Field Case Mgr-Medical

Aetna Inc. Washington , DC 20319

Posted 2 months ago

Job Description:

JOIN OUR GROWING TEAM

Are you tired of bedside nursing?

Are you looking to get away from 12-hour hospital shifts while continuing to utilize your RN expertise to impact the lives of patients in your local community?

We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Registered Nurses to join our Workers' Compensation Field Case Management team. This opportunity offers a competitive salary, full benefits, and a performance-based bonus paid out on a monthly or quarterly basis.

POSITION SUMMARY

Responsible for in person assessment, planning, implementation and coordination all case management activities associated with an injured employee to evaluate the medical and disability needs of an injured worker and facilitate the patients appropriate and timely return to work. Acts as a liaison with patient/family, employer, provider(s), insurance companies, and healthcare personnel.

Fundamental Components but not limited to the following:

  • Provides comprehensive management of injured employees in various hospital settings and physician practices, with the objective of improving quality outcomes and decreasing costs.

  • Applies case management concepts, principles, and strategies in the development of an individualized case plan that addresses the injured employees broad spectrum of needs, including assessment, goal setting, establishing interventions related to goals, monitoring success of the interventions, evaluating the success of the overall case plan, and reporting outcomes.

  • Interviews employees in their home, physician office, or in other facilities to provide initial and ongoing case management services.

  • Conducts regular discussions and updates with the injured workers primary care physicians, other providers including behavioral health providers, or the injured employees insurance company and employer regarding the status of a particular injured employee.

  • Serves as the injured employees advocate to ensure they receive all necessary care; develops knowledge of community resources and alternate funding arrangements available to the injured employee when services are not available under their benefits program.

  • Develops and maintains productive relationships with hospital social workers and community resources to assure appropriate management of injured employees.

  • Works with Workers Compensation Defense and Plaintiff Attorneys; testifies as required.

  • Maintains confidentiality of injured employees information in accordance with HIPAA regulations; completes the all training and certifications as required by Maryland Board of Nursing and Workers Compensation Commission

  • Performs other related duties as required.

BACKGROUND/EXPERIENCE:

  • Must have strong clinical background with minimum of 3-5+ yrs of RN experience.

  • Bilingual preferred but not required.

  • Work from home but daily travel in and around Central Maryland required.

  • Knowledge of laws and regulations governing delivery of rehabilitation services.

  • Knowledge of workers compensation and disability industry a plus

  • Excellent analytical and problem solving skills

  • Ability to work with a multidisciplinary team

  • Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications.

  • Effective communications, organizational, and interpersonal skills.

EDUCATION

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

LICENSES AND CERTIFICATIONS

Nursing/Registered Nurse (RN) is required

  • Must have current Maryland RN license in good standing.

  • WCCM required but can be obtained after hire.

  • CCM preferred.

  • Home Health, prior Workers Comp/Case Management/Rehab experience a plus.

FUNCTIONAL EXPERIENCES

Functional

  • Nursing/Case Management/1-3 Years

Functional

  • Nursing/Medical-Surgical Care/1-3 Years

Functional

  • Nursing/Home Health Care Ambulatory Nursing/1-3 Years

Functional

  • Nursing/Disability/1-3 Years

Functional

  • Nursing/Emergency Room/1-3 Years

TECHNOLOGY EXPERIENCES

Technical

  • Operating Systems/Windows/1-3 Years/End User

Telework Specifications:

WAH Due to need to do visits with employers, injured workers, physicians.

ADDITIONAL JOB INFORMATION

Work from home but daily travel in and around Southern Maryland/ DC/ Annapolis region. Schedule is flexible during the day depending on appointments. High bonus potential.

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.

All employees are expected to embody our values of Excellence, Integrity, Caring and Inspiration in all that they do as an employee. The overall responsibility of the Field Case Manager is to ensure the injured worker receives the best possible care in a timely and efficient manner towards full rehabilitation and return to work. Please note that we do offer mileage reimbursement for local travel.

As a Workers' Compensation Field Case Manager, you will be offered:

  • Autonomy

  • Productivity incentives

  • Monday-Friday schedule

  • Reimbursement for mileage, tolls, parking, licensure and certification

  • Laptop, iPhone & printer/fax/scanner all in one.

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.


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Field Case Mgr-Medical

Aetna Inc.