WV, WY).

Candidate preferably located within 45 minutes of an Aetna office.

POSITION SUMMARY

This Registered Nurse Case Manager position is an exciting opportunity to join a growing Aetna Custom Care Team located in our Blue Bell, PA office. You'll have the opportunity to work in an exciting, fast pace atmosphere and administer a high touch integrated model for various dedicated customers.

Fundamental Components:

  • The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individuals benefit plan and/or health care needs through communication and available resources to promote optimal, cost-effective outcomes.

  • The CM process includes: assessing the member's health status and care coordination needs, inpatient review and discharge planning, developing and implementing the case management plan, ongoing evaluation of the case plan with Medical Director as indicated, exceptional disease education skills and case closure when closure criteria achieved.

  • Requires an RN with an unrestricted active license.

BACKGROUND/EXPERIENCE

  • 3-4 years clinical practice experience (Medical/Surgical) required

  • Unrestricted RN required

  • Bilingual preferred

  • Case Management Certification (CCM) preferred

EDUCATION

The highest level of education desired 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) preferred

FUNCTIONAL EXPERIENCES

Functional

  • Nursing/Medical-Surgical Care/4-6+ Years

Functional

  • Nursing/Case Management/1-3+ Years

Functional

  • Nursing/Discharge Planning/1-3+ Years

Functional

  • Medical Management/Medical Management

  • Disease management/1-3+ Years

TECHNOLOGY EXPERIENCES

Technical

  • Desktop Tools/Microsoft Outlook/1-3+ Years/End User

Technical

  • Desktop Tools/Microsoft Word/1-3+ Years/End User

Technical

  • Desktop Tools/Microsoft Explorer/1-3+ Years/End User

REQUIRED SKILLS

Benefits Management/Understanding Clinical Impacts/FOUNDATION

General Business/Applying Reasoned Judgment/ADVANCED

Service/Providing Solutions to Constituent Needs/ADVANCED

DESIRED SKILLS

Benefits Management/Maximizing Healthcare Quality/FOUNDATION

Benefits Management/Supporting Medical Practice/FOUNDATION

Finance/Managing Aetnas Risk/FOUNDATION

Telework Specifications:

Considered for current internal teleworkers Blue Bell, Pa area.

Option for telework will be evaluated after a certain period of employment

ADDITIONAL JOB INFORMATION

We value leadership, creativity and initiative. If you share those values and a 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 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.


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